Working with suicidal patients

www.thebeverlyhillstherapist.com

Working with

Suicidal Patients

M a p l e C o u n s e l i n g

C e n t e r

M a r k A l l i s o n

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©Mark Allison 2010 www.thebeverlyhillstherapist.com

What we will cover in this

workshop

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History of Suicide

Prevention Hotlines

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Wednesday, October 13, 2010


what the bleep do you know about suicide!

1. More women than men attempt suicide?Women attempt suicide three times as often as men, though men

Die by suicide four times as often as women.

2. More people die by suicide than by homicide?

30,000 die by suicide, 20,000 by homicide!

3. Most suicides are committed by drug overdose?

Actually, most suicides are by gun shot.

4. In the US, Suicides occur most frequently in the Spring?True, People die by suicide more often during spring and summer. The

idea that suicide is more common in the winter holidays is a

misconception.

5. It’s best not to talk about suicide to a depressed client?

Many depressed people have already considered suicide as an option

Discussing it openly helps the suicidal person sort through the problems

And generally provides a sense of relief and understanding.

It’s one of the most helpful things you can do.4



6. In California, if a client tells a therapist that he is going to kill himself, the therapist, by law, must report it?

Kinda of False. In California, the law does not require a licensed

therapist to report a suicide threat by their patient.

Two conditions where it is mandatory:

1. A minor or student at a school

2. If Client threatens to take his own life along with another person

and the indented victim is reasonably identifiable.

7. Suicide rates are generally higher than the national average in the Western states and lower in the Eastern and Midwestern states?

8. Young people who are suicidal often give warning signs

True, According to NAMI, it is highest in the western states...

True. 5



9. Most deaths by suicide can be prevented

True. Well...kind of....

10. The most important predictor of suicide attempt is the presenceof a specific detailed plan, no matter what age or sex the person is.

True, a detailed specific plan should alarm a therapist that

patient is at a higher lethality risk.

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facts and myths about Suicide

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Legal & Ethical Issues

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Legal & Ethical Issues

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What is the point of

this?

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Listen!

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Empathy Vs. Sympathy

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Talking to Suicidal

Patients

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Talking to suicidal

patients on the phone

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Talking to suicidal

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Lethality assessment

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Open ended

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open ended

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closed ended

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flow and followup

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Warning signs

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What’s The Number 1

Warning sign

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Risk factors

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Suicide Risk assessment

1. Are they thinking about killing themselves? (ask directly)

2. Do they have a plan? When?

3. Do they have the means to commit suicide at their hands?

4. Are they alone?

5. Have they been drinking or intoxicated (drugs street or prescription)

6. Have they ever attempted to kill themselves before

7. Is there a gun in the home? Number 1 method for completed suicides

8. Family History of suicide and/or depression

9. Medications

10.Mental illness - Diagnosis

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Suicide

risk

assessment

ESIRE

Ideation Psych Pain Hopeless/Helpless Burden Trapped Alone

AP ABILITY

Priors Attempts Available Means Survivor Violence Intoxicated/Sub. Abuse Mood Change/Out of Touch Anxiety/Insomnia

NTENT

Specific Plan Preparatory Behaviors Intent To Die -

UFFERS

Immediate Supports Social Supports Planning For The Future Engaged With Counselor Ambivalence For Life/Death Core Values/Beliefs Sense Of Purpose

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D.C.I.B


assessment tool

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29


assessment tool

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Capability

30

28

29

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assessment tool

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Capability

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assessment tool

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Intent

32


assessment tool

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Buffers/connectedness

33

31

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33



assessment tool

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Buffers/connectedness

34


Risk Assessment

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35


Assessing the RiskG%(3##+##(&"#6O(+`3C"/+(+3-*(#+-$"%/(IY+#"&+O(H3534"1"$'O(E/$+/$(3/.(m,Q+&#J<(E)(3(C3^%&"$'(%)()3-$%&#("#(!"?*(%&(=%.+&3$+g!"?*O($*3$(-%C5%/+/$("#(5&+#+/$<(m3#+('%,&(&3$"/?(I)&%C(X($%(MJ(%/($*+()%11%7"/?(C%.+1(3/.('%,&(3##+##C+/$($&3"/"/?D

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Suicide Risk Assessment

Scale

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37


Interventions

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38


Interventions

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U<E/-&+3#+.(-1"+/$(-%/$3-$

T<H%1134%&3$"0+(eB-$"%/(F13/f

[<c&?3/"u+(3(U[a*%,&(#,"-".+(73$-*(3C%/?()3C"1'(

3/.()&"+/.#

M<!+15($%(3&&3/?+()%&(3(0%1,/$3&'(*%#5"$31"u3$"%/

V<E/"$"3$+("/0%1,/$3&'(*%#5"$31"u3$"%/(IMKMXJ

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Lethality assessment

summary

K< B#6(."&+-$1'(3&+($*+'(*30"/?($*%,?*$#(34%,$(6"11"/?($*+C#+10+#

U< Y%($*+'(*30+(3(513/8((!%7(#5+-"P-("#("$8(2*+/8

T< E#($*+&+(3--+##($%($*+(C+3/#8

[< !30+($*+'($*%,?*$(34%,$(#,"-".+("/($*+(53#$(U((C%/$*#8

M< B&+($*+'(.&"/6"/?g,/.+&($*+("/l,+/-+8

V< A+-+/$(%&(5&"%&(3$$+C5$#8

W< B&+($*+'(31%/+8

N< :3C"1'(*"#$%&'(%)(#,"-".+(3/.(%&(.+5&+##"%/8

L< =+/$31(E11/+##(I=3^%&(Y+5&+##"%/(Y"#%&.+&Om"a5%13&(+$-J8

KX<B&+($*+'(%/(3/'(C+."-3$"%/#8

KK<Y%($*+'(*30+(3(?,/(%&(3--+##($%(3(?,/8

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Vignettes

k,+#$"%/#

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concluding

thoughts

Y+0+1%5(,/.+&#$3/."/?(3/.($&,#$

>"#$+/()%&(7%&.#(3/.()++1"/?#($*3$("/."-3$+(

#,"-".31($*%,?*$#<

B##+##()%&(#,"-".+(,#"/?(#,"-".+(&"#6(

3##+##C+/$($+-*/"d,+

Y+0+1%5(."&+-$"%/(3/.()%-,#

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Suicide Prevention

Hotline

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Role Play

k,+#$"%/(F+&"%.

H%/-1,#"%/

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End

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Working with suicidal patients

Health & Medicine

Transcript of Working with suicidal patients