Cognitive-Behavioral Therapy for Deliberate Self-Harm
Abstract
Patients who engage in deliberate self-harm (DSH) form a heterogeneous population. There is a need for psychotherapeutic interventions that give therapists the flexibility to tailor the treatment plan to the needs of an individual patient. To detect essential ingredients for treatment, three different cognitive-behavioral theories of DSH will be reviewed: (1) the cognitive-behavioral theory of Linehan (1993a), (2) the cognitive theory of Berk, Henriques, Warman, Brown, and Beck (2004), and (3) the cognitive-behavioral theory of Rudd, Joiner, and Rajab (2001). A review of these theories makes it possible to compare the different approaches to the essential aspects in the treatment of DSH: a trusting patient-therapist relationship, building emotion regulation skills, cognitive restructuring, and behavioral pattern breaking. An overview will be given of therapeutic techniques that can be used to address the cognitive, emotional, behavioral, and interpersonal problems associated with DSH.
References
(1997). The integrative power of cognitive therapy. New York: Guilford.
(1999). The effectiveness of partial hospitalization in the treatment of borderline personality disorder: A randomized controlled trial. American Journal of Psychiatry, 156, 1563–1569.
(2000). Effectiveness of psychotherapeutic treatment of personality disorder. British Journal of Psychiatry, 177, 138–143.
(2001). Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: An 18-month follow-up. American Journal of Psychiatry, 158, 36–42.
(1967). Depression. New York: Harper & Row.
(1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.
(2003). Dysfunctional problem solving in borderline personality disorder. Cognitive Therapy Today, 8. Retrieved December 18, 2003, from www.beckinstitute.org/Feb03/index.html
(1979). Cognitive therapy of depression. New York: Wiley.
(1987). Social skills training treatment for depression. New York: Pergamon.
(2004). A cognitive therapy intervention for suicide attempters: An overview of the treatment and case examples. Cognitive and Behavioral Practice, 11, 265–277.
(2005). Cognitive therapy for the prevention of suicide attempts. A randomized controlled trial. Journal of the American Medical Association, 294, 563–570.
(2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behavior Research and Therapy, 44, 371–394.
(2000). Adolescent suicidal behavior: A general population perspective. In , The international handbook of suicide and attempted suicide (pp. 249–259). Chichester: Wiley.
(2004). Factors associated with suicidal phenomena in adolescents: A systematic review of population-based studies. Clinical Psychology Review, 24, 957–979.
(2000). Risk factors and life processes associated with the onset of suicidal behavior during adolescence and early adulthood. Psychological Medicine, 30, 23–39.
(1997). Attempted suicide. In , Science and practice of cognitive behavior therapy (pp. 285–313). Oxford: Oxford University Press.
(1998). Deliberate self-harm: Systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition. British Medical Journal, 317, 441–447.
(1989). Problem solving. In , Cognitive behavior therapy for psychiatric problems: A practical guide (pp. 406–426). Oxford: Oxford University Press.
(2000). Collaborating to prevent suicide: A clinical-research perspective. Suicide and Life-Threatening Behavior, 30, 8–17.
(2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archives of General Psychiatry, 59, 741–749.
(2004). Psychotherapy with suicidal people:Aa person-centered approach. Chichester: Wiley.
(1993a). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.
(1993b). Skills training manual for treating borderline personality disorder. New York: Guilford.
(1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064.
(1993). Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry, 50, 971–974.
(1994). Interpersonal outcome of cognitive-behavioral treatment for chronically parasuicidal borderline patients. American Journal of Psychiatry, 151, 1771–1776.
(2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs. therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63, 757–766.
(2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology, 62, 459–480.
(2006). Problem solving ability and repetition of deliberate self-harm: A multicenter study. Psychological Medicine, 36, 45–55.
(1999). Toward a clinical model of suicidal behavior in psychiatric patients. American Journal of Psychiatry, 156, 181–189.
(1989). Problem-solving therapy for depression: Theory, research, and clinical guidelines. New York: Wiley.
(2002). Affect regulation and addictive aspects of repetitive self-injury in hospitalized patients. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1333–1341.
(2003). Suicidal behavior as a cry of pain: Test of a psychological model. Archives of Suicide Research, 7, 297–308.
(2001). Therapeutic empathy with the suicidal wish: Principles of therapy with suicidal individuals. American Journal of Psychotherapy, 55, 166–184.
(1989). Cognitive therapy in practice: A case formulation approach. New York: Norton.
(2001). Essential components of cognitive-behavior therapy for depression. Washington DC: American Psychological Association.
(2001). Socioenvironmental and cognitive risk and resources: Relations to mood and suicidality among inpatient adolescents. Journal of Cognitive Psychotherapy: An International Quarterly, 15, 195–222.
(2000). Personality types and suicidal behavior: An exploratory study. Suicide and Life-Threatening Behavior, 30, 199–212.
(2001). Treating suicidal behavior. An effective, time-limited approach. New York: Guilford.
(1998). Negative life events and adolescent suicidal behavior: A critical analysis from the stress process perspective. Journal of Adolescence, 21, 415–426.
(2002). Mindfulness-based cognitive therapy for depression. A new approach to preventing relapse. London: Guilford.
(2005). Social problem solving in adolescents with suicidal behavior: A systematic review. Suicide and Life-Threatening Behavior, 35, 365–387.
(1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) help? Behavior Research and Therapy, 33, 25–39.
. (2001). Understanding suicidal behavior. The suicidal process approach to research, treatment and prevention. Chichester: Wiley.
(2002). Dialectical behavior therapy of borderline patients with and without substance use problems. Implementation and long-term effects. Addictive Behaviors, 27, 911–923.
(1996). The complexity of adaptation to trauma. Self-regulation, stimulus, discrimination, and characterological development. In , Traumatic stress (pp. 182–214). New York: Guilford.
(2003). Dialectical behavior therapy for women with borderline personality disorder: 12-month, randomized clinical trial in The Netherlands. British Journal of Psychiatry, 182, 135–140.
(1984). The psychological treatment of depression. A guide to the theory and practice of cognitive-behavior therapy. London: Croom Helm.
(2006). Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior. Journal of Clinical Psychology: In session, 62, 201–210.
(1997). Cry of pain: Understanding suicide and self-harm. Penguin: London.
(2002). Suicide and attempted suicide. London: Penguin Books.
(1996). Effects of early negative life experiences on cognitive functioning and risk for suicide: A review. Clinical Psychology Review, 16, 177–195.
(1994). Cognitive therapy for personality disorders: A schema-focused approach (rev. ed.). Sarasota, FL: Professional Resource Press.
(1994). Reinventing your life: How to break free from negative life patterns and feel great again. New York: Penguin Group.
