by Diane and John
Cutting behavior is not uncommon among teens and pre-teens in general populations and among foster kids, who have suffered trauma of some kind, it may be even more prevalent.
Cutting behavior refers to the act of cutting into the skin, deeply scratching or any self-harm activity done usually on a child's arms or legs with some kind of sharp implement. It is not an indicator of a suicide attempt, but is an attempt by the child to deal with emotional pain that they cannot express any other way.
Recognized most often in girls, it does happen in children of both sexes. It often starts as a response to a self-esteem issue (body hatred, response to molestation etc) but once it becomes a habit, it is turned to as a release of any kind of stresser.
If you receive a child in foster care who is a "cutter," hopefully the issue is already being addressed through counseling and therapy. Be sure to talk about it with your team to be sure, as the behavior is ofter well-hidden by the child.
Dealing with the issue in your foster home should be part of your open conversation. Just as we recommend with sexual issues, it should be part of the family conversation, and if the child is willing to work on the behavior, a plan can be developed.
Cutting releases endorphins which releases the stress the child feels when under pressure. Although counseling works long term, in your home, you want to provide ways to help your foster child deal with emotional pressure.
If the child is not in school, try running, basketball or any sport the child enjoys. It should be something enjoyable, and not seen as a punishment. Since the issue is something that the family will talk about openly, when you notice the child is under stress, you can initiate the conversation: "Honey, do you feel okay, do you need to burn off some pressure? Why don't you and your brother go for a bike ride?" Afterwards, you can talk about how the physical exercise is a way to substitute for the cutting.
If the child is in school, start with a simple behavioral modification technique, a rubber band around her wrist. A quick snap can relieve building emotional pressure and can be just a first step to learning to deal with angst. Deep breathing should follow. Then a program where he or she can simply snap her fingers, squeeze her earlobe or take other measures to trigger her decompression.
Coach your pre-teen or teen to know that the issues that trigger these events, perceived failures at school or in sports, feelings of rejection etc, are all part of life, are part of growth and can be accepted and moved through. Build self-esteem through other therapeutic process and exercises as well.
Check out the WebMD information on Cutting for more information.