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Table 2 An overview of the content of the ERITA treatment protocol

From: Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: a feasibility study

Adolescent treatment Parent program
(Module) Content (Module) Content
(1) Functions of NSSI
Information about NSSI, exploring the functions driving NSSI and other self-destructive behaviors. Introduction to the concept of valued direction.
(1) Psychoeducation
Information about NSSI, emotional reactivity, the role of an invalidating environment, and skills in validation.
(2) Functionality of emotions
Facts about basic emotions, the functionality of emotions and why it is important to be aware of them.
(2) Repetition and homework review
(3) Emotional awareness
Increase emotional awareness by becoming aware of the different components of emotions.
(3) How to improve parenting in the long run
Activate yourself and your child in order to increase positive interactions.
(4) Emotions provide information that can guide our behavior
How to identify the information that emotions provide about our environment and ourselves. How to act on that information or express emotions in healthy ways.
(4) Repetition and homework review
(5) Primary vs. secondary emotions
Introducing the concept of primary and secondary emotions, how to differentiate between them, and why this is important.
(5) Conflict management and problem solving
Emotional awareness and six steps for problem solving.
(6) Emotional avoidance / unwillingness
Conceptualize problematic behaviors as an act of unwillingness. Metaphors describing the paradoxical consequences of our efforts to control/suppress emotions.
(6) Repetition and homework review
(7) Emotional willingness / acceptance
Willingness as the solution. What willingness is and is not.
(7) Summary and evaluation
Repetition and evaluation.
(8) Non-avoidant emotion regulation strategies
How to regulate emotions by distraction and approach strategies.
(9) Take control over impulsive behaviors
Definition of impulsive behaviors. Techniques for resisting urges: distraction, behavior substitution, and remind yourself of long-term negative consequences, and consequence modification.
(10) Valued directions
Values are different from goals. Identify valued directions.
(11) Commitment to valued actions
Identify and commit to valued actions.
(12) Relapse prevention
Identify which skills have been helpful; identify high risk situations and strategies for preventing relapse.