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What is self-mutilation and how do OTs deal with it?

William Lambert, MS, OTR/L

October 1, 2021

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What is self-mutilation and how do OTs deal with it?

Answer

Self-mutilation is a maladaptive coping skill for dealing with uncomfortable feelings. Once I asked an adolescent why she cut, and she said, "When I see the blood flow, I feel better." Naturally, it is our job to teach coping skills that are not harmful to one's body. However, I have read that there is a certain euphoria that comes with cutting.

For self-management, how do we help our clients to handle and cope with those uncomfortable feelings better? We can teach self-management strategies for stress, anger, and emotions. Two alternative coping strategies for self-mutilation are holding an ice cube on the skin, which presents a burning feeling, or snapping a rubber band. Both are not going to cause permanent damage. The key is that these are temporary alternative coping strategies.

We want them not to engage in self-harm and develop positive coping strategies through cognitive-behavioral therapy, dialectical behavioral therapy, and sensory approaches. This is perfect for occupational therapy. We can also work on problem-solving, tactile stimulation, massage, self-soothing, communication skills, and things like that.


william lambert

William Lambert, MS, OTR/L

William L. Lambert, MS, OTR/L holds a bachelor’s degree in English and Psychology and a bachelor’s and advanced master’s degree in occupational therapy. He has over twenty years of experience working with children and adolescents in inpatient and community settings. Currently he holds the position of Faculty Specialist in the Department of Occupational Therapy at The University of Scranton where he teaches the psychosocial-based courses and conducts ongoing research on current preferred adolescent occupations. He developed the Scranton Adolescent Interest Checklist, © as a contemporary assessment tool for use with this population. He authored chapters on children and adolescents in Cara and MacRae’s 2019 textbook Psychosocial Occupational Therapy: An Evolving Process and on posttraumatic stress disorder in Weiss, Morgan and Kinnealey’s A Practitioners Guide to Clinical Occupational Therapy published in 2012. He was the lead author of the psychosocial chapters in the National Occupational Therapy Certification Exam Review & Study Guide published in 2019 and the National OTA Certification Exam Review & Study Guide, both edited by Rita P. Fleming-Castaldy. He is on the editorial board of the journal Occupational Therapy in Healthcare. Mr. Lambert is a member of the American Occupational Therapy Association, the Pennsylvania Occupational Therapy Association, and the World Federation of Occupational Therapists He has presented numerous times at state and national occupational therapy conferences.


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