Psychotherapists' Experience of Working with Suicidal Clients

Psychotherapists' Experience of Working with Suicidal Clients PDF Author: Tina Podlogar
Publisher:
ISBN:
Category :
Languages : en
Pages : 253

Get Book

Book Description
Suicidality does not fit into the traditional medical illness model. Working with suicidal clients requires unique therapeutic approaches and is frequently referred to as one of the most demanding aspects of therapeutic work. Providing effective treatment and care for help-seeking suicidal individuals is of crucial importance. However, it cannot be automatically assumed that all mental health professionals feel competent to work with clients who are suicidal. Intriguingly, specific training in suicidality is frequently overlooked by psychological and medical study programs, even though such training has the potential to improve suicide intervention skills. Mental health professionals encounter different difficulties and challenges when faced with clients that experience suicidal ideation and/or have engaged in suicidal behaviour before or during treatment. We believe that it is essential to study professionals' experiences both from the point of view of providing high-quality care for the clients, as well as from the point of view of professionals' own well-being and mental health. With the aim to gain an overview and at the same time and in-depth understanding of their experiences, we conducted a study with a combination of quantitative and qualitative methods. Participants of the quantitative part of the study were 106 professionals (19 men and 87 women) with an educational background in psychology, medicine or other fields, who are working in the field of mental health. They reported having at least one experience of treatment of a suicidal client. The collection of data with the questionnaires took place between October 2017 and January 2019. The questionnaires inquired about participants' socio-demographic and professional characteristics, difficulties experienced in working with suicidal clients, attitudes toward suicide prevention, and coping strategies (constructive and avoidant) used under challenging situations in therapeutic or counselling work. The analysis of quantitative data was carried out with the SPSS program. Eleven psychotherapists (four men and seven women) participated in the qualitative part of the study. Semi-structured individual interviews that lasted approximately one hour were conducted between January and November 2018. The interviews focused primarily on topics of therapeutic alliance, therapists' experiences of suicidality peak in the clients, therapists' suicidality-related attitudes, knowledge and understanding, therapists' emotions, difficulties experienced in practice with suicidal clients and resources, and crisis management. The qualitative data was analysed by the principles of grounded theory with the use of ATLAS.ti program. On average, participants are relatively confident in their competence for working with suicidal clients. On the other hand, they also experience a certain level of difficulties with regards to working with suicidal clients. Importantly, participants that received a suicidality-related training feel more competent than those who did not receive such training. Higher self-assessed competence is, in turn, related to a lower frequency of experiencing different types of difficulties in practice with suicidal clients. While other factors, related to experiencing difficulties (e.g. attitudes), were also identified, confidence in own competence seems to be a strong predictor of most types of difficulties. Analysis of qualitative data resulted in identification of nine themes and 32 subthemes. The themes are grounded on 919 quotations, coded with 261 codes and 18 smart codes. On the basis of the findings, we developed a model of dynamic balance in therapists' experiences and views on working with suicidal clients. The model includes six core themes, each of them representing an aspect of therapists' experience and views where a dynamic balance is needed between two different poles. The core themes are: (i) understanding of suicidality: the general vs. specific; (ii) the role of alliance: protective factor vs. no guarantees; (iii) attitudes: acceptant vs. life oriented; (iv) emotional response: worry vs. trust; (v) responsibility: therapist's professionality vs. client's autonomy; and (vi) focus: suicidality vs. individual as a person. The model also takes into account other variables that may be relevant to the process and outcomes of the therapy: contextual factors (variables related to system regulations and therapeutic setting) and variables, related to the therapist in a general sense and the client (including the client's family). Finally, the model considers the outcomes of the process for the therapist and the client. The findings have the potential to be useful for mental health professionals and psychotherapists in understanding different aspects of their experience and difficulties that they may encounter when working with suicidal clients. We believe that adequate suicidality-related training should be provided to professionals who are working with suicidal clients. Further on, the findings (especially the model) may also aid the therapists in identifying aspects of their experience that should be considered and worked on, e.g. in different forms of professional support.

Psychotherapists' Experience of Working with Suicidal Clients

Psychotherapists' Experience of Working with Suicidal Clients PDF Author: Tina Podlogar
Publisher:
ISBN:
Category :
Languages : en
Pages : 253

