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The purpose of this advocacy leadership plan is to bring awareness of and decrease the number of students in grades 9-12 that use self-harm as a coping mechanism within a high school in Ohio. It is the belief of the counseling staff that all persons deserve to live a life of safety and have high quality instruction to regulate their emotions. However, suicide is the leading cause of death among people between the ages of 10 and 34 in the United States (Professional Psychology, 2018). There has been a significant increase in these numbers in the past 20 years (Professional Psychology, 2018). For every death by suicide, estimates show that individuals self-harm, or attempt suicide 8-25 times prior (Brown, 2018). Often times, non-suicidal self-injuries are indicator to die by suicide in the future. Many students within this high school have been informally identified as self-harming by teachers and peers. However, there is not currently a program in place to assist these students in learning how to regulate their emotions or work towards a better quality of life.

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What is Dialectical behavior therapy for adolescents (DBT)? This video can be used to show students and families what can be expected when working through DBT. 

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It is the mission of this program to equip all students in grades 9-12 with the qualities they need to identify self-harm and NSSI among themselves and peers. The mission of this program is also to identify students who have used self-harm or NSSI in the past and train them in healthy emotional regulation.

The vision of this program is that all students in grades 9-12 will feel safe and comfortable reaching out to others for help as needed. As well as have the skills to help their peers and ask for help from safe adults as needed. Students in grades 9-12 will learn the best ways to cope for themselves and create safety plans to keep themselves safe in times of crisis.
Students in grades 9-12 will be issues a beginning of the school year survey to assess their Subjective Well-Being, which will be used as baseline data for the program (ASCA, 2013). This survey will be reviewed by a member of the counseling staff. Counseling staff will work to identify student who have used non-suicidal self-injury or self-harm as coping mechanisms. These students will be assigned to a counselor and a small group of peers based on student interest and comfort level, which can be determined after intake interviews. It is during this time in the program that services and interventions will be provided by counseling staff in the school building (ASCA, 2013). Students will work through counseling, identify goals, learn new coping skills, emotional regulation, and find a sense of connectedness with their peers. Students will also work with counselors to create safety plans for times of crisis. This will be done through a series of dialectal behavior therapy, groups, coaching, and consultation. This includes information night and communication with stakeholders of the program. Students will assess their progress at three months, and six months, making necessary changes to goals and reflecting upon their growth. At the end of nine months, an exit survey will be completed by the students and counselors to determine if more therapy is needed and if extended counselor days can be utilized throughout the summer as students move into a new grade level. This will give all stakeholders insight to the outcome data of the program (ASCA, 2013).

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What is Dialectical behavior therapy for adolescents (DBT)?

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Mindsets
M1. Belief in development of whole self, including a healthy balance of mental, social/emotional and physical well-being
M 2. Sense of acceptance, respect, support and inclusion for self and others in the school environment
M 4. Self-confidence in ability to succeed
M 5. Belief in using abilities to their fullest to achieve high-quality results and outcomes
Behaviors
B-SMS 1. Responsibility for self and actions
B-SMS 2. Self-discipline and self-control
B-SMS 6. Ability to identify and overcome barriers
B-SMS 7. Effective coping skills
B-SMS 9. Personal safety skills
B-SS 2. Positive, respectful and supportive relationships with students who are similar to and different from them
B-SS 3. Positive relationships with adults to support success
B-SS 4. Empathy
B-SS 8. Advocacy skills for self and others and ability to assert self, when necessary

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By May 2023, awareness of self-harm and NSSI for students in grades 9-12 will increase to 90% based on baseline and outcome data provided through surveys. (ASCA, 2019)
By May 2023, students in grades 9-12 who have used NSSI and self-harm will decrease to 10% based on baseline and outcome data provided through surveys. (ASCA, 2019)

The goal of this program is to reduce the number of non-suicidal self-injuries and self-harm use by students in grades 9-12. The school district in which this program is designed can be identified as having a low socioeconomic population in southeastern Ohio. The high school holds approximately 220 students in these grades. NSSI and self harm have been identified as issues many students are struggling with in this population. Through this program, students will feel a better sense of acceptance, validation, support, and connectedness by utilizing DBT (Dialectal Behavior Therapy) for a period of 9 months. Studies show that this type of therapy has shown some success decreasing the use of self-harm in teens.

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Reach a Crisis Counselor | Crisis Text Line

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Crisis Text Line provides free, 24/7 support via text message. Text HOME to 741741 to connect with a trained Crisis Counselor.

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- Parents will work through workshops and information sessions offered throughout the school year by counselors within the school building. Communication with parents on in a confidential way will be important for the success of the students involved.
- Teachers will present the baseline assessment to students at the beginning of the school year. Teachers will need to be trained in language to use when  discussing self-harm with students. All school staff with be trained through Signs of Suicide with National Children's Hospital. Select staff will be trained to present suicide lessons to sophomores each school year. It will be important for all teachers to communicate relevant information to counselors throughout the year.
-Administration will be made aware of students who are working through the program so they can be pulled out during study halls throughout the school year. It will be important for the administrators to communicate with counselors and parents throughout the year, while working with students in any disciplinary action.
-Coaches will also be provided with all school staff training and will be put in contact with counselors so they can communicate on an as-needed basis.
-Peers will be made aware of suicide, NSSI, and self-harm awareness throughout the school year by teachers, posters, and assessments.
-Outside agencies will work with school hired counselors to work on individual counseling and group counseling with students throughout the year. Because the school district works with Hopewell Health Centers, the in-school counselors will know the students they work with very well and will have the opportunity to see them on a regular basis.

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Dec 18, 2020 - Some research shows that between 7% and 47% of teens self-harm, although the number of teens engaging in deliberate self-injury is, by some researcher

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American School Counselor Association. (2013). School counselor leadership: The essential practice (3rd ed.). Alexandria, VA: Author.

American School Counselor Association. (2019a). ASCA national model: A framework for school counseling programs (4th ed.). Alexandria, VA: Author.

Brown University Child & Adolescent Behavior Letter, Oct 2018, Vol. 34, Issue 10, p4

Professional Psychology: Research and Practice. Vol. 49. (4), Aug, 2018 pp. 274-281