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Marshall CA, Crowley P, Carmichael D, Goldszmidt R, Aryobi S, Holmes J, Easton C, Isard R, Murphy S. Effectiveness of Suicide Safety Planning Interventions: A Systematic Review Informing Occupational Therapy. Can J Occup Ther 2022; 90:208-236. [PMID: 36324257 DOI: 10.1177/00084174221132097] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background. Suicide safety planning (SSP) is a suicide prevention approach that involves developing a collaborative plan between a service provider such as an occupational therapist and a person who is at risk of suicide. Purpose. To synthesize effectiveness studies on SSP. Method. Using the Joanna Briggs Institute methodology, we conducted a systematic review of effectiveness studies including a: (1) title and abstract screening; (2) full-text review; (3) critical appraisal; and (4) narrative synthesis. Findings. We included 22 studies. Critical appraisal scores ranged from 38.5 to 92.3 (m = 63.7). The types of interventions included were: standard and enhanced SSP (n = 11); electronically delivered SSP (n = 5); and SSP integrated with other approaches (n = 6). Only three studies identified meaningful activity as a component of SSP. Evidence across a range of studies indicates that SSP is effective for reducing suicide behavior (SB) and ideation (SI). While some studies have demonstrated effectiveness for reducing symptoms of mental illness, promoting resilience and service use, the number of studies exploring these outcomes is currently limited. Implications. Occupational therapists support individuals expressing SI, and SSP is a necessary skill for practice.
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Lundin Å, Bergenheim A. Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists. BMC Psychiatry 2020; 20:597. [PMID: 33375943 PMCID: PMC7771061 DOI: 10.1186/s12888-020-03004-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/07/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. METHODS Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. RESULTS The analysis of the material revealed an overarching theme, Through barriers and taboos - the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. CONCLUSIONS The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.
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Affiliation(s)
- Åse Lundin
- Division of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
- Närhälsan Rehabilitation Centres, Region Västra Götaland, Gothenburg, Sweden.
| | - Anna Bergenheim
- Division of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Närhälsan Rehabilitation Centres, Region Västra Götaland, Gothenburg, Sweden
- Research, Development and Education Centre Fyrbodal, Region Västra Götaland, Vänersborg, Sweden
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Feldman JI, Cassidy M, Liu Y, Kirby AV, Wallace MT, Woynaroski TG. Relations between Sensory Responsiveness and Features of Autism in Children. Brain Sci 2020; 10:brainsci10110775. [PMID: 33114357 PMCID: PMC7690864 DOI: 10.3390/brainsci10110775] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 01/15/2023] Open
Abstract
Autism is a neurodevelopmental condition defined by differences in social communication and by the presence of restricted and repetitive patterns of behavior, interests, and activities (RRBs). Individuals with autism also commonly present with atypical patterns of sensory responsiveness (i.e., hyporesponsiveness, hyperresponsiveness, and sensory seeking), which are theorized to produce cascading effects across other domains of development. The purpose of this study was to examine differences in sensory responsiveness in children with and without autism (ages 8–18 years), as well as relations between patterns of sensory responsiveness and core and related features of autism. Participants were 50 children with autism and 50 non-autistic peers matched on age and sex. A comprehensive clinical battery included multiple measures of sensory responsiveness, core features of autism, adaptive behavior, internalizing behaviors, cognitive ability, and language ability. Groups significantly differed on all three patterns of sensory responsiveness. Some indices of core and related autism features were robustly associated with all three patterns of sensory responsiveness (e.g., RRBs), while others were more strongly associated with discrete patterns of sensory responsiveness (i.e., internalizing problem behaviors and hyperresponsiveness, language and sensory seeking). This study extends prior work to show that differences in sensory responsiveness that are linked with core and related features of autism persist in older children and adolescents on the spectrum.
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Affiliation(s)
- Jacob I. Feldman
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (M.T.W.); (T.G.W.)
- Correspondence: ; Tel.: +1-615-936-5470
| | - Margaret Cassidy
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN 37232, USA; (M.C.); (Y.L.)
- National Institutes of Health, Bethesda, MD 20814, USA
| | - Yupeng Liu
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN 37232, USA; (M.C.); (Y.L.)
- Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Anne V. Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT 84112, USA;
| | - Mark T. Wallace
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (M.T.W.); (T.G.W.)
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN 37232, USA
- Department of Psychology, Vanderbilt University, Nashville, TN 37232, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA
| | - Tiffany G. Woynaroski
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (M.T.W.); (T.G.W.)
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN 37232, USA
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