Treatment: What do we know works? Treatment: What do we know works?
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Transcript of Treatment: What do we know works? Treatment: What do we know works?
Treatment:
What do we know works?
Treatment:
What do we know works?
We need to talk in simple and understandable terms about suicide Clearly articulated treatment model and
suicidality as targets Patients can understand and invest
When People drop out of treatment, action needs to be taken immediately to re-engage them Recognize that it is most likely a persistence of
hopelessness Frequently related to “simple things” that block
treatment participation Motivation, ambivalence, and intent to die
What Do Effective Treatments Have in Common?
What Do Effective Treatments Have in Common?
What Do Effective Treatments Have in Common? People that are suicidal have poor skills
‣ Skills deficiencies targeted, not just symptoms
People need to take ownership of their treatment‣ Addressed self-reliance, self-awareness,
individual control‣ Commitment to treatment
People need to know what to do during a crisis‣ Crisis management/access to emergency
services‣ Limited access to method
Provide an understandable model Explain why the suicide attempt(s)
happened The importance of shame, guilt
Contextualize/Normalize the problem Label and reinforce the presence of
ambivalence Reasons for living, reasons
for dying
Facilitating Hope During the First Contact
•It is vital that clients deconstruct their suicidal cycle—explore it, move into it.
•Support clients identifying components; recognizing patterns or themes associated with their cycle Create a narrative of event Construct a timeline
Wenzel, Brown, Beck (2009). Cognitive Therapy for Suicidal Patients; Rudd, Joiner, & Rajab (2001). Treating Suicidal Behavior: An effective, time-limited approach
As long as suicidal clients are unable to understand their suicidal cycle, they remain
victims to it.
As long as suicidal clients are unable to understand their suicidal cycle, they remain
victims to it.
Have patients describe the events and situations and their reactions to these events in as much detail as possible.
Beginning of the story: Major decision point associated
with increased suicide risk Strong emotional reaction to a
specific event External event such as a significant loss Internal event such as an automatic
thoughtsSource: Wenzel, Brown,& Beck (2009)
1. Understand the function of suicidal behavior or thinking from the patient’s perspective; that the behavior “makes sense” to the patient in the context of his or her history, vulnerability, and circumstances.
2. Empathize with the patient’s strong feelings and desire to be reduce distress.
3. Refrain from trying to solve the patient’s problems before understanding the motivations for suicide.
4. Don’t rush the interview!Source: Wenzel, Brown,& Beck (2009)
Criticism from Step-father and Mom
didn’t do anythingStormed off and
isolated self
“I can’t take it anymore. I can’t stand being so
upset so easily like this.”
Angry and Depressed
Anger
“That’s it. I’m doing it. I want to die. I want to end it. I want it to stop.”
Overdosed on 20 sleeping pills
Regrets that the attempt did not
succeed
ACTIVATING EVENTAFFECTIVE RESPONSE
KEY AUTOMATIC THOUGHTS
(MOTIVATION)
SUICIDE ATTEMPTREACTION TO THE
ATTEMPT
KEY AUTOMATIC THOUGHTS (SUICIDE
INTENT)
BEHAVIORAL RESPONSE
AFFECTIVE RESPONSE
Source: Wenzel, Brown, & Beck (2009)
Treatment JournalCoping cardsHope KitDistraction techniquesRelaxation skillsSelf-soothing