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APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.
The S.A.F.E. Alternatives® philosophy begins with the assumption that, although temporarily helpful, self-injurious behavior is ultimately a dangerous and futile coping strategy that interferes with intimacy, productivity, and happiness. There is no "safe" or "healthy" amount of self-injury. Dr. Lader and S.A.F.E. (Self Abuse Finally Ends) Alternatives also believe that self-injury is not an addiction over which one is powerless for a lifetime—people can and do stop injuring with the right kinds of help and support. Self-injury can be transformed from a seemingly uncontrollable compulsion to a choice. The S.A.F.E. Alternatives® philosophy respects the autonomy and choice-making capacities of the individual. It is not an authoritarian model; S.A.F.E. does not believe that helpers can or should take all the responsibility for keeping the self-injurer safe. Ultimately, the self-injurer must be empowered to learn to keep themselves safe. In order to get well, there must be a shift in the locus of responsibility from the helper to the one being helped. The helping relationship is a partnership, not a "parental" relationship. At S.A.F.E., counselors try to create a "culture of safety" in which the injurer comes to realize that self-injury destroys relationships, but safety brings people closer to them. S.A.F.E. also does not employ infantilizing, restricting methods of behavior control, which reinforce the individual's sense of helplessness and powerlessness. Dr. Lader's theoretical orientation could best be described as a brief analytic approach that encourages the reliance on words, in the context of relationships, as the primary means for managing feelings and gaining self-awareness and self-control. Self-injurers have often learned that feelings must be discharged through physical action: If not self-injury, then punching, hitting, self-neglect, or imitating self-injury through "pretend actions." At S.A.F.E., counselors help clients learn to use the therapeutic relationship as well as other coping strategies (behavioral and cognitive–behavioral) to delay the urge to self-harm, reflect on what one is feeling, and choose an alternative mode of coping. S.A.F.E. refers to this process as "enlarging the window of opportunity" between the urge to self-injure and the actual act of self-injury—a window of time that "frees up" the self-injurer to try something different. The S.A.F.E. approach is designed for any adolescent or adult self-injurer, male or female, who is of at least average intelligence. It is not designed for those suffering from severe developmental disabilities, autism, or Asperger syndrome. In addition, it is not appropriate for those that are actively psychotic or suicidal, although clients may have experienced these symptoms at various points in their lives. Those diagnosed with severe dissociative identity disorder might also have difficulty with our therapeutic approach. |
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