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Book Review: Treating self-destructive behaviors in trauma survivors: A clinican’s guide

Treating self-destructive behaviors in trauma survivors is focused on helping clinicians effectively address client selfharm when working with those who have experienced trauma. Ferentz presents a succinct definition of self-destructive behaviors by stating that acts of self-harm are ‘‘creative attempts to cope with untenable thoughts, feelings, and memories’’ (p. 7). Ferentz acknowledges that those who present with selfdestructive behaviors are often labeled as manipulative, yet she contends that the self-harming behavior represents an attempt by the individual to communicate his or her distress. Even from the opening chapter, Ferentz presents her stance that trauma survivors who self-injure deserve to be treated with respect and dignity. She encourages clinicians to suspend judgment and to avoid simplistic explanations for complex client behaviors. The text is organized into three parts: It makes sense given where they’ve come from (Part I), understanding and working with self-destructive behaviors (Part II); and helping others while taking care of ourselves (Part III). In Part I, the author discusses a strength-based approach to working with trauma survivors. She provides an overview of the role of attachment in the development of self-destructive behaviors. Ferentz underscores the importance of ‘‘working with’’ client selfdestructive behavior rather than engaging in a ‘‘power struggle’’ with the client (p. 18). By directing the reader to view self-destructive behaviors as coping mechanisms, the author encourages a greater understanding of how to effectively treat these behaviors in a caring and compassionate manner. In Part II, Ferentz explains the cycle of self-destructive behavior. This provides an important foundation for helping clinicians understand the development and maintenance of self-destructive behaviors. In this section, the author discusses treatment approaches to effectively address self-destructive behaviors. Ferentz provides a model, CARESS, which stresses a behavioral approach to help clients work with self-destructive impulses. CARESS is an acronym which stands for Communicate Alternatively, Release Endorphins and Self-Soothe. CARESS is described as an ‘‘alternative to the standard safety contract’’ with the goal being a reduction in therapist-client power struggles (p. 137). The author provides an excellent overview of the applicability of the RESS model in Chapter 13 of the text. In the last section, Part III, the author focuses on clinician self-care. She addresses issues related to countertransference, boundaries, and effectively balancing life and work. This section is imperative for those who work with trauma, as it provides a reminder of the need to engage in constant self-care. Ferentz writes in an engaging and easy-to-understand style. She presents a compassionate approach to working with trauma survivors who engage in self-destructive behaviors. The author provides case vignettes throughout the text to help illustrate important concepts. The treatment suggestions provided in text will help clinicians develop strategies to effectively guard against burnout when working with this difficult-to-treat population. This text is highly recommended for professionals who work with trauma survivors and those who engage in selfharming behaviors.