Presenter: Barent Walsh, Ph.D 

This presentation will have two parts. Part I will review the basics of working with youth who present with non-suicidal self-injury (NSSI; such as cutting, burning, skin picking) and/or suicidal behavior. Evidence-based approaches for understanding, assessing, and treating these problems will be reviewed. Suicide and self-injury will be clearly differentiated, but the empirical link between recurrent NSSI and suicide attempts will also be elucidated. Klonsky’s new “Three Step Model for Suicide” will be explicated. Joiner’s new “Acute Suicidal Affective Disturbance (ASAD) will also be discussed.

Part II will focus on the challenges and rewards for professionals working with the loss, trauma, and misery of self-destructive clients. We will discuss the role of compassion, fortitude, and gravitas in working with self-destructive clients. Recommendations will be proposed for sitting with loss, misery, and impermanence. The risks of working with prolonged misery in others (such as vicarious traumatization) will also be reviewed. Self-care for professionals will be emphasized with identification of what helps maintain a compassionate frame, an activist’s stance, and an optimistic commitment. 

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