Susan Alejandre

Exemplar#3:
CriticalIncidentManualDeliberateSelfHarm
StandardsMet:

Standard25:PreventionEducation&Training
Standard27:Collaboration,Coordination&TeamBuilding
Standard29:IndividualCounseling

Introduction
ThethirdexemplarIchoseistheCriticalIncidentManual,whichisfocusedonthetopic
DeliberateSelfHarm.ThisassignmentwascompletedinmyCounselingInterventionswith
ChildrenandAdolescents:SchoolCounselingandSchoolPsychologyclass.Threeschool
counselingstudentsandthreeschoolpsychologystudentsdevelopedthiscounselingintervention
manualonDeliberateSelfHarmduetotheincreaseofstudentsthroughoutthenationthatare
deliberatelyharmingthemselves.Selfharmissadlybecomingtoocommoninourschoolsand
staffmembersneedtobepreparedonhowtorespondwhentheysuspectorknowthattheir
studentisselfharming.Themanualconsistsofusdefiningdeliberateselfharm,understanding
andrespondingtoselfharm,warningsigns,schoolwideinterventions/trainings,evidencebased
counselingtherapies,selfinjurycontagion,NASPsresponsetoselfharm,ASCAsresponseto
selfharm,andcommunityresources.Thismanualcanbeusedatanelementary,middle,and
highschoollevelbecauseselfharmisstartinginelementaryschoolandcontinuesontomiddle
andhighschool(Gerling,2013).Schoolsneedtobepreparedonhowtoeffectivelyhelptheir
studentsandwhatinterventionsandresourcesareavailabletoensurethatstudentsarereceiving
thehelptheyneed.

Susan Alejandre
Standards
Standard29:PreventionEducation&Training
Theamountofstudentsengaginginselfharmisveryconcerning,whencreatingthis
manualIlearnedtheimportanceofeducatingstaffmembersandfamiliesaboutthisissuesothat
theyarebetterequippedonhowtorespondtosituationsinwhichastudentisharming
themselves.Schoolstaffmemberssuchasschoolcounselors,schoolpsychologists,
administration,nurses,teachers,andotherstaffmembersshouldreceivethismanualasan
educationtoolandtrainingtounderstandwhatDeliberateSelfHarmis,whatresearchhasfound
thatisoccurringinthebrainofstudentsthatareselfharming,andtheinterventionstheschool
willbeprovidingstudents.WhencreatingthismanualIlearnedhowtoidentifywarningsigns
thataremostcommonamongstudentsthatareinflictinginselfharm.Teachersspendmostof
theirtimewithstudentssoitisessentialthatIbeabletoprovidethewarningsignsinthemanual
andbeabletomakeitasclearaspossiblesothatteachersareabletoeasilyreadtheinformation
andfollowtheprocedureonhowtorespond.Byteachersandstaffmembersbeingableto
identifystudentsthathaveanyofthesewarningsignstheyareabletoreferthestudenttothe
schoolpsychologistorme.IhavegainedtheknowledgeofhowIshouldrespondwhenhavinga
studentdisclosethattheyareselfharmingsuchasremainingclam,beingsupportive,never
leavingthestudentalone,etc.
Standard27:Collaboration,Coordination&TeamBuilding
Beingplacedinagroupwithschoolpsychologystudentsforthismanualallowedmeto
learnabouttheirroleasaschoolpsychologistsandhowtheyplaceanessentialroleinstudent
crises.Allourteammembershadawealthofknowledgeandexperiencethatwasagreat

Susan Alejandre
contributionwhencreatingthismanual.Welearnedtolistentoeachothersideasand
collaboratetogetheronwhatinformationwouldbehelpfultostaffmemberssothatitcanbe
includedinthemanual.
Ilearnedthataschoolcounselor,schoolpsychologist,nurse,andadministratorsneedto
collaboratetogetherandworkasateamtoensurethesafetyofthestudent.Thisincludesdoinga
riskassessmentonthestudent,notifyingparents,referringthestudenttothehospital(or
designatedoutsideresourcee.g.AuroraBehavioralHealthCare)iftheyareatriskofharming
themselves,andinterventionsinplaceforwhenthestudentcomesbacktoschool.
Standard25:IndividualCounseling

Igainedcompetencyinthisstandardthroughresearchingthemosteffectivecounselor

responseswhenindividualcounselingastudentthatsharesthattheyareharmingthemselves.
TheseveralresearcharticlesthatIfoundstressedthatschoolpersonnelshouldremaincalmwhen
learningthatthestudentisselfharmingsothatthestudentfeelssafeandremainscalmaswell.
Throughmyexperiencingworkingwithstudentsthatareselfharming,Ihaveseenhow
importantitistoremainstrong,empathetic,andcalmwhenastudentisbreakingdowncrying
sharingthattheyhavebeenengaginginselfharm.Thestudentatthemomentdoesnotneed
someonewhoisgoingtojudgethemorpanicwhendisclosinginformation.Theyneedasmuch
supportaspossible.
Throughourresearchwefoundinformationabouttwoevidencebasedinterventionsthat
researchhasshownthathavebeeneffectiveinhelpingstudentsthatengageindeliberateself
harm.ThetwointerventionsareCognitiveBehavioralTherapyandDialecticalBehavioral
Therapy,whichareusedinindividualcounselingwiththestudent.AsaschoolcounselorIam

Susan Alejandre
nottrainedinusingthesetwotherapiesbutIdohavethereasonabilityofreferringthestudent
outtoatherapistthatcanuseoneofthesetherapies.AsaschoolcounseloritisimportantthatI
stillmeetthestudentonaweeklybasestoprovideanyadditionalsupportandtocheckonthe
studentswelfare.

Reflection
IhavelearnedsomuchaboutDeliberateSelfHarmfromcompletingthisassignment.
Havingtoworkonthisassignmentwithschoolpsychologystudentsallowedmetolearnabout
theirroleanddutiesasschoolpsychologistsandittaughtmetheimportanceofcollaborating
withindividualsthatIwillbecollaboratingwithwhenastudentisselfharming.Ilearnedabout
recentresearchonthefindingsofstudentsthatareselfharmingaswellascommunityresources
availabletostudents.Icandefinitelyseemyselfusingthismanualatmyschoolsiteaswell
trainingstaffmembersaboutdeliberateselfharm.