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Patel SR, Sullivan SR, Mitchell EL, Jager-Hyman S, Stanley B, Goodman M. Qualitative Study of Telehealth Delivery of Suicide-Specific Group Treatment "Project Life Force". JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023; 8:1-10. [PMID: 36618084 PMCID: PMC9811055 DOI: 10.1007/s41347-022-00297-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
Minimal evidence exists for suicide-specific group treatment for high-risk patients offered over telehealth. This qualitative study assessed the acceptability, feasibility, and impact of a telehealth suicide safety planning intervention (SPI) multi-session group. High-risk suicidal Veterans (n = 17) participating in "Project Life Force-telehealth" (PLF-T); a manualized, 10-session SPI video group completed semi-structured qualitative interviews including measures of acceptability, appropriateness, and feasibility. We also interviewed the PLF-T coordinator and PLF-T group facilitators to identify adaptations to deliver PLF-T and learn about barriers and facilitators to implementation. A summary template and matrix analysis approach was used to analyze qualitative data. Veteran group participants were mostly male (88%), age 50 (SD = 15.6), ethnically diverse, and either divorced or separated (54%). Suicide symptoms upon study entry included past month ideation with methods (100%); and past year aborted, interrupted, or actual suicide attempt (59%). Participant interviews revealed an overall positive endorsement of PLF-telehealth with enhanced suicidal disclosure, and improved ability to manage urges and mitigate loneliness. On scales from 1 to 20, PLF-T was rated as highly acceptable (M = 17.50; SD = 2.92), appropriate (M = 17.25; SD = 3.59), and feasible (M = 18; SD = 2.45) by participants. Adaptations to deliver PLF-T included using a communications coordinator to conduct assertive outreach and engagement, adding a telehealth orientation session, restructuring sessions to review suicide severity, and screen-sharing safety plans to maximize learning. PLF-T enhanced convenience and access without compromising safety. Concerns included privacy and technological limitations including connectivity. Project Life Force-telehealth is acceptable and feasible to deliver via telehealth. This opens the possibility of delivery to hard-to-reach high-risk populations. ClinicalTrials.gov Identifier: NCT0365363.
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Affiliation(s)
- Sapana R. Patel
- The New York State Psychiatric Institute, New York, NY USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 100, New York, NY 10032 USA
| | - Sarah R. Sullivan
- Veterans Integrated Service Network (VISN), 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters Veterans Affairs Medical Center, Bronx, NY USA
- Hunter College and The Graduate Center, City University of New York, New York, NY USA
| | - Emily L. Mitchell
- Veterans Integrated Service Network (VISN), 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters Veterans Affairs Medical Center, Bronx, NY USA
| | - Shari Jager-Hyman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Corporal Michael Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
| | - Barbara Stanley
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 100, New York, NY 10032 USA
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY USA
| | - Marianne Goodman
- Veterans Integrated Service Network (VISN), 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters Veterans Affairs Medical Center, Bronx, NY USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
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Chammas F, Januel D, Bouaziz N. Inpatient suicide in psychiatric settings: Evaluation of current prevention measures. Front Psychiatry 2022; 13:997974. [PMID: 36386981 PMCID: PMC9650354 DOI: 10.3389/fpsyt.2022.997974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/05/2022] [Indexed: 12/01/2022] Open
Abstract
The risk of suicide in psychiatric hospitals is 50 times higher than in the general population, despite patient safety being a priority for any hospital. However, to date, due to the complexity of assessing suicide risk, there has been no consensus on the suicide prevention measures that should be in place in hospitals. The aim of this work is: To provide an overview of the progress that has been made in the field of inpatient suicide prevention in recent years; discuss the problems that remain; and suggest potential future developments. As new clinical dimensions (notably anhedonia, psychological pain and hopelessness) develop, they should become new therapeutic targets. Team training (like the Gatekeeper Training Program) and the latest advances in suicide risk assessment (such as the Collaborative Assessment and Management of Suicidality) should be implemented in psychiatric wards. Suicide prevention plans (e.g., ASSIP, SAFE-T, etc.) represent easy-to-administer, low-cost interventions. The Mental Health Environment of Care Checklist has been proven effective to reduce suicide risk at hospitals. Furthermore, the types of psychotherapy recommended to reduce suicide risk are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). There are several pharmacological treatments for suicide risk, such as lithium and clozapine, which have been shown to be effective in the long term, as well as ketamine and esketamine, which are more effective in the short term. Following some encouraging recent results, buprenorphine may also be proposed to patients with a suicide risk. Triple chronotherapy rapidly improves depressive symptoms over 9 weeks. Regarding brain stimulation techniques, rTMS has proven to be effective in alleviating multiple dimensions of suicidality.
