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Episode 10

Understanding And Treating Self-Harm In Wilderness

Episode 10

In this episode of the SKYlights podcast, clinical therapist Kirsten Bolt explores the reasons people self-harm and the steps involved in treating self-harm. With assessment and reassessment, we start to understand the history, severity, circumstances, and intentions surrounding the behavior, allowing us to help students to develop the skills to regulate emotions and communicate their needs to others.

 

GUEST PROFILE

Kirsten Bolt

Kirsten Bolt

Clinical Therapist - Adolescent Girls Group

Kirsten is a Licensed Marriage and Family Therapist. She graduated from Syracuse University in 1999, Summa Cum Laude, with a BS in Health and Exercise Science. Instead of following her projected course to study Biomechanics, she turned west, seeking something that felt missing. That trip landed her in Utah amid stunning red-rock canyons, wide sandy rivers, and abundant sunshine. Kirsten finds wilderness to be a uniquely powerful setting for young people to connect to themselves, to others, and to their means of contributing to the world.

Her wilderness therapy career began as a field guide in 2004. In that role, she felt drawn to the deeply intimate, interpersonal work that occurred with families, and in 2007 she enrolled at the University of Oregon to complete a graduate degree in Couple and Family Therapy. Her other clinical experiences enable her to understand complex intra- and interpersonal dynamics. Her clinical background includes working at the Center for Family Therapy in Eugene, Oregon, with couples, families, and individuals of all ages experiencing a wide variety of struggles. She facilitated bereavement support groups for elementary-aged children, served high school girls in an impoverished community, led mother-daughter support groups, and provided individual and family therapy services at a center for girls aged 10-18. Kirsten is particularly passionate about family therapy, and she believes family growth is vital in working with young people individually.

Following graduate school, she worked for two years as a wilderness therapist at Aspen Achievement Academy and then, in 2011, joined Open Sky to deepen her holistic approach to wellness. Since then she has worked with adolescent boys and girls, as well as young adult men and women. Kirsten’s expertise and passion manifest most in working with adolescent girls. She works with a wide range of adolescent girls, from clinically complex, treatment-resistant girls with complicated family systems and externalizing behaviors to over-functioning girls who internalize their emotions and hurt themselves as a result. As a family therapist, Kirsten is skilled in clarifying complicated systemic issues and helping formulate a concrete diagnostic assessment. She is supportive of parents who might need extra coaching due to anxiety, grief, and other personal struggles. With her firm and directive approach, Kirsten confronts presenting issues and holds students and families accountable to their therapeutic work, while circumventing the shame that can interfere with progress.

Kirsten evokes peer confrontation and challenge as an additional means to elicit change. Common themes she emphasizes are emotional regulation, assertive communication, identity development, vulnerability, and healthy relationships. She incorporates humor and playfulness and quickly develops strong therapeutic relationships. She works collaboratively and uses the entire treatment team (the family system, Open Sky staff, previous home professionals, educational consultants, etc.) to help students stabilize, assess clinical issues and needs, and treat presenting issues while developing an appropriate longer-term treatment plan. Kirsten incorporates principles of Dialectical Behavior Therapy (DBT) and Eye Movement Desensitization and Reprocesssing Therapy (EMDR) to support students with issues related to emotional dysregulation, trauma, and emerging personality disorders.

Most of Kirsten’s childhood was spent in Maryland, but she also was privileged to spend five years overseas in England and Germany. Still living in Utah, Kirsten finds inspiration observing the landscape, running whitewater rivers, climbing sandstone cracks, mountain biking, trail running, skiing, playing guitar and piano, and spending quality time with her husband, children, dogs, and cats. Kirsten is humbled daily by her personal experiences as a mother, stepmother, and partner, and she believes her clinical work is significantly deeper as a result.

SELECT QUOTES

Students are here in a really tightly-contained, safe environment, where we’re able to intervene constantly, where we’re able to help them understand why they’re doing what they’re doing, and help them determine some motivation to do something differently.

When we think about self-harm in the context of Glasser’s core needs, so often what people are trying to do is meet two of the five primary human needs. They’re trying to meet love and belonging, and they’re trying to meet power and control. Power and control is trying to moderate the emotion or help feel the emotion. They might be communicating the distress that they’re feeling through self-harm to meet their need for love and belonging. So often these are people who are really struggling with feeling worthy and struggling with feeling a sense of belonging, and feeling alone in the world. In that case, relationship becomes incredibly important. Partly there’s the interruption of the behavior to do something different in creating motivation, and additionally, the relationship is an incredibly important piece in helping them feel worthy, connected, and a sense of hope.

Sometimes students come in and they’re in distress, because inherently wilderness therapy is designed to create enough discomfort that they have to develop some new skills to be able to develop resiliency and be able to manage emotions.

Being able to connect on a relational level and on an emotional level really charges me as a person and as a therapist. I enjoy helping inspire and helping people see a way forward, To be honest, we’re not just seeing self harm. It’s usually a whole variety of other issues. I love being able to weed through all the layers and help people understand, yes, there’s this complicated picture, but what is this actually about? I love the human connection. I love emotional work and helping people learn how to deal with their emotions.

MEET THE HOST

Emily Fernandes

Emily Fernandes

Executive Director & Co-Founder

On a wilderness trip in Alaska with the National Outdoor Leadership School (NOLS) in 1995, Emily discovered she could combine two of her passions: working with youth and being outdoors. Since then, she has worked for Aspen Achievement Academy, Hurricane Island Outward Bound School, and Connecticut Wilderness School. She was part of the founding team at Open Sky.

Emily worked as the lead therapist for adolescent girls for her first 5 years at Open Sky. Her areas of clinical expertise include depression, anxiety, grief and loss, trauma, self-harm, disordered eating, and adoption and attachment issues. Her clinical approach is informed by cognitive behavioral, psychodynamic, family systems, and attachment theories. Relationship building through letter writing is a major focus of her work with students and families.

As a founder and owner of Open Sky, as well as the Clinical and Executive Director, Emily brings a breadth of knowledge with her background as a therapist, field guide, trainer, logistics coordinator, emergency responder, and field director, Emily is known for her direct, caring leadership style, her ability to inspire excellence in others, and her team oriented approach. The student treatment plan is her compass for her decision-making regarding Open Sky’s students, families, and employees.

Emily loves reading, writing, yoga, mountain biking, telemark skiing, rock climbing, spending time with friends and family, and cooking with foods from the local farmers’ market.

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