Treatment of self-harm behaviour in adolescents – what works?
According to population studies 5-10% of adolescents report past-year self-harm. Although a very common motive for self-harm in adolescents is to get relief from strongly negative emotions, many self-harm episodes are motivated by a wish to die. A large proportion of adolescents who have self-harmed, receive no treatment for their emotional and behavioural problems. Further-more, many of those who have been referred to specialized care drop out prematurely because of their treatment interfering behaviours or lack of support from families or clinical services. Since self-harm is a powerful predictor of completed suicide there is a strong need to develop effective interventions that are accessible and acceptable to self-harming adolescents and their families, as well as feasible to deliver in community mental health settings. This has been the aim of substantial amounts of research published over the last two decades, but the first trials to demonstrate effectiveness of treatments in preventing repetition of self-harming and suicidal behaviour have emerged only during recent years. In this lecture we will review what works in treatment of self-harming adolescents and discuss how this new knowledge may be used in daily clinical practice. There is reason for treatment optimism provided we are able to disseminate the new knowledge into routine clinical practice in the many contexts self-harming adolescents are encountered.
Treatment of self-harming adolescents with Borderline Personality Disorder
Borderline Personality Disorder (BPD) is a diagnosable disorder in adolescence and BPD diagnosed at this age is highly predictive of adult personality pathology and long-term impairment, morbidity, and mortality. Repetitive suicidal and self-harming behaviours are often present, which, along with comorbid substance use disorders, a reluctance to accept treatment and a high tendency of dropping out early make many clinicians consider adolescents with borderline features a difficult-to-treat patient population. In this workshop you will learn how to assess and understand self-harming behaviour in adolescents with BPD-traits and how to plan the treatment and how to motivate and engage adolescents and their parents for treatment.
Prof. MD PhD Lars Mehlum
Past President of the European Society for the Study of Personality Disorders (ESSPD)
President of the International Academy of Suicide Research (IASR)
Past president of the International Association for Suicide Prevention (IASP)
Founding director of the National Centre for Suicide Research and Prevention at the Institute of Clinical Medicine, University of Oslo, Norway.
The aims of this workshop
You will learn how to move the focus of treatment from crisis intervention into a focus of growth while maintaining patient safety and managing upcoming suicidal crises. You will be introduced to key knowledge based principles in the treatment and learn how to enhance patients capabilities and skills to regulate emotions and cope with difficult relations and situations. You will also learn about common barriers to treatment and to implementation of knowledge based treatments for adolescents and discuss possible ways of reducing them.
Prof. MD PhD Lars Mehlum
Education and Training
Over many years he has been an advisor on mental health and suicide prevention in his home country, to the WHO, the EU and governments in countries such as the US, China and Germany. He has lectured widely in many countries and has established several advanced training programmes, such as a Master’s program in suicide prevention at the University of Oslo and national therapist training programs in Dialectical Behaviour Therapy (DBT) and Complicated Grief Treatment (CGT). The founding editor of the journal Suicidologi published since 1996 he is also a member of the editorial board of several international journals.
He is the founding director of the National Centre for Suicide Research and Prevention at the Institute of Clinical Medicine, University of Oslo, Norway. A psychiatrist and psychotherapist he is a past president of the International Association for Suicide Prevention (IASP) and currently the president of the European Society for the Study of Personality Disorders (ESSPD) and the president of the International Academy of Suicide Research (IASR).
His clinical studies also focuses on the prevalence of self-harm and BPD in teenagers and the risk and course of suicidal behaviours in this age group. He is also conducting studies of the epidemiology of self-harm and completed suicide in the general population and various non-clinical samples through large scale national registers and he has published widely on these subjects and has received several national and international awards.
With his research group he focuses on the clinical course of suicidal and self-harming behaviour with respect to etiological and prognostic factors such as stressors and negative life events, personality traits and disorders, major psychiatric illness and the efficacy of interventions, among them Dialectical Behaviour Therapy.