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Affiliation(s)
- Francesca Chammas
- Centre de Recherche Clinique, EPS Ville-Evrard, Neuilly-sur-Marne, France
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Sufrate-Sorzano T, Pérez J, Juárez-Vela R, Garrote-Cámara M, de Viñaspre RR, Molina-Luque F, Santolalla-Arnedo I. Umbrella review of nursing interventions NIC for the treatment and prevention of suicidal behavior. Int J Nurs Knowl 2022. [PMID: 35997164 DOI: 10.1111/2047-3095.12392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this umbrella review was to determine the most effective nursing interventions for the prevention and management of suicidal behavior. In order to do so, the review identifies interventions from the Nursing Interventions Classifications taxonomy with evidence to this end. METHODS A systematic search was conducted for systematic reviews included in the PubMed, CINAHL, Cochrane, Scopus, Web of Knowledge, and Joanna Briggs Institute databases between January 1, 2011 and May 1, 2020. FINDINGS The review is made up of 21 systematic reviews. In order to carefully analyze the interventions described, these were coded into categories, grouping the interventions into those based on psychological therapy, interventions related to pharmacotherapy, interventions related to the professional relationship between health professional and patient, and interventions aimed at the general public. CONCLUSIONS Nursing interventions for suicide risk management are prevalent in the scientific literature and are shown to be effective for patients with suicidal ideation or suicide attempts. Prevention and treatment of suicidal behavior require the provision of coping tools, behavioral interventions that directly address suicidal thoughts and behaviors, and support through therapeutic partnerships, among others. IMPLICATIONS FOR NURSING PRACTICE This paper synthesizes the most current evidence on the most effective Nursing Interventions Classifications interventions for the treatment and prevention of suicidal behavior. It provides nursing practitioners with a comprehensive review of the therapeutic interventions with the best evidence and is useful for the development of clinical guidelines and protocols, as well as for the development of health policies and plans.
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Affiliation(s)
- Teresa Sufrate-Sorzano
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain.,Department of Nursing, GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Jesús Pérez
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Raúl Juárez-Vela
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain.,Department of Nursing, GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - MaríaElena Garrote-Cámara
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain
| | - Regina Ruiz de Viñaspre
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain
| | - Fidel Molina-Luque
- Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain.,Group for the Study of Society, Health, Education and Culture (GESEC). University of Lleida, Lleida, Spain.,Research Institute in Social and Territorial Development (INDEST), University of Lleida, Lleida, Spain
| | - Iván Santolalla-Arnedo
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain.,Department of Nursing, GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
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Parra LA, van Bergen DD, Dumon E, Kretschmer T, La Roi C, Portzky G, Frost DM. Family Belongingness Attenuates Entrapment and Buffers Its Association with Suicidal Ideation in a Sample of Dutch Sexual Minority Emerging Adults. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:983-1001. [PMID: 33398694 DOI: 10.1007/s10508-020-01838-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 05/17/2023]
Abstract
Sexual minority emerging adults are more likely to engage in suicidal ideation than their heterosexual counterparts. Experiences of homophobic violence are associated with suicidal ideation. Yet, the specific mechanisms linking homophobic violence to suicidal ideation remain unclear. Entrapment and social belongingness were tested to determine their relevance for understanding the link between homophobic violence and suicidal ideation. A sample of sexual minority Dutch emerging adults (N = 675; ages 18-29, M = 21.93 years, SD = 3.20) were recruited through online platforms and flyers. Homophobic violence was expected to be positively associated with suicidal ideation and entrapment. The association between homophobic violence and suicidal ideation was expected to be indirectly linked through entrapment. We explored whether various sources of social belongingness moderated the path between entrapment and suicidal ideation and whether those sources of social belongingness moderated the indirect effect of homophobic violence on suicidal ideation through entrapment. Results showed that homophobic violence and entrapment were positively associated with suicidal ideation and that family belongingness was negatively associated with suicidal ideation. Homophobic violence and suicidal ideation were not indirectly linked through entrapment. The interaction effect between entrapment and family belongingness was significant, suggesting that, on average, the effect of entrapment on suicidal ideation decreased when family belongingness was high. These results suggest that family belongingness may reduce the association between entrapment and suicidal ideation while adjusting for homophonic violence. Reducing entrapment and improving family belongingness may be useful targets for programs aimed at preventing suicidal ideation among sexual minority emerging adults.
