Behavior therapy for nonsuicidal self-injury

Lynch, Thomas R. and Cozza, Caroline (2009) Behavior therapy for nonsuicidal self-injury. In, Nock, Matthew K. (ed.) Understanding Nonsuicidal Self-Injury: Origins, Assessment, and Treatment. Washington, US. American Psychological Association, pp. 211-250. (doi:10.1037/11875-012).

Record type: Book Section

Abstract

The primary aim of this chapter is to examine nonsuicidal self-injury (NSSI) from a modern behavioral perspective, influenced by a prominent behavioral theory that considers negative emotions as the primary proximal cause of NSSI. First, we briefly define what we mean by modern behaviorism. Second, we outline our theoretical petspective and review behavioral domains that we consider important when conducting a functional analysis of NSSI, including (a) biological, establishing, and stimulus control operations; (b) consequential operations; (c) a special form of consequential operation—self-punishment; and (d) rule-governed operations. Next, we review interventions that have been used to treat NSSI, focusing primarily on dialectical behavior therapy (DBT) because it is the only behavioral treatment with empirical support. Finally, we outline the hypothesized mechanisms of change unique to DBT. We do not attempt to discuss all potential mechanisms that could be associated with change in patient outcomes, nor do we believe it is possible to do so at this stage of treatment development. Instead, we focus on hypothesized mechanisms that we believe to be particularly salient in the treatment of NSSI.

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