This is a book for clinicians who specialize in helping trauma survivors and, through the course of treatment, find themselves unexpectedly confronted with client disclosures of self-destructive behaviors, including self-mutilation and other manifestations of deliberately "hurting the body" such as bingeing, purging, starving, substance abuse and other addictive behaviors. Arguing that standard safety contracts are not effective, the book introduces viable treatment alternatives, assessment tools, and new ways of understanding self-destructive behavior using a strengths-based approach that distinguishes between the "experimental" Non-Suicidal Self-Injury (NSSI) that some teenagers occasionally engage in, and the self-destructive behaviors that are repetitive and chronic. It also explores a cycle of behavior and uses case studies to show clinicians how to personalize the cycle with clients and form a template for treatment. In its final sections the book focuses on counter-transferential responses and the different ways in which therapists can work with self-destructive behaviors and avoid vicarious traumatization by adopting tools and strategies for self-care.