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Affiliation(s)
- Luis A Parra
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA.
- Department of Human Ecology, University of California, Davis, Davis, CA, USA.
- Center for Mind and Brain, University of California, Davis, Davis, CA, USA.
| | - Diana D van Bergen
- Department of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Eva Dumon
- Department of Head and Skin, Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium
| | - Tina Kretschmer
- Department of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Chaïm La Roi
- Institute for Futures Studies, Stockholm, Sweden
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Gwendolyn Portzky
- Department of Head and Skin, Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium
| | - David M Frost
- Department of Social Science, University College London, London, UK
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Lutz J, Mashal N, Kramer A, Suresh M, Gould C, Jordan JT, Wetherell JL, Beaudreau SA. A Case Report of Problem Solving Therapy for Reducing Suicide Risk in Older Adults with Anxiety Disorders. Clin Gerontol 2020; 43:110-117. [PMID: 31131742 DOI: 10.1080/07317115.2019.1617378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objectives: Suicide is a global public health problem among older adults. Problem-solving therapy (PST) has demonstrated promise in reducing late-life suicide risk, chiefly in secondary analyses of studies on late-life depression. PST mitigates negative beliefs about one's problem-solving abilities and maladaptive problem-solving styles, which suicidal older adults report. The effects of PST on suicide risk in older adults with primary anxiety disorder diagnoses have not been examined. Anxiety is a risk factor for suicide, but it is less studied in research on suicide compared to depression. This paper describes two cases of older individuals with anxiety disorders and suicidal ideation who completed six sessions of PST. Methods: Assessments of suicide risk, anxiety, depressive symptoms, and problem-solving ability were administered. Results: Both cases exhibited a clinically significant reduction in suicide risk, along with reductions in anxiety, worry, and depressive symptoms by posttreatment. Conclusions & Clinical Implications: Findings highlight the potential for PST as a psychotherapeutic intervention for reducing suicide risk in older adults with anxiety disorders.
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Affiliation(s)
- Julie Lutz
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA
| | - Nehjla Mashal
- General Psychiatry Outpatient Services, VA San Francisco Health Care System, San Francisco, CA, USA
| | - Abigail Kramer
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA.,Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Madhuvanthi Suresh
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA.,Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Christine Gould
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Joshua T Jordan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Julie Loebach Wetherell
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sherry A Beaudreau
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Awenat YF, Peters S, Gooding PA, Pratt D, Shaw-Núñez E, Harris K, Haddock G. A qualitative analysis of suicidal psychiatric inpatients views and expectations of psychological therapy to counter suicidal thoughts, acts and deaths. BMC Psychiatry 2018; 18:334. [PMID: 30326878 PMCID: PMC6192165 DOI: 10.1186/s12888-018-1921-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/02/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Suicide is a global problem and suicidal behavior is common in acute psychiatric wards. Inpatient suicides regularly occur with 10.4/100,000 such deaths recorded in the UK in 2016. Inpatient suicides are potentially the most avoidable of all suicides as inpatients have 24-h staff contact. Current inpatient treatment prioritizes maintenance of physical safety by observation, medication and general supportive measures, however efficacious and effective specific treatments are lacking. Psychological treatments have a growing evidence base for suicide prevention yet provision of inpatient therapy is uncommon. The present qualitative study aimed to understand the patient acceptability issues by investigating suicidal inpatients views and expectations of a novel suicide-focussed cognitive behavioural psychological therapy which was nested alongside a pilot clinical trial of the intervention. METHODS Thematic analysis of semi-structured individual qualitative interviews with twenty suicidal psychiatric inpatients to investigate their views and expectations about ward-based suicide-focused psychological treatment. RESULTS Two main themes were identified. The first, 'A therapy that works', revealed inpatients' views of the necessary components for effective ward-based suicide-focused psychological therapy. The second, 'Concerns about in-patient suicide-focused therapy', depicted their fears about engaging in this treatment. Results suggested that suicide-focused psychological therapy was cautiously welcomed by inpatients' whose narratives expressed their needs, priorities and concerns. Further data analysis enabled formation of a user-informed model of suicide-focussed psychological therapy which offers guidance for researchers and clinicians. CONCLUSIONS We conclude that hospitalization of suicidal individuals offers a critical opportunity to intervene with effective treatment to preserve life and that suicide-focussed psychological therapy is likely to be well received by suicidal inpatients warranting further testing with a sufficiently powered definitive trial. It is important that provision of ward-based psychological therapy for suicidal inpatients addresses the considerable context-specific challenges inherent in this setting. TRIAL REGISTRATION NUMBER ISRCTN 17890126 , Registry: UK Clinical Trials Gateway, Date of registration: 22/04/15, Date of enrolment of first participant to the trial: 20/05/14 (retrospectively registered).
