VISTAS Online is an innovative publication produced for ACA by Dr. Garry R. Walz and Dr. Jeanne C. Bleuer of Counseling Outfitters, LLC. Its purpose is to provide a means of capturing the ideas, information and experiences generated by the annual ACA Conference and selected ACA Division Conferences. Papers on a program or practice that has been validated through research or experience may also be submitted. This digital collection of peer-reviewed articles is authored by counselors, for counselors. VISTAS Online contains the full text of over 900 proprietary counseling articles published from 2004 to 2017.
Therapy on the Cutting Edge: Supportive Perspectives of the Inclusion of Self-Injury in the DSM-V
Steve Bain and LaVonne Fedynich
Currently, there is no formal diagnosis for self-injury to be found in the most prominent source for mental health professionals, the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, [DSM-IV-TR], 2000). Selfinjurious behavior may be the newest teen disorder sweeping the nation and support to include a formal diagnosis of self-injury in the newest manual, the DSM-V, is growing. Research continues to support the belief that non-suicidal self-injury is growing among teenagers, reaching younger students, and often continuing to be an issue for young people throughout early adulthood. For the mental health professional, accurately diagnosing and treating can be especially difficult, particularly since self-injury is not listed as a stand-alone diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (2000). Currently, this diagnostic manual includes self-injury as a symptom of or associated with Borderline Personality Disorder (BPD), as shown in Table 1. Yet many practitioners find their clients do not easily fit into that diagnostic category. This article will seek to examine the significance and implications for the inclusion of self-injury in the DSM-V. Attention will be given to rationale for the diagnosis, contemporary issues facing therapists and clients, and practical suggestions for effective therapeutic intervention strategies. The inclusion of self-injury as a diagnosis in the DSM-V will assistant professionals as they seek to define the problem of self-injury, describe the profile of self-injurers more clearly, and develop a plan for education, intervention, and prevention as it relates to the disorder.