Behavioral Treatment of Self-Injury: 2001 to 2016.

Pitchford et al. (2019) read every self-injury treatment paper published from 2001 to 2016.

They compared these newer studies to the classic 1964-2000 body of work.

The goal was to see if today’s cases and outcomes look different from the old days.

More of the recent cases hurt themselves for internal sensory reasons, not for attention or escape.

Treatments now work a little less well than they did in the older literature.

In short, expect tougher automatic self-injury and slightly weaker effects.

Fovel et al. (1989) and Leung et al. (2011) already showed that many clients self-restrain or show syndrome-linked patterns. A et al. fold those facts into the big picture.

Davies et al. (2014) warned not to call SIB a sign of depression in ID. A et al. agree and show the field has moved past that idea.

Wilkinson et al. (1998) proved attention-based SIB can be tamed with NCR or FCT. A et al. note these bright results are harder to reach now because automatic cases dominate.

Your next case is more likely to be sensory-driven and stubborn. Start with a full functional assessment, but plan for multiple sensory substitutes and medical checks. Track data closely; the window for quick success has narrowed since the textbooks were written.