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Self inflicted cutting, home stressors, late elementary

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http://www.pbisworld.com/tier-2/teach-coping-skills/, http://www.pbisworld.com/tier-2/teach-relaxation-techniques/\n\nHere are some additional resources that may be helpful: http://kidshealth.org/teen/your_mind/problems/resisting_cutting.html http://kidshealth.org/teen/your_mind/feeling_sad/cutting.html#\n\nThis really is a complicated issue with many layers that you will be limited in being able to address in the school setting. There really needs to be outside therapeutic intervention, in-home counseling, etc."}" data-sheets-userformat="{"2":961,"3":{"1":0},"9":0,"10":1,"11":4,"12":0}">Presenting Behavior:
Please describe the behavior:
Self inflicted cutting

How old is the student?
Late Elementary

Where and when does the behavior occur?
In the home

Frequency and duration of behavior?
Mostly weekends

What happens before and after behavior?
Being picked on by other students. Has been encouraged with tips on how to cut by other peers.

What does the student get from engaging in the behavior?
Attention from parents and connection to peers

What is the emotional state of the student during the behavior?
Unknown

Who is the behavior directed at?
Parents and peers

Is the behavior intentional or involuntary?
Intentional

Student strengths and interests?
Happy student when at school, doesn't really share any interests

Have you noticed any patterns?
Home stressors due to parents drinking

Other information and comments:
Student tries to avoid parents when they are drinking. Parents not abusive, but seem to ignore student's wants and needs.

Possible Interventions:
This sounds like a very difficult circumstance for this student at a very critical stage in physical and social/emotional development. This is a tough issue with many layers. This will be very hard to fully address in the school setting due to the limited capacity of the school's services.

The student should be in some kind of counseling, whether that is outside of school or in school with the social worker or counselor. (get in contact with local health agencies to see if there are any free groups for cutters or resources to bring a counselor into school to run a several week group) Would the parents consent to any type of in school or outside services? Or would they be defensive and refuse to give permission?

Is the student open with you about the cutting or does the student not know you know? (first step to addressing this issue is for the cutter to confide in someone they are cutting) Does the student have a good rapport with any specific adult in the building that would be willing to spend some time with the student (and not necessarily in a therapeutic way, more of a mentorship)?

Based on your info, there seems to be a conflict. On one hand it seems the student is cutting to get attention from parents, but the student does their best to avoid them when they are drinking. Does the student try to avoid them when they are not drinking? Does the student show their parents the cuts?

Does the student show their cuts to friends? Does the student have any real friends?

One thing I'm thinking that needs to be weeded out is whether the cutting is a coping strategy, an attention getting strategy, or both. A lot of cutters hide the cuts and do not show others, while some purposefully lift their sleeve in front of a teacher or friend with the intention they will get "caught".

Some possible intervention strategies:
I mentioned mentoring earlier. If the student has a good rapport with an adult, perhaps they could meet with the student for 10 or 15 minutes once a week in their class just to hang out and chat or play a game. This could be an alternate outlet to vent or receive attention.

If at all possible, outside counseling would be great. If not, then an adult the student has a good rapport with or mentor from above could set goals with regard to cutting. For example, reducing the number of times the student cuts while increasing the number of alternate coping strategies used instead or in place of cutting (this could be journaling, listening to music, drawing, talking to someone or a pet, scribbling, deep breathing, self talk, etc).

Provide a journal to the student and let them have the last or first 5 minutes of school to write in it. It could be kept securely with the adult the student has a rapport with or the student could keep it and bring it. You would want a more private place for the student to go for these 5 minutes, a low traffic area.

Self esteem seems like an issue, so building this is important. Find the student's strengths and praise these while giving opportunities for the student to demonstrate them. For example, if the student likes to draw, give the student a special drawing assignment, get the student signed up for the art club, display the student's work in the showcase, etc. If the student is a good writer, have the student write a story then use it for a lesson or have the student make small books (booklets) of the student's story and let the student read it to a lower L classroom, if you have lower L in your building.

Any clubs or organizations the student can be involved in would be helpful, preferably ones that the student can be successful in. Or if the student has a strong interest in something, maybe the student could start a club.

If weekends are tough for the student, see if there are any friends the student can hang out with on those days or places in the community the student can go to, like a community center, library, etc.

As I mentioned above, teach the student alternative coping strategies: journaling, listening to music, drawing, talking to someone or a pet, scribbling, deep breathing, self talk, etc. Here is the PBISWorld page on it: http://www.pbisworld.com/tier-2/teach-coping-skills/, http://www.pbisworld.com/tier-2/teach-relaxation-techniques/

Here are some additional resources that may be helpful: http://kidshealth.org/teen/your_mind/problems/resisting_cutting.html http://kidshealth.org/teen/your_mind/feeling_sad/cutting.html#

This really is a complicated issue with many layers that you will be limited in being able to address in the school setting. There really needs to be outside therapeutic intervention, in-home counseling, etc.

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