Deliberate and undeliberated self harm: theoretical basis and evaluation
of a personal con-struct psychotherapy intervention
David Winter*/**, Suchitra Bhandari*, Christopher Metcalfe*, Tony Riley***;
Lester Sireling*; Sue Watson*
* Barnet Health Care NHS Trust, Edgware Community Hospital, ** University
of Hertfordshire, Hatfield Herts, *** Mental Health Services, London
Borough of Barnet, Whetstone (UK)
Abstract
Acts of ‘deliberate self harm’ vary widely in nature, ranging from
those which are the outcome of a long process of deliberation to those
appear largely undeliberated. In this paper the varying routes to self
harm will be considered from a personal construct theory perspective, in
terms of such concepts as fatalistic and chaotic views of the world, undispersed
dependency, difficulties in construing the construction process of others,
foreshortening of the Circumspection - Pre-emption - Control Cycle, and
hostility. Illustrations will be provided from interviews with clients
attending Accident and Emergency Departments following episodes of self
harm. A therapeutic intervention based on the personal construct theory
perspective will be described, and results will be presented from a research
study in which clients who had self harmed were allocated either to this
interven-tion or to a ‘normal clinical practice’ condition. Clients were
assessed pre- and post-treatment and at 6-month follow-up a repertory grid,
a dependency grid, and a range of other measures, and re-cords were kept
of repeat episodes of self-harm. These assessments provided some evidence
of the effectiveness of the personal construct psychotherapy intervention.
Both group and individual case studies will be presented.
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