View

Book Description
Suicidality does not fit into the traditional medical illness model. Working with suicidal clients requires unique therapeutic approaches and is frequently referred to as one of the most demanding aspects of therapeutic work. Providing effective treatment and care for help-seeking suicidal individuals is of crucial importance. However, it cannot be automatically assumed that all mental health professionals feel competent to work with clients who are suicidal. Intriguingly, specific training in suicidality is frequently overlooked by psychological and medical study programs, even though such training has the potential to improve suicide intervention skills. Mental health professionals encounter different difficulties and challenges when faced with clients that experience suicidal ideation and/or have engaged in suicidal behaviour before or during treatment. We believe that it is essential to study professionals' experiences both from the point of view of providing high-quality care for the clients, as well as from the point of view of professionals' own well-being and mental health. With the aim to gain an overview and at the same time and in-depth understanding of their experiences, we conducted a study with a combination of quantitative and qualitative methods. Participants of the quantitative part of the study were 106 professionals (19 men and 87 women) with an educational background in psychology, medicine or other fields, who are working in the field of mental health. They reported having at least one experience of treatment of a suicidal client. The collection of data with the questionnaires took place between October 2017 and January 2019. The questionnaires inquired about participants' socio-demographic and professional characteristics, difficulties experienced in working with suicidal clients, attitudes toward suicide prevention, and coping strategies (constructive and avoidant) used under challenging situations in therapeutic or counselling work. The analysis of quantitative data was carried out with the SPSS program. Eleven psychotherapists (four men and seven women) participated in the qualitative part of the study. Semi-structured individual interviews that lasted approximately one hour were conducted between January and November 2018. The interviews focused primarily on topics of therapeutic alliance, therapists' experiences of suicidality peak in the clients, therapists' suicidality-related attitudes, knowledge and understanding, therapists' emotions, difficulties experienced in practice with suicidal clients and resources, and crisis management. The qualitative data was analysed by the principles of grounded theory with the use of ATLAS.ti program. On average, participants are relatively confident in their competence for working with suicidal clients. On the other hand, they also experience a certain level of difficulties with regards to working with suicidal clients. Importantly, participants that received a suicidality-related training feel more competent than those who did not receive such training. Higher self-assessed competence is, in turn, related to a lower frequency of experiencing different types of difficulties in practice with suicidal clients. While other factors, related to experiencing difficulties (e.g. attitudes), were also identified, confidence in own competence seems to be a strong predictor of most types of difficulties. Analysis of qualitative data resulted in identification of nine themes and 32 subthemes. The themes are grounded on 919 quotations, coded with 261 codes and 18 smart codes. On the basis of the findings, we developed a model of dynamic balance in therapists' experiences and views on working with suicidal clients. The model includes six core themes, each of them representing an aspect of therapists' experience and views where a dynamic balance is needed between two different poles. The core themes are: (i) understanding of suicidality: the general vs. specific; (ii) the role of alliance: protective factor vs. no guarantees; (iii) attitudes: acceptant vs. life oriented; (iv) emotional response: worry vs. trust; (v) responsibility: therapist's professionality vs. client's autonomy; and (vi) focus: suicidality vs. individual as a person. The model also takes into account other variables that may be relevant to the process and outcomes of the therapy: contextual factors (variables related to system regulations and therapeutic setting) and variables, related to the therapist in a general sense and the client (including the client's family). Finally, the model considers the outcomes of the process for the therapist and the client. The findings have the potential to be useful for mental health professionals and psychotherapists in understanding different aspects of their experience and difficulties that they may encounter when working with suicidal clients. We believe that adequate suicidality-related training should be provided to professionals who are working with suicidal clients. Further on, the findings (especially the model) may also aid the therapists in identifying aspects of their experience that should be considered and worked on, e.g. in different forms of professional support.

Therapists' Experiences of Counselling Suicidal Clients

Therapists' Experiences of Counselling Suicidal Clients PDF Author: Joan Louise Mackay
Publisher:
ISBN:
Category : Suicidal behavior
Languages : en
Pages : 254

View

Book Description


Therapists' Experiences of Counselling Suicidal Clients [microform]

Therapists' Experiences of Counselling Suicidal Clients [microform] PDF Author: Joan Louise MacKay
Publisher: National Library of Canada = Bibliothèque nationale du Canada
ISBN:
Category : Suicidal behavior
Languages : en
Pages : 254

View

Book Description


Counselling Suicidal Clients

Counselling Suicidal Clients PDF Author: Andrew Reeves
Publisher: SAGE
ISBN: 1446204855
Category : Psychology
Languages : en
Pages : 200