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Affiliation(s)
- Yvonne F Awenat
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Zochonis Building, Brunswick St, Manchester, M13 9PL UK
- Manchester Academic Health Science Centre, MAHSC, Manchester, UK
- Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Zochonis Building, Brunswick St, Manchester, M13 9PL UK
- Manchester Academic Health Science Centre, MAHSC, Manchester, UK
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Patricia A Gooding
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Zochonis Building, Brunswick St, Manchester, M13 9PL UK
- Manchester Academic Health Science Centre, MAHSC, Manchester, UK
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Zochonis Building, Brunswick St, Manchester, M13 9PL UK
- Manchester Academic Health Science Centre, MAHSC, Manchester, UK
- Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Emma Shaw-Núñez
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Zochonis Building, Brunswick St, Manchester, M13 9PL UK
- Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Kamelia Harris
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Zochonis Building, Brunswick St, Manchester, M13 9PL UK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Zochonis Building, Brunswick St, Manchester, M13 9PL UK
- Manchester Academic Health Science Centre, MAHSC, Manchester, UK
- Greater Manchester Mental Health NHS Trust, Manchester, UK
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Bedford LA, Dietch JR, Taylor DJ, Boals A, Zayfert C. Computer-Guided Problem-Solving Treatment for Depression, PTSD, and Insomnia Symptoms in Student Veterans: A Pilot Randomized Controlled Trial. Behav Ther 2018; 49:756-767. [PMID: 30146142 DOI: 10.1016/j.beth.2017.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/18/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
Depression is a highly prevalent psychological disorder experienced disproportionately by college student military veterans with many deleterious effects including risk for suicide. Treatment can help, but the debilitating nature of depression often makes seeking in-person treatment difficult and many are deterred by stigma, inconvenience, concerns about privacy, or a preference to manage problems themselves. The current study examines the efficacy of a computer-guided Problem-Solving Treatment (ePST®) for reducing symptoms of depression, posttraumatic stress disorder (PTSD), and insomnia in student military veterans. Twenty-four student veterans (Meanage = 32.7) with symptoms of depression were randomly assigned either to a treatment group receiving six weekly sessions of ePST or to a minimal contact control group (MCC). Participants completed the Patient Health Questionnaire-9 (PHQ-9) depression scale at baseline and then weekly through post-ePST or post-MCC. PTSD and insomnia questionnaires were also completed at baseline and posttreatment. A linear mixed model regression showed a statistically significant Group (ePST vs. MCC) × Time (pretreatment through posttreatment) interaction for depression, with the ePST showing substantial improvements in depressive symptoms over the 6-week period. Significant improvements were also seen in PTSD and insomnia symptoms. Results suggest that ePST can effectively treat depression, PTSD, and insomnia symptoms in student military veterans and may be a viable alternative for those who are not able to access live therapy. Future work should examine the durability of treatment effects and utility for more severe depression and suicide prevention.
