Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-16T15:27:24.775Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychological interventions in self-injurious behaviour

Working with people with a learning disability

Published online by Cambridge University Press:  03 January 2018

Sabrina Halliday  and
Kelvin Mackrell
Sabrina Halliday*
Affiliation:
Clinical Psychology, Psychotherapy and Counselling Unit, Leeds CMH Trust
Kelvin Mackrell
Affiliation:
Department of Clinical Psychology, Wakefield and Pontefract Community NHS Trust
*
S. Halliday, Department of Clinical Psychology, Learning Disability Service. St Mary's Hospital, Greenhill Road, Leeds LS12 3QE
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Psychological approaches to working with people with learning disabilities who self-injure have developed over the past 30 years.

Method

The major literature is reviewed and an ecological framework is described which emphasises the importance of environmental, interpersonal and intrapersonal dynamics to understanding the multi-factorial nature of self-injury. Case examples are given.

Results

Self-injury is seen as essentially communicative and functionally adaptive; it is the person's best attempt to deal with abusive, neglecting or traumatic environments or events.

Conclusions

The persistence of self-injurious behaviour once established, requires an interdisciplinary approach which addresses comprehensively the variety of factors which have contributed to the development and maintenance of self-injury.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 172 , Issue 5 , May 1998 , pp. 395 - 400
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

This paper was originally presented, in part, at a conference ‘Self-injurious behaviour in people with a learning disability’ at Thomas Danby College, Leeds. 1 November 1996. See related papers pp. 381–394. this issue.

References

Babiker, G. & Arnold, L. (1997) The Language of Injury: Comprehending Self-Mutilation. Leicester: BPS.Google Scholar
Baumeister, A. A. (1978) Origins and control of stereotyped movements. In Quality of Life in Severely and Profoundly Mentally Retarded People (ed. C. E. Myers). Washington: American Association on Mental Deficiency.Google Scholar
Baumeister, A. A. & Rollings, J. P. (1976) Self-injurious behaviour. In International Review of Research in Mental Retardation (ed. N. R. Ellis), Vol. 8, pp. 1–34. New York: Academic Press.Google Scholar
Borthwkk-Duffy, S. A. (1994) Prevalence of destructive behaviours; a study of aggression, self-injury and property destruction. In Destructive Behaviour in Developmental Disabilities (eds Thompson, T. & Gray, D. B.). London: Sage.Google Scholar
Bronfenbrenner, U. (1979) The Ecology of Human Development: Experiments by Nature and Design. Cambridge, MA: Harvard University Press.Google Scholar
Carr, E. G. & Durand, V. M. (1985) Reducing behaviour problems through functional communication training. Journal of Applied Behaviour Analysis, 18, 111–126.Google Scholar
Cataldo, M. & Harris, J. (1982) The biological basis for self-injury in the mentally retarded. Analysis and Intervention in Developmental Disabilities, 2, 21–39.Google Scholar
Chadwick, R. & Stenfert Kroese, B. (1993) Do the ends justify the means? Aversive procedures in the treatment of severe challenging behaviours. In People with Learning Disability and Severe Challenging Behaviour (eds Fleming, I. & Stenfert Kroese, B.). Manchester: University Press.Google Scholar
Clements, J. (1992) I can't explain … challenging behaviour: towards a shared conceptual framework. Clinical Psychology Forum, 39, 29–37.Google Scholar
Conn, L. M. & Lion, J. R. (1983) Self-mutilation: a review. Psychiatric Medicine, 1, 21–33.Google Scholar
Corbett, J. (1975) Aversion for the treatment of self-injurious behaviour. Journal of Mental Deficiency Research, 19, 679–695.Google Scholar
Emerson, E. (1990) Severe self-injurious behaviour: some of the challenges it presents. Mental Handicap, 18, 92–98.Google Scholar
Emerson, E. & Bromley, J. (1995) The form and function of challenging behaviours. Journal of Intellectual Disability Research, 39, 388–398.Google Scholar
Goldiamond, I. E. (1974) Toward a constructional approach to social problems. Behaviourism, 2, 1–84.Google Scholar
Greenspan, G. S. & Samuel, S. E. (1989) Self cutting after rape. American Journal of Psychiatry, 146, 789–790.Google Scholar
Guess, D. & Carr, E. (1991) Emergence and maintenance of stereotypy and self-injury. American Journal of Mental Retardation, 96, 299–319.Google Scholar
Jones, R. S. P. & Eayrs, C. B., (eds) (1993) Challenging Behaviour and Intellectual Disability: A Psychological Perspective. Kidderminster: BILD Publications.Google Scholar
Jones, R. S. P., Walsh, P. G. & Sturmey, P. (1995) Stereotyped Movement Disorders. Chichester: Wiley.Google Scholar
La Vigna, G. W. & Donnellan, A. A. (1986) Alternatives to Punishment: Solving Behaviour Problems with Non-Aversive Strategies. New York: Irvington.Google Scholar
Mackrell, K. (1997) Behavioural approaches. In The Psychiatry of Learning Disabilities (ed. S. Read), pp. 307–331. London: W B. Saunders.Google Scholar
Murphy, G. H. & Wilson, B. (1985) Self-Injurious Behaviour: A Collection of Published Papers. Kidderminster: BIMH Publications.Google Scholar
Oliver, C. & Head, D. (1993) Self-injurious behaviour: functional analysis and interventions. In Challenging Behaviour and Intellectual Disability: A Psychological Perspective (eds Jones, R. S. P. & Eayrs, C. B.), pp. 12–13. Kidderminster: BILD Publications.Google Scholar
Oliver, C., Murphy, G. H. & Corbett, J. A. (1987) Self-injurious behaviour in people with mental handicap: a total population survey. Journal of Mental Deficiency Research, 31, 147–162.Google Scholar
Rusch, R. G., Hall, J. C. & Griffin, H. C. (1986) Abuse provoking characteristics of institutionalized mentally retarded individuals. American Journal of Mental Deficiency, 90, 618–624.Google Scholar
Schneider, M. J., Bijam-Schulte, A. M., Janssen, C. G. C., et al (1996) The origin of self-injurious behaviour of children with mental retardation. British Journal of Developmental Disabilities, 83, 136–148.Google Scholar
Sinason, V. (1992) Mental Handicap and the Human Condition: New Approaches from The Tavistock. London: Free Association Books.Google Scholar
Stenfert Kroese, B., Dagnan, D. & Loumidis, K. (1997) Cognitive Behaviour Therapy for People with Learning Disabilities. London: Routledge.Google Scholar
Thompson, T. & Gray, D. B., (eds) (1994) Destructive Behaviour in Developmental Disabilities. London: Sage.Google Scholar
Vizard, E. (1988) Child sexual abuse: the child's experience. British Journal of Psychotherapy, 5, 77–91.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.