Responding to Self Harm in Children and Adolescants

This book is targeted at professionals who may encounter, or work with, children and adolescents at risk of self-harming. Walker is an expert in child and adolescent mental health and as a social worker and psychotherapist has had many years of hands on experience.

Self-harming is a distressing behaviour that appears to be on the increase among young people, but the awareness or competencies required to identify and treat it are regrettably often lacking. This book is the ideal starting point, giving the reader an awareness of the often hidden signs, how to approach the young person and their family and the different types of help available.

The book is deliciously political which is refreshing, and in my opinion, important because if mental health care and provision is not sufficiently funded and is operating, circa 1970s it is in danger of doing more harm than good. There appears to little encouragement or incentive to progress, taking into account all new areas of research from genetics, neuroscience, nutrition in addition to the more standard CBT. Without embracing the genetic and neurosciences mental health will remain a taboo and shady area of health. Negative attitudes to mental health problems are rife amongst care providers and the general public alike and many old attitudes and beliefs about the causation are still, in my opinion, entrenched in the seventies without a willingness to shift direction. Walker at least dares to challenge government policies, funding and expectations believing that if mental health issues are not addressed until they have reached crisis point and then only offer fire fighting, the cost financially and emotionally far outweigh the costs of tackling problems before they arise. In the asperger community we regularly hear of children refused special boarding schools because the LEAs insist a local school can meet the needs with the aid of an assistant only to hear later that the child has become aggressive, is drinking or taking drugs and has opted out of all education. If the parent's earlier concerns about the child's and families needs had been addressed, it is probable that such an outcome could have been averted and the subsequent financial costs of social workers, psychiatrists, police, emergency foster care would have funded a special school placement ten times over.

The book is not a complete manual that the reader can absorb and then

confidently treat a young person with self-harming problems but it starts a process of education and encourages an open and non-judgemental attitude, where the child‘s distress is properly heard. There are many tips which include engaging the young person in what will help them and taking advantage of literature which has pulled together the experiences and opinions of past and present self-harmers.

The book is divided into four short chapters with a useful resource section. I feel it would have been helpful to have a few sentences about what each listed organisation does so that the reader can decide the ones most relevant to their needs. The first chapter gives a simple introduction and explanation about self-harm, Chapter 2 shows how to recognise and treat it . Chapter 3 looks at early intervention and the recovery journey and the final chapter considers how the child can be supported by a range of individuals.

This is not a self-help book although it is certainly straight forward and informative enough for a parent or adolescent child to read as a starting point to understanding what is happening. I would have liked more emphasis on the effect of hormones during puberty as a significant contributor to adolescent anxst. The distress many feel during adolescence maybe a significant contributor to self-harming as well as peer group pressure just as happens with excessive drinking. It was recognised that some individuals are born less resilient and will always struggle to cope more than others and therefore life stresses will hit them harder. I feel that most books do not emphasise this enough and that practitioners need to catch up with the dearth of material suggesting that a genetic vulnerability is a significant factor in many distressing health problems. Only then can we learn to modify the child's world earlier in life to protect the vulnerable child and arm them with some better coping mechanisms and supports before they reach the teens. I also cannot help but feel that if one took a perfect family and asked a teenager to pretend to have a particular problem and then brought in a team of experts that models about causation of the feigned illness would be applied and that many family dynamics identified to fit the beliefs about causation - I‘d like to set up such a scenario for a reality based tv programme to see how experts tend to see and interpret what they want to.

This said I would not hesitate to recommend this book as it has a lot of useful points and challenges the political system, daring to jump off the fence.