BookLaurel L. Williams, Owen Muir, editors.
Summary: This volume presents a comprehensive and practical approach to the treatment of suicide and NSSI for adolescents utilizing a mentalizing framework. The beginning of the text provides up-to-date information on the theory of a mentalizing therapy in order to ground the readers in the neuroscientific underpinnings of a mentalizing approach. Next chapters provide information on the fundamental building blocks of a mentalizing therapy at the individual and family level. These chapters provide step-by-step approaches in order to provide examples of the techniques involved in mentalizing treatment that can be employed to address suicidality and NSSI. The next chapter builds on these concepts as the reader learns about mentalizing failures involved in common co-morbidities in adolescents who are experiencing suicidality and/or employing NSSI. The next several chapters cover practical issues related to working within this patient population including the key concept of social systems and connections for both providers and adolescents, the ability of mentalizing theory and therapy to integrate with other effective therapies, how to approach sessions after a suicide attempt, resiliency for patient, family and the provider, along with important self-care for a therapist if a patient commits suicide. The final chapter brings all of the aforementioned elements together in order for the reader to conceptualize employing a mentalizing approach to adolescents and their families when suicide and NSSI concerns are a predominate focus of care. Illustrations of specific therapeutic approaches and a list of resources and guidelines where available are also included. Adolescent Suicide and Self-Injury is an excellent resource for all clinicians working with youths at risk for suicide and/or self-injury, including psychiatrists, psychologists, pediatricians, family medicine physicians, emergency medicine specialists, social workers, and all others.
Contents:
Intro
Contents
Contributors
1: What Is Mentalizing?
Introduction
Brief History
The Four Dimensions
Whose Mental State? Self Versus Other
What Kind of Mental State? Affective Versus Cognitive
What Kind of Cues Are Used? Internal Versus External
How Does the Awareness Come About? Automatic Versus Controlled
The Development of Typical Mentalizing
The Normative Timeline
The Importance of Parenting and Attachment
The Development of Atypical Mentalizing
The Alien Self
Pre-mentalizing Modes: The Target of Treatment
Conclusion
References 2: Core Mentalizing Techniques
Introduction
The Mentalizing Stance
"Not Knowing"
Holding the Balance
Disengaging from Non-mentalizing
Highlighting and Promoting Mentalizing
Psychic Equivalence
Teleological Mode
Pretend Mode
Notice and Name: The Mentalizing Loop
Conclusion
Suggested Reading
3: Mentalizing in Family Work
Introduction
Case Introduction
Initial Family Mentalizing Assessment and Formulation
Example Formulation
Promoting the Mentalizing Stance in Therapy
Holding the Balance: Curiosity Holding the Balance: Slowing Down/Emotion Regulation
Holding the Balance: The Affect Focus
Holding the Balance: The "Here and Now" Focus
Holding the Balance: Perspective-Taking
Highlighting Good or Improved Mentalizing: Humility
Highlighting Good or Improved Mentalizing: Humor
Highlighting Good or Improved Mentalizing: Impact Awareness
Highlighting Good or Improved Mentalizing: Forgiveness
Disengaging from Non-mentalizing: Psychic Equivalence
Disengaging from Non-mentalizing: Pretend Mode
Disengaging from Non-mentalizing: Teleological Mode
The Mentalizing Loop Psychic Equivalence: "Open Door?"
Pretend Mode: The "Ferris Wheel"
Teleological Mode: "Lecture Voice"
Conclusion
References
4: Mentalization-Based Treatment Activities, Games, and Intersession Activities
Introduction
Introducing the Other (Introduction, a Challenge for Pretend Mode)
The Pause Button (a Challenge for Psychic Equivalence or Teleological Mode)
Inverted Roles Activity (All Three Mentalizing Failures)
The "Feeling and Doing" Activity (Pretend Mode)
Family Modeling (Pretend Mode, General Lack of Knowledge)
The Mind [or Brain] Scan (Pretend Mode General Lack of Mentalizing)
Safety, Timing, and Communicating About Games/Activities
Modeling the Mentalizing Stance, Playfulness, Humility, and Use of Humor
Troubleshooting Avoidance of Games
Conclusion
References
5: Suicidality in Context
Introduction
Childhood Trauma
Maltreatment Disrupts Mentalizing, Attachment, and Trust
How Can Therapists Work Productively with Youth Who Have Suffered Maltreatment?
Bullying
Personality Factors
Borderline Personality Disorder
Narcissism
Antisocial Personality Disorder
Internalizing Disorders