Post on 06-May-2015
Suicidal patients
THE SUICIDAL PATIENT
Development of a Suicidal Crisis: 1.) faced with a problem that is preceived as unsovable 2.) view problem as continuing despite best efforts to solve it 3.) see suicide as only solution 4.) disregard all other problem solving options 5.) believe that dealth will bring relief
Hopelessness and suicide: Suicidal individuals tend to believe that their difficulties as
both unendurable and unsolvable. View difficulties as insurmountable and feel hopeless in the
face of these problems
Schemata of suicidal patients: 1.) vunerability to loss or abandonment in conjunction with a
belief that others are rejecting, judgemental, and hold unreasonably high expectations for them
2.) perceptions of personal incompetence and helplessness 3.) poor distress tolerance 4.) a perception of defectiveness and unlovability 5.) a belief that it is important to impress others
who are fighting any of these things are at a higher risk for suicide: psychiatric disorder life event stressor, physical illness, personality disorder, social problems
Any individual who presents with suicide symptoms is at risk Prior suicide attempts is a major predictor of suicide Suicide is sometimes an impulsive act
Its not only the life event that is intolerable it is the emotional state that accompanies it
High risk patients need a safe environment and it is the responsibility of the practitioner to ensure and assess that. A patient who have lethal, immediate, and precise suicidal plans will require a safe environment or hospitalization.
Questions about suicide plan, method, and when intended outcome with a precise plan with lethal means arranged for the next 24-48 hours constitutes high risk
Factors to Assess Routinely: A comprehensive suicide risk assessment evaluation of
demographic characteristics, recent life stressors, psychiatric diagnosis, and family history of suicide
Feelings of hopelessness and helplessness and if the client believes that living another day is an endless cycle of emotional pain and distress that will only end by taking their life
Assessments & Qestionaires:1.reasons for living scale (Linehan, 1985) to measure adaptive
characteristics in suicide;
scale for suicide ideation (Beck et al., 1971);
hopelessness scale/Beck Hopelessness Scale (Beck, 1993; Beck et al.,
1974b) to assess degree of suicide risk;
prediction of suicide scale (Beck et al., 1974a);
Los Angeles suicide prevention scale (Los Angeles Center for Suicide
Prevention, 1973);
Beck Depression Inventory II (Beck, 1978; Beck & Steer 1987; Beck et al.,
1961; Beck et al., 1996);
Scale for Assessment of Suicidal Potentiality (Battle, 1985);
PATHOS screening questionnaire (following adolescent deliberate self-harm)
(Kingsbury, 1993).
Crisis-intervention model:Continuing therapy model:
Treatment Modalities:
"primary assumption is that feeling
suicidal is an acute crisis that will pass,
the second assumption is that it is
possible to prevent suicide"
(Pulakos,1993).
"the idea that suicide can be prevented
leads to an emphasis on assessment
and identifying those at high risk"
(Pulakos, 1993).
therapists should assess for suicidality
in depth and repeat idly , hospitalization
is an important therapy adjunt to this
therapy.
focuses more on suicidal behavior and
attempted suicide
"there is an assumption that suicidal
thoughts and behavior may result from
chronic behavior pattern rather than an
acute crisis. chronic suicidal behavior is
viewed as an interpersonal or problem
solving behavior that reflects a persons
style of realting to the world" (Pulakos,
1993)."this is an assumption that
suicidality is a part of the persons life
style" (Pulakos, 1993).
"emphasizes reframing the suicidal
behavior as a problem solving behavior
and working with it as you would any
maladaptive behavior" (Pulakos,1993).
http://www.youtube.com/watch?v=z6idLnw4DY8
References: Overholser, J. C., Braden, A., & Dieter, L. (2012). Understanding suicide
risk: identification of high-risk groups during high-risk times. Journal Of Clinical Psychology, 68(3), 349-361.
doi:10.1002/jclp. 20859 Pulakos, J. (1993). Two models of suicide treatment: Evaluation and recommendations. American Journal Of Psychotherapy, 47(4),
603 Ruddell, P., & Curwen, B. (2002). Understanding suicidal ideation and
assessing for risk. British Journal Of Guidance & Counselling, 30(4), 363-372. doi:10.1080/0306988021000025583
Yufit, R., & Lester, D. (2005). Assessment, treatment, and prevention of suicidal behavior. Hoboken, New Jersey: John Wiley & Sons, Inc.