The authors advance motivational interviewing and the transtheoretical model of change as a conceptual framework for counseling clients who engage in nonsuicidal self-injurious behaviors. The major principles of motivational interviewing are applied in a case study of a client who self-injures. Recommendations are made for mental health counseling practice.

We evaluated a behavioral skills training program for adults with autism spectrum disorder and mild or no intellectual disabilities who were interested in learning the skills used by behavior therapists to work with young children with autism and other developmental disabilities. Four adults, aged 21 to 30 years, participated. We trained each individually using verbal and written instructions, modeling, and role play with feedback to teach 2 basic skills to an adult who played the role of a young child with autism. We evaluated generalization of the discrete-trial training skills by having the participant (a) teach the adult confederate 2 additional targets that we had not included in training and (b) teach a new skill to a young child with autism. Results indicated that 3 of the 4 participants rapidly acquired discrete-trial training skills and that these skills generalized to new targets with the confederate adults and to teaching an actual child with autism.

In this article, the authors present risk management considerations of which mental health counselors should be aware when counseling adolescents who engage in nonsuicidal self-injury. They address considerations related to self-injury and suicide, assessment and evaluation, countertransference, social contagion, and body privacy and make recommendations to minimize client and counselor risk while enhancing client care. Rachel M. Hoffman is affiliated with Meridian Community Care.

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