My program of study is an MA in Professional Counseling, LPC. My personal goal is to graduate. A professional goal is to secure a job that allows me to continue applying and growing in my profession.

From this course, I would like to gain skills in providing care that recognizes and responds to the effects of trauma. I want to learn specific therapeutic approaches for working with trauma survivors. I would also like to know about resources available for trauma survivors and how to guide them effectively.

As we advance into this field, I want to connect with professionals and peers in the field to share insights and experiences.

1. Consistent with research evidence on risk and resilience following trauma

2. Applicable and practical in field settings

3. Appropriate for developmental levels across the lifespan

4. Culturally informed and delivered in a flexible manner

Understanding Non-Suicidal Self-Injury (NSSI) and Suicide Attempts

Non-suicidal self-injury: Deliberate harm to oneself without the intent to die, often used as a coping mechanism for emotional distress.

Suicide Attempts: Intentional actions taken to end one’s life, which may or may not result in death.

Types of Assessments

Mental Health Assessments: Evaluate the individual’s emotional state, history of self-injury or suicidal behavior, and underlying mental health issues.

Risk Assessments: Determine the immediacy of the risk of self-harm or suicide, using standardized tools such as the Columbia-Suicide Severity Rating Scale (C-SSRS).

Identifying At-Risk Behaviors

At-Risk Behaviors to Address:

Frequent Self-Injury: Engaging in self-harm behaviors repeatedly.

Verbal Expressions of Hopelessness: Statements indicating feelings of worthlessness or despair.

Social Withdrawal: Isolating from friends or family and avoiding social interactions.

Substance Abuse: Using drugs or alcohol as a means of coping with emotional pain.

Addressing At-Risk Behaviors

Crisis Intervention Strategies: Implement immediate interventions when risk is identified, such as safety planning and crisis counseling.

Therapeutic Approaches: Utilize cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) to help individuals develop healthier coping mechanisms.

Multi-Agency Collaboration

Collaborating Agencies:

Mental Health Services: Provide therapy and crisis intervention services.

Emergency Services: Respond to acute crises and ensure safety.

School Counselors or Social Workers: Monitor students at risk and provide support.

Community Health Organizations: Offer resources and educational programs.

Roles in the Plan:

Mental Health Services: Conduct assessments and provide ongoing therapy.

Emergency Services: Intervene in acute situations and transport individuals to care if necessary.

School Counselors: Facilitate supportive environments and provide resources for students.

Community Organizations: Promote awareness and prevention initiatives.

Protocol for Contacting Agencies

Designated Points of Contact: Establish clear communication lines with each agency.

Emergency Protocols: Create specific procedures for contacting emergency services during a crisis.

Regular Coordination Meetings: Hold meetings to discuss ongoing cases and strategies.

Universal Screening Assessments

Standardized Tools: Implement assessments like the Beck Scale for Suicide Ideation (BSSI) and the NSSI Assessment Tool to identify individuals at risk.

Routine Screening: Regularly screen at-risk populations (e.g., students, clients) for early detection.

Referral Process

Assessment of Needs: Identify individuals requiring additional support through thorough evaluations.

Referral to Specialized Services: Connect individuals to mental health professionals or crisis centers for further assistance.

Follow-Up Mechanism: Ensure ongoing support and check-ins to monitor progress.

Incorporating Cultural Competence

Cultural Sensitivity Training: Provide training for staff on understanding cultural differences in expressions of distress and coping mechanisms.

Tailored Interventions: Adapt intervention strategies to align with the cultural backgrounds of individuals.

Community Engagement: Collaborate with cultural organizations to enhance outreach and support.

Special Populations Considerations

Adolescents and Young Adults: Address developmental factors and peer influences that may contribute to NSSI and suicidal behaviors.

LGBTQ+ Individuals: Provide inclusive support that acknowledges unique stressors faced by this population.

Individuals with Disabilities: Ensure accessibility to mental health resources and accommodations.

Training for Community Members

Workshops on NSSI and Suicide Prevention: Offer training sessions that educate community members about recognizing signs and providing support.

Crisis Intervention Training: Provide certification courses for staff and volunteers on crisis intervention techniques.

Ongoing Support Networks: Establish groups that provide ongoing education and support to community members.

Forms for Crisis Plan Appendix

Crisis Assessment Form: Template for documenting assessments related to NSSI and suicide attempts.

Referral Form: Standardized form for referring individuals to mental health services.

Incident Report Form: Documentation for any self-injury or suicide attempt incidents.

Legal Requirements and Ethical Codes

Confidentiality Laws: Adhere to HIPAA regulations to protect patient privacy.

Mandatory Reporting: Follow state laws regarding the reporting of suicidal ideation or attempts.