View

Book Description
"I have worked in psychiatry as well as in private practice with suicidal people. I found it poignant and true when Reeves points out that people do not have to be mad to be suicidal and '...that assessing suicide potential fundamentally lies in engaging with the suicidal client at a deeper relational level'. So true. This thoroughly researched book is written with passion and compassion. It will be a valuable addition to the libraries of therapists and anyone else who works with suicidal people." - Therapy Today, July 2010 "A uniquely accessible, comprehensive and practical guide. Essential reading for counsellors and psychotherapists and all helping professionals who work with clients at risk of suicide." - Mick Cooper, Professor of Counselling, University of Strathclyde "A 'must read' for counsellors of all experience levels, offering sound practical strategies alongside thought-provoking case studies and discussion points. Reeves addresses this difficult topic with depth, breadth and integrity. Excellent." - Denise Meyer, developer and lead author of www.studentdepression.org "Andrew Reeves brings together his experience as a social worker, counsellor and academic to explore the essential elements in working with suicidal clients. His openness and integrity in writing about this complex topic creates a valuable resource for reflective practice." - Barbara Mitchels, Solicitor and Director of Watershed Counselling Service, Devon. Counselling Suicidal Clients addresses the important professional considerations when working with clients who are suicidal. The 'bigger picture', including legal and ethical considerations and organisational policy and procedures is explored, as is to how practitioners can work with the dynamics of suicide potential in the therapeutic process. The book is divided into six main parts: - The changing context of suicide - The prediction-prevention model, policy and ethics - The influence of the organisation - The client process - The practitioner process - The practice of counselling with suicidal clients. The book also includes chapters on the discourse of suicide, suicide and self-injury, and self-care for the counsellor. It is written for counsellors and psychotherapists, and for any professional who uses counselling skills when supporting suicidal people.

Counselling Suicidal Clients

Counselling Suicidal Clients PDF Author: Andrew Reeves
Publisher: SAGE
ISBN: 1412946352
Category : Psychology
Languages : en
Pages : 200

View

Book Description
Counselling Suicidal Clients addresses the important professional considerations when working with clients who are suicidal. The ‘bigger picture’, including legal and ethical considerations and organizational policy and procedures is explored, as is to how practitioners can work with the dynamics of suicide potential in the therapeutic process. The book is divided into six main parts: The changing context of suicide The prediction-prevention model, policy and ethics The influence of the organization The client process The practitioner process The practice of counseling with suicidal clients

Dialectical Behavior Therapy with Suicidal Adolescents

Dialectical Behavior Therapy with Suicidal Adolescents PDF Author: Alec L. Miller
Publisher: Guilford Publications
ISBN: 1462532055
Category : Psychology
Languages : en
Pages : 346

View

Book Description
Filling a tremendous need, this highly practical book adapts the proven techniques of dialectical behavior therapy (DBT) to treatment of multiproblem adolescents at highest risk for suicidal behavior and self-injury. The authors are master clinicians who take the reader step by step through understanding and assessing severe emotional dysregulation in teens and implementing individual, family, and group-based interventions. Insightful guidance on everything from orientation to termination is enlivened by case illustrations and sample dialogues. Appendices feature 30 mindfulness exercises as well as lecture notes and 12 reproducible handouts for "Walking the Middle Path," a DBT skills training module for adolescents and their families. Purchasers get access to a Web page where they can download and print these handouts and several other tools from the book in a convenient 8 1/2" x 11" size. See also Rathus and Miller's DBT? Skills Manual for Adolescents, packed with tools for implementing DBT skills training with adolescents with a wide range of problems.ÿ

Qualitative Analogue Study on Student Therapist's Reactions to Client Suicidality

Qualitative Analogue Study on Student Therapist's Reactions to Client Suicidality PDF Author: Cynthia A. Beevers
Publisher:
ISBN:
Category : Mental health counseling
Languages : en
Pages : 249

View

Book Description
Suicidal clients are a reality for both professional and student therapists providing counseling (Chemtob et al., 1988; Dexter-Mazza & Freeman, 2003; Goodman, 1995; Howard, 2000; Jacobson, Ting, Sanders, & Harrington, 2004; Kleespies, Penk, & Forsyth, 1993; Kleespies, Smith, & Becker, 1990; Mackelprang, Karle, & Cash, 2014; McAdams & Foster, 2000). Previous research has investigated the experiences of professional therapists working with suicidal clients, but little is known about student therapists' experiences with suicidal clients. Only two studies were found investigating the experiences of student therapists working with suicidal clients (Kleespies et al., 1993; Kleespies et al., 1990). However, in the two studies explicitly focusing on student therapists' experiences with suicidal clients, participants were doctoral students from clinical or counseling psychology programs that were in their pre-doctoral internship. No information was found regarding the experiences of student therapists currently attending a master's degree program. Further, both studies exploring the experiences of doctoral students working with suicidal clients used a retrospective design. Thus, no information was found about the immediate reactions of student or professional therapists when working with a suicidal client. The current dissertation aims to add to existing literature by using a phenomenological design and analogue methodology to better understand the immediate reactions of master's level student therapists to a written vignette of a client's clinical summary that included a history of suicidal behaviors and a second written vignette of a counseling dialogue with the client that included a discussion of the client's suicidality. Specifically, this study aims to better understand: (a) what reactions do student therapists have in response to a written clinical summary of a potential client that includes a history of suicidal behaviors?, (b) what reactions do student therapists have when anticipating working with a client that has a history of suicidal behaviors?, and (c) what reactions do student therapists have to a written analogue of a counseling dialogue with a suicidal client? An Interpretive Phenomenological Analysis (IPA; Finlay, 2011; Larkin, Watts & Clifton, 2006) approach was used in the current study to analyze data gathered through semi-structured interviews with participants. Participants in this study described a range of complex and sometimes contradictory reactions in response to a written vignette of a client clinical summary that included a history of suicidal behaviors, and a written vignette of a counseling dialogue that included a discussion of the client's suicidality. Further, findings indicated that these reactions would likely influence participants' approach to working with a real suicidal client, particularly in regard to hesitancy assessing a client's suicide risk. Based on findings from the current study, recommendations are made to better inform graduate training in suicide prevention for master's level student therapists.

