The Genesis of S.A.F.E. ALTERNATIVES®

By Karen Conterio

In the early 80’s I was reading the newspaper and I came across an advertisement in the TV Guide regarding a Chicago hospital that treated self-mutilation.  Coincidentally, I was in school to become a certified group facilitator.  One of the criteria for graduation was developing and facilitating a psychotherapy group.  Having been formally trained in the substance abuse field, I didn’t want to facilitate a group for alcoholics because that population was already well served. Due to what others have called my “maverick” personality, I wanted to do something that had not yet been done.  Therefore, I contacted the aforementioned hospital and was put in touch with the medical director.

As it turned out the hospital didn’t actually have any formalized treatment for self-injurers.  I asked if I could try to develop a group for this population.  I was told that such a service would be much needed and that they found my proposal intriguing.   They also offered space and one client with whom I could work.

Being trained as a group facilitator, working with one client would not be feasible.  I explained the situation to the client and together we embarked on a mission to find more members for the group.  I went to the Chicago Tribune and asked one of the writers if she would be willing to do a story on self-mutilation. The writer agreed. Shortly thereafter the story ran as the lead in the Tempo section of the Chicago Tribune. This was probably the first non-clinical media coverage of self-mutilation.

One week later I contacted a local T.V. show called AM Chicago.  The show was newly hosted by a relatively unknown personality, by the name of Oprah Winfrey.  I spoke with them about producing a segment on self-mutilation.  The suggestion was met with disbelief that this behavior even existed, and they requested that something be sent to them in writing.  I then sent the Chicago Tribune article and was booked for the show one week later.  AM Chicago was the first local show to provide an open discussion of self-injury.  This show was nominated for an Emmy.

From there, AM Chicago contacted a producer from “People Are Talking”, Ms. Winfrey’s previous employer and told them about the program.  “People are Talking” in-turn requested that I appear on their show in Baltimore.

Within one month’s time there were other requests for interviews and television appearances.  I gained confidence in my message and decided to seek a national audience with shows such as Phil Donahue.  In 1985 the Phil Donahue Show was the first national T.V. program to feature the topic of self-injury. 

The name “S.A.F.E. ALTERNATIVES” (Self Abuse Finally Ends) originated on my trip home from the Phil Donahue show.

After being on the Donahue show, I was contacted by a psychiatrist named Armando Favazza, M.D., about the possibility of collaborating on research.  During this early period, I had been in the process of developing a survey for people who self-injure.  Favazza and I enhanced the survey, and a university enthusiastically partook in the dissemination of that survey.  There were 1,250 surveys sent in which at the time of publication (1986) was the largest study to date, conducted on self-injury.

Over the next year there were numerous talk shows and print media requests. The psychotherapy group I had started now swelled to 20 members.  I often found myself saying “be careful what you ask for.”

The psychiatrist who had originally offered me space was medical director of another hospital in Chicago.  He asked if I would collaborate on an inpatient program at Hartgrove Hospital along with the Director of the Woman’s Program, Dr. Wendy Lader, Ph.D.

When the idea was proposed to add a track for people who intentionally harm themselves to Dr. Lader’s Program, she was highly skeptical and extremely concerned about the fit.  In short time, I made Dr. Lader a believer in the possibilities of such a program.

In April of 1986 the new program was formed.  The name of the program was the Program for the Treatment of Self Injury or PITSI.  It was a 30-day inpatient treatment program, which was, at the time, considered short term.  The PITSI program was housed at Hartgrove Hospital in Chicago for 10 years.  With the advent of managed care, it became increasingly difficult to get approval for the full 30 days.  In an effort to stay viable, a “step-down” component was added allowing the program to maintain its overall success rate.  While not ideal, we adjusted the program to meet the changing times, while simultaneously refusing to compromise on maintaining our exacting standards for excellence in care.

In the mid 90’s a name change was needed. The name of the program changed to S.A.F.E. ALTERNATIVES®.

When the “Oprah Winfrey Show” moved to a national audience, Dr. Lader and I were invited to be on the show.  This was the second national audience to hear about the S.A.F.E. ALTERNATIVES® Program.

Wendy Lader and I were able to envision the possibility that hospital care could become increasingly more difficult to obtain which is why we initially wrote the book “Bodily Harm: The Breakthrough Healing Program for Self-Injurers“. The hope was that even those who are unable to access intensive inpatient specialized care, would be able to better understand the goals of treatment and follow guidelines outlined in the book for getting the help they needed.

In 2001, Michelle Seliner, MSW, LCSW (current owner and Clinical Director of S.A.F.E. ALTERNATIVES®) joined the program.  Her leadership enabled Dr. Lader and I to focus on expanding S.A.F.E. through national speaking engagements, product development and vast media exposure (see S.A.F.E. in the News). Collaboratively along with our treatment team the program expanded to meet the needs of the growing number of adolescent self-injurers, then went on to complete the continuum of care for adults and adolescents with a weekly group psychotherapy program (see S.A.F.E Choice™) and individual/family therapy (see S.A.F.E. Clinic). The S.A.F.E. Program provides the foundation from which recovery from self-injury begins.

S.A.F.E. ALTERNATIVES® Programs currently operate in St. Louis, Missouri.  Our goal is to provide our clinical expertise and experience to those who wish to end the pain of self-injury and believe that ‘Quality of Life is a Choice.’

Karen Conterio

Karen Conterio