I used this book as a "book club" case study in a graduate-level special education course. This story follows the author's life and struggle with cutting and self mutilation. Kettlewell is candid and does not sugarcoat, allowing the reader to experience her raw emotions and struggle with family, fitting in, and other developmentally appropriate rights-of-passage. Because Kettlewell is so thorough in her writing and covers the range of her entire life, this book is an important read for those who are studying special education, social work, psychology, or psychiatry. If you want to read more about cutting and self mutilation, I recommend "Cut" by Patricia McCormick in addition to "Skin Game."