Therapeutic and Legal Issues for Therapists Who Have Survived a Client Suicide

Therapeutic and Legal Issues for Therapists Who Have Survived a Client Suicide PDF Author: Kayla Weiner
Publisher: Routledge
ISBN: 1317825233
Category : Psychology
Languages : en
Pages : 130

View

Book Description
The death of a patient is every therapist’s worst nightmare. Even more frightening is the debilitating silence that surrounds a therapist after the death of a client. What do you do? How do you proceed with your personal and professional life? Until now, advice on surviving a patient’s suicide has been scarce. This book examines this much-overlooked topic to help you continue to live and practice confidently. The authors of this courageous book mix first-person narratives with professional strategies to help therapists deal with the emotional and legal consequences that follow the loss of a client. Therapeutic and Legal Issues for Therapists Who Have Survived a Client Suicide provides you with: models of coping strategies for clinicians after a client completes a suicide an examination of factors that compound the trauma for the therapist survivor examples for dealing with a client’s family suggestions for developing curricula for training institutions recommendations for supervisory guidelines explanations of—and means of mitigating—legal liability This practical book describes various ways of dealing with clinician and supervisory responsibilities after a client’s self-inflicted death. It will show you how to minimize the legal risks of working with suicidal clients and help you regain your sense of professional competence if a suicide occurs. New methods of screening and treatment assistance are offered. With about 30,000 suicides occuring the the United States annually, and many of those people in treatment at or near the time they commit suicide, thousands of clinicians face this trauma yearly. The clear, specific, therapeutic and legal guidelines you’ll find in the book, as well as the philosophical discussions, make it a vital read for therapists, counselors, social workers, nurses, supervisors, and educators in mental health training institutions.

ǂThe ǂmodel of Dynamic Balance in Therapists' Experiences and Views on Working with Suicidal Clients

ǂThe ǂmodel of Dynamic Balance in Therapists' Experiences and Views on Working with Suicidal Clients PDF Author: Tina Podlogar
Publisher:
ISBN:
Category :
Languages : en
Pages : 11

View

Book Description
Working with suicidal clients is frequently referred to as one of the most demanding and anxiety-provoking aspects of therapeutic work. The aim of this study was to obtain an in-depth understanding of therapists' experience in treating suicidal individuals and develop a theoretical model of it. Eleven psychotherapists (4 men and 7 women) participated in individual semi-structured interviews. The interviews were audiotaped, transcribed and analyzed by the principles of grounded theory. We developed a model of dynamic balance in therapists' experiences and views on working with suicidal clients. The model includes six core themes, which represent aspects of therapists' experience and views where a dynamic balance is needed between two different poles. The core themes are: (i) understanding of suicidality: the general vs. specific; (ii) the role of alliance: protective factor vs. no guarantees; (iii) attitudes: acceptant vs. life-oriented; (iv) emotional response: worry vs. trust; (v) responsibility: therapist's professionality vs. client's autonomy; and (vi) focus: suicidality vs. individual as a person. The model takes into account other variables that are relevant to the process and outcomes of the therapy: factors, related to the therapist and the client, as well as system regulations and therapeutic setting. The presented model may be helpful for mental health professionals in reflecting on their experiences of working with suicidal clients, describing the relevant topics and the way they relate to each other.

Countertransference and Related Experiences of Psychologists Serving Suicidal Patients: Implications for Training and Supervision

Countertransference and Related Experiences of Psychologists Serving Suicidal Patients: Implications for Training and Supervision PDF Author: Perry A. Staltaro
Publisher: Universal-Publishers
ISBN: 1599423006
Category :
Languages : en
Pages :

View

Book Description
This study examined countertransference and other experiences of therapists serving suicidal patients. A survey was constructed to assess for aversion, narcissistic injury and similar iatrogenic constructs. Participants offered both Likert scale responses and spontaneous unstructured comments. Likert data were analyzed quantitatively. Content and phenomenological analyses were applied to the comments. The findings suggest that a substantial number of therapists treating suicidal patients experience negative countertransferences. The implications for training, treatment and supervision are discussed.