S.A.F.E. Alternatives: A Treatment Program for Self-Injury

Self-harm is defined by Karen Contario and Wendy Lader as, "The deliberate mutilation of the body or a body part, not with the intent to commit suicide but as a way of managing emotions that seem too painful for words to express." There are several different types of self-harm, which can include, but are not limited to: cutting, burning, scratching to excess, excessively pulling out one's own hair, ingesting toxic or sharp objects, biting oneself, hitting oneself, breaking one's own bones, amputating limbs, fingers, etc., and interfering with the healing of wounds. If you or someone you love is engaging in self-injurious behavior, S.A.F.E. Alternatives offers programs, from which you may benefit.

S.A.F.E. (Self-Abuse Finally Ends) Alternatives was founded by Karen Contario and Wendy Lader in April, 1986. The S.A.F.E. Alternatives program offers different levels of care in order to meet as many individuals' needs as possible.

S.A.F.E. Alternatives Adolescent Expressions: S.A.F.E. Alternatives Adolescent Expressions is a program specifically designed to address the needs and challenges teens face. For instance, according to the website, teens will often be ambivalent about giving up their self-injurious behaviors and may see those who want them to stop as trying to take something away from them. This program teaches teens about the consequences of self-harming behavior as well as empowers them to choose to stop.

Females and males who are 12 years of age and older and whose self-harming behavior can be maintained on an outpatient basis are appropriate individuals for this program. While in the program, adolescents will attend treatment Monday through Friday for 6 to 7 hours each day. The program requires each teen to sign the S.A.F.E. Promise, to participate in individual, family, and group therapy, to find an outpatient therapist for ongoing treatment after they leave the program, to identify five alternatives he or she may use instead of self-harm, and to address all forms of harming behavior, including food issues. Additionally, while adolescents are in the Adolescent Expressions program, they will receive case management, learn how to manage impulses, receive medication management, and create an aftercare plan.

S.A.F.E. Alternatives Choice: The S.A.F.E. Alternatives Choice program offers weekly psychotherapy group sessions to adolescents and adults who desire to stop self-harming. Each group runs for a six-week segment and all group participants are encouraged to attend individual and/or family therapy on an outpatient basis as well. Each group member must sign the S.A.F.E. Choice Promise and a group contract.

The S.A.F.E. Choice Promise asserts that a group member will use an alternative method of coping when he or she is thinking about self-harming, will not interfere negatively with anyone else's treatment, will not describe specific acts of self-harm or show off any wounds or scars, will work hard, and will notify a staff member if he or she is or knows of someone else who is feeling suicidal.

S.A.F.E. Alternatives Intensive: The S.A.F.E. Alternatives Intensive program is intended for individuals 12 years old and older who desire to stop self-harming. At the present time, the program indicates it can only house individuals aged 12-21 years old, but there are plans to expand the program to serve individuals over the age of 21 in 2011. The Intensive program is a residential program that runs 7 days a week with an average stay being approximately four weeks long. The program is voluntary and every participant must agree to sign a Safety Contract stating they will not engage in any self-harming behaviors for the duration of his or her stay. Additionally, each individual in the program is expected to participate in all individual, group, and family therapy sessions, to identify alternative ways to manage impulses, and to complete 16 writing assignments during his or her stay.

S.A.F.E. Alternatives Focus: Finally, S.A.F.E. Alternatives Focus is a self-help group for individuals who want to stop self-injury and learn new ways of coping. These self-help groups are facilitated by individuals in different communities across the country. Group sessions are focused on learning to verbalize and communicate feelings, learning how to tolerate feelings and distress, learning how to give and receive constructive criticism, how to take safe risks, and learning interpersonal skills. Each group lasts 12 weeks, meeting for approximately 2 hours each week.

All group members are also encouraged to be in individual therapy while attending group and to sign group guidelines. The group guidelines state that a member will not discuss acts of self-harm in group, will not engage in self-injury during group sessions, will not be late or miss more than two groups (except in an emergency), will call another group member if one cannot attend a group session, will call his or her therapist or a crisis line if he or she is feeling suicidal, will not use drugs or alcohol before group sessions, will utilize "I" statements, will not physically or verbally threaten any other group member, and will keep who is in the group and what is discussed during session confidential.

If you engage in self-harm, you may want to consider getting into treatment with the programs S.A.F.E. Alternatives offers. You can discover more about each program by visiting the S.A.F.E. Alternatives website. If you would like to receive an evaluation for admission into the S.A.F.E. Choice, S.A.F.E. Adolescent Expressions, or the S.A.F.E. Intensive programs, you may call 800-DON'T-CUT (800-366-8288 or e-mail info@selfinjury.com.

Sources:

S.A.F.E. Alternatives: S.A.F.E. Choice: S.A.F.E. Promise:
http://www.selfinjury.com/forms/admission_safechoice_promise.pdf

Contario, K., & Lader, W. (1998). Bodily Harm: The Breakthrough Healing Program for Self-Injurers. Hyperion: New York.

S.A.F.E. Alternatives:
http://www.selfinjury.com/