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Beyond Fear and Control discusses ways in which services can change the focus from managing or 'stopping' self harm to working with young people in more permissive, 'young person centred' and empowering ways. Although the need for such a change is increasingly being recognised, the practical implications and ethical dilemmas of this shift have rarely been explored. This book addresses this gap by providing in-depth descriptions of a range of invative practices which are effective in supporting young people who self harm. People harm themselves in many ways and for many different reasons. Whilst we recognise that there is a complex relationship between self harm and suicide, this book is about supporting young people who use self harm primarily as a way of coping with distress. In this context self harm can be viewed as - the expression of, and temporary relief from overwhelming, unbearable and often conflicting emotions, thoughts or memories, through a self injurious act which they can control and regulate. Undoubtedly young people who self harm arouse strong emotional reactions in most people including fear, helplessness, confusion and anger.Responses are often based on a need to try and protect or rescue young people from danger. However, our heightened emotional response, coupled with myths and misunderstandings about both young people and self harm, can lead us to respond in ways that, rather than being empowering and helpful, can be felt as controlling and harmful.
Helen Spandler is a research fellow in the Department of Social Work, University of Central Lancashire (UK). Sam works as a freelance consultant clinical psychologist, trainer, therapist, and expert witness, and was a Research Fellow at Manchester Metropolitan University for over 15 years. She specialises in work around child sexual abuse, within community and secure care services with children, adolescents, (and their parents) and adults. Her books include Understanding Women and Child Sexual Abuse: Feminist revolutions in theory, research and practice (London: Psychology Press). Sam is also designing a training manual and producing a video pack (together with Flexible Films) for working with clients who have experienced child sexual abuse. Sam has also worked for the department of health as a national adviser on sexual violence and mental health.