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Health Professionals Facing Suicidal Patients: What Are Their Clinical Practices? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061210. [PMID: 29890677 PMCID: PMC6024946 DOI: 10.3390/ijerph15061210] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/05/2018] [Accepted: 06/05/2018] [Indexed: 12/15/2022]
Abstract
Clinical work with suicidal people is a demanding area. Little is known about health professionals’ practices when faced with suicidal patients. The aims of this study were to: (1) describe the practices most likely to be adopted by professionals facing a suicidal patient and (2) analyze the differences according to professional characteristics (group, specific training on suicide, and experience with suicidal patients). A self-report questionnaire that was developed for this study was filled out by 239 participants. Participants were psychologists, psychiatrists, and general practitioners who work in different contexts: hospitals, public health centres, schools or colleges, and community centres. Principal components analysis, analyses of variance, and t-tests were used. Four components were identified: (1) Comprehensive risk assessment; (2) protocols, psychotherapy and connectedness; (3) multidisciplinary clinical approach; and, (4) family, explaining a total of variance of 44%. Positive associations between suicide-related variables (training and experience) and practices were found. In general, health professionals’ practices are evidence-based, however a relevant percentage of professionals can benefit from training and improve their practices.
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Ward-Ciesielski EF, Tidik JA, Edwards AJ, Linehan MM. Comparing brief interventions for suicidal individuals not engaged in treatment: A randomized clinical trial. J Affect Disord 2017; 222:153-161. [PMID: 28709022 PMCID: PMC5558839 DOI: 10.1016/j.jad.2017.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/25/2017] [Accepted: 07/05/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Non-treatment-engaged individuals experiencing suicidal thoughts have been largely overlooked in the intervention literature, despite reviews suggesting most individuals who die by suicide were not in treatment immediately prior to their death. Most intervention studies recruit individuals from treatment providers, potentially neglecting those individuals who are not already engaged in services. These individuals clearly represent a group in need of additional empirical attention. METHODS A randomized clinical trial was conducted to compare a single-session dialectical behavior therapy skills-based intervention to a relaxation training control condition. Ninety-three non-treatment-engaged subjects participated in a single in-person assessment, received one of the intervention protocols, and completed follow-up phone interviews for three months including measures of suicidal ideation, emotion dysregulation, and coping skills, as well as other relevant assessments. RESULTS Both conditions reported significantly reduced levels of suicidal ideation, depression, and anxiety; however, analyses revealed no significant differences between conditions on the main outcome measures of suicidal ideation, emotion dysregulation, skills use, depression, or anxiety. LIMITATIONS The two interventions may have been too similar to permit detection of differential effects with this sample size. Specifically, the control condition may have been too active and there may have been stylistic overlap by providers who delivered both interventions. CONCLUSIONS Encouragingly, half of subjects contacted other mental health services during the follow-up period. Although the two interventions under investigation did not yield differential results, the significant changes in important domains across interventions suggest that brief interventions may hold promise for this difficult-to-reach population.
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Affiliation(s)
- Erin F. Ward-Ciesielski
- University of Washington, 3935 University Way NE, Seattle, WA 98195,Hofstra University, 135 Hofstra University, Hempstead, NY 11549,Corresponding author at (Permanent Address): Erin F. Ward-Ciesielski, Ph.D. Hofstra University Department of Psychology, 135 Hofstra University, Hempstead, NY 11550. Tel.: + 516-463-7608,
| | - Julia A. Tidik
- University of Washington, 3935 University Way NE, Seattle, WA 98195
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Abstract
BACKGROUND Suicide is a pervasive and complex issue that can challenge counselors through the course of their careers. Research and practice focus heavily on crisis management and imminent risk rather than early intervention strategies. Early intervention strategies can assist counselors working with clients who have suicidal ideation, but are not at imminent risk, or with clients whose risk factors identify them as having a stronger trajectory for suicidal ideation. AIMS This systematic literature review examines the current literature on working with clients with suicidal ideation who are not at imminent risk, to ascertain the types of information and strategies available to counselors working with this client group. METHOD An initial 622 articles were identified for analysis and from these 24 were included in the final review, which was synthesized using a narrative approach. RESULTS Results indicate that research into early intervention strategies is extremely limited. CONCLUSION It was possible to describe emergent themes and practice guidelines to assist counselors working with clients with suicidal ideation but not at imminent risk.
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Affiliation(s)
- Kate Monaghan
- 1 University of Tasmania, School of Health Sciences, Faculty of Health, Launceston, Tasmania, Australia
| | - Martin Harris
- 2 University of Tasmania, Centre for Rural Health, School of Health Sciences, Faculty of Health, Launceston, Tasmania, Australia
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11
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Moore H, Donohue G. The impact of suicide prevention on experienced Irish clinicians. COUNSELLING & PSYCHOTHERAPY RESEARCH 2016. [DOI: 10.1002/capr.12060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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