Ethical Guidelines: Align with ethical standards from organizations like the American Psychological Association (APA) and the National Association of Social Workers (NASW).

References

Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885-890.

Muehlenkamp, J. J., & Gutierrez, P. M. (2004). An investigation of the functions of non-suicidal self-injury in a sample of college students. Journal of American College Health, 52(2), 78-84.  Joiner, T. E. (2005). Why People Die by Suicide.

Harvard University Press.

Carpenter, R. W., & Hepp, J. (2021). What does it mean that it doesn't hurt? Understanding the role of pain in nonsuicidal self-injury. Clinical Psychology: Science and Practice, 28(4), 358–359. https://doi.org/10.1037/cps0000042

Centers for Disease Control and Prevention (CDC). (2020). Suicide Mortality in the United States, 1999-2019. https://www.cdc.gov/nchs/products/databriefs/db398.htm

Attending Behavior

Eye contact

Warmth

Body posture

Vocal style

Verbal following

Overall empathy

Questioning

Open-ended

Close-ended

Paraphrasing

Restating in own words

Clarifying

A close-ended question that serves to clarify what the client just said

Reflection

Painful feelings

Positive feelings

Ambivalent feelings

Nonverbal feelings

Summarization

Tying together precipitating event, subjective distress, and cognitive elements

Break Down the Problem

Identifying the Nature of the Crisis and Therapeutic Interaction

Identify the precipitating event

Identify cognitions

Identify subjective distress

Identify impairments in functions: behaviorally, socially, academically, occupationally

Ethical checks: suicide, homicide, organic issues, psychosis, substance abuse, child abuse, elder abuse

Therapeutic interaction statements: educational, empowerment, validation, reframes

Commitment to Action

Coping Strategies

Explore what client wants to do now to cope

Explore what client has tried in the past to cope

Explore other things client can do to cope

Offer alternative strategies for coping:

Support groups

Twelve-step groups

Marital or family therapy

Lawyer

Doctor

Bibliotherapy

Reel therapy

Assertion training

Stress management

Shelters or other agencies

Secure commitment and follow-up

Kanel, K. (2014). A guide to crisis intervention. Cengage Learning.

Ivey, A.E., Gluckstern, N.B., & Ivey, M.B. (1997). Basic attending skills, 3rd edition. Microtraining Associates.

• Cavanaugh, B. (2016). Trauma-Informed Classrooms and Schools. Beyond Behavior. https://doi.org/10.1177/107429561602500206

  Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., ... & Giles, W. H. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258. https://doi.org/10.1016/S0749-3797(98)00017-8

  ·       Parker, R., & Hodgson, D. (2020). ‘One size does not fit all’: Engaging students who have experienced trauma. Issues in Educational Research, 30(1), 245.

  ·       Schulman, M., & Maul, A. (2019). Screening for adverse childhood experiences and trauma. Center for Health Care Strategies. Retrieved from TraumaInformedCare.chcs.org

  ·       Stratford, B., Cook, E., Hanneke, R. et al. A Scoping Review of School-Based Efforts to Support Students Who Have Experienced Trauma. School Mental Health 12, 442–477 (2020). https://doi.org/10.1007/s12310-020-09368-9

   

• Corey, G. (2016). Theory and Practice of Counseling and Psychotherapy (10th ed.). Cengage Learning.

• Egan, G. (2014). The Skilled Helper: A Problem-Management Approach to Helping (10th ed.). Cengage Learning.

• Kanel, K. (2018). A Guide to Crisis Intervention (5th ed.). Cengage Learning.

• Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2018). Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society (8th ed.). Cengage Learning.

• Nelson-Jones, R. (2016). Theory and Practice of Counseling and Psychotherapy (7th ed.). SAGE Publications.

• Rogers, C. R. (2007). A Way of Being. Houghton Mifflin Harcourt.

·        Kanel, K. (2014). A guide to crisis intervention. Cengage Learning.

·        Ivey, A.E., Gluckstern, N.B., & Ivey, M.B. (1997). Basic attending skills, 3rd edition. Microtraining Associates. 

Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885-890.

Muehlenkamp, J. J., & Gutierrez, P. M. (2004). An investigation of the functions of non-suicidal self-injury in a sample of college students. Journal of American College Health, 52(2), 78-84.  Joiner, T. E. (2005). Why People Die by Suicide.

Harvard University Press.

Carpenter, R. W., & Hepp, J. (2021). What does it mean that it doesn't hurt? Understanding the role of pain in nonsuicidal self-injury. Clinical Psychology: Science and Practice, 28(4), 358–359. https://doi.org/10.1037/cps0000042

Centers for Disease Control and Prevention (CDC). (2020). Suicide Mortality in the United States, 1999-2019. https://www.cdc.gov/nchs/products/databriefs/db398.htm