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THE SUICIDAL CLIENT Sheet Music
Latin suicid Introduction: Suicide is not a diagnosis or a disorder; it is a behavior. Suicide (Latin suicid caedere, "to kill oneself") is the act of a human being intentionally causing his or from sui from sui caedere, own death. death. Suicide is often committed out of despair of despair , or attributed to some underlying ment disorder which disorder which includes depression, depression, bipolar disorder, schizophrenia, schizophrenia, alcoholism and drug abuse.Financial abuse.Financial difficulties, difficulties, interpersonal relationships and other undesirable situations play significant role.
The Judeo- Christian belief has been that life is a gift from god and that taking it is a gift God and that taking it is strictly forbidden (Carroll- Ghosh, Victor, & Bourgeois, 200 recent, and more secular, view has influenced how some individuals view suicide in our so Growing support for an individual’s right to choose death over pain has been evidenced. S individuals are striving to advance the cause of physician- assisted suicides for the terminal Approximately 95 percent of all persons who commit or attempt suicide have a diagnosed m disorder (Sadock & Sadock, 2003).
Definition of Suicide: According to Durkheim, suicide refers to “every case of death resu directly or indirectly from a positive or negative death performed by the victim himsel which strives to produce this result.”
Epidemiologica Epidemiologicall Factors: Factors: Approximately 30,000 persons in the United States end their each year by suicide. These statistics have established suicide as the third leading cause of (behind accidents and homicide) among young Americans ages 15 to 24 years, the fifth le cause of death for ages 25 to 44, and the eighth leading leading cause of death for individuals individuals age 64 (National Center for Health Statistics, 2004). Many more people attempt suicide than suc and countless others seriously contemplate the act without carrying it out. Suicide has beco major health care problem in the United States today.
Risk Factors:
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Not useful Useful Marital Status: The suicide rate for single persons is twice that ofmarried persons, Divo separated, or widowed persons have rates four to five times greater than those of the ma (Tondo and Baldessarini, 2001).
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The suicide rate among young people ages 15 to 19 peaked in 1990 at 11.1 per 100,00 declined to 7.4 per 100,000 in 2002 (National Center for Health Statistics, 2004). Several fa put adolescents at risk for suicide, including impulsive and high-risk behaviors, untreated m disorders (e.g., firearms), and substance abuse. The use of firearms, which accounts for abo percent of cases, is the most common method of completed suicide in children and adolesce
Religion: Historically, suicide rates among Roman Catholic populations have been lowe rates among Protestants and Jews (Sadock & Sadock, 2003). In a recent study published American Journal of Psychiatry, depressed men and women who consider themselves affi with a religion are less likely to attempt suicide than their non- religious counterparts (Derv al., 2004).
Socioeconomic status: Individuals in the very highest and lowest social classes have h suicide rates than those in the middle classes (Sadock & Sadock, 2003). With reg occupation, suicide rates are higher among physicians, musicians, dentists, law enforce officers, lawyers, and insurance agents.
Ethnicity: With regard to ethnicity, most studies demonstrate that whites are at highest ris suicide, followed by Native Americans, African Americans, Hispanic Americans, and A Americans (Caroll-Ghosh, Victor, & Burgeois, 2003).
Other Risk Factors: Individuals with mood disorders (major depression and bipolar disorde Reading a Preview far more likely to commit suicide You're than those in any other psychiatric or medical risk g Sadock & Sadock (2003) report, “Almost 95 percent of all people who commit or attempt su Unlock full access with a free trial. have a diagnosed mental disorder. Depressive disorders account for 80 percent of this fig Other psychiatric disorders that may account for suicidal behavior include psycho Download With Free Trial substance abuse disorders, schizophrenia, personality disorders, and anxiety disorders (Ton Baldessarini, 2001).
Theories of Suicide
1. Psychological Theories:
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a response to the in Anger Turned Inward. Freud (1957) believed that Useful was useful suicide Not self- hatred that an individual possessed. The anger had originated toward a love obje was ultimately turned inward against the self. Freud believed that suicide occurred as a
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Chapter 1 Introduction
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History of Aggression and Violence. Some studies have indicated that violent beh often goes hand – in –hand with suicidal behavior (Caroll- Ghosh, Victor, & Bourg 2003). These studies correlate the suicidal behavior in violent individuals to conscious therefore citing rage as an important psychological factor underlying the suicidal beh (Hendin,1991).
Shame and Humiliation. Some individuals have viewed suicide as a “facemechanism- a way to prevent public humiliation following a social defeat such as a su loss of status or income. Often these individuals are too embarrassed to seek treatme other support systems.
Developmental Stressors. Rich, Warsadt, and Nemiroff (1991) have as developmental level with certain life stressors and their correlation to suicide. The stre of conflict, separation, and rejection are associated with suicidal behavior in adolescenc early adulthood. The principal stressor associated with suicidal behavior in the 40 to 60 old group is economic problems. Medical illness plays an increasingly significant role age 60 and becomes the leading predisposing factor to suicidal behavior in individuals than age 80.
Sociological Theory:
Durkheim (1951) studied the individual’s interaction with the society in which he o Reading a Preview lived. He believed that the moreYou're cohesive the society, and the more that the individual f integrated part of the society; the less likely he or she was to commit suicide. Durk Unlock full access with a free trial. described three categories of suicide:
Download With Free Trial Egoistic suicide is the response of the individual who feels separate and apart from mainstream of society. Integration is lacking and the individual does not feel a part o cohesive group (such as a family or a church).
Altruistic suicide is the opposite of egoistic suicide. The individual who is prone to altr suicide is excessively integrated into the group. The group is often governed by cul religious, or political ties, and allegiance is so strongSign thatupthe individual will sacrifice h to vote on this title her life for the group. Useful Not useful
Anomic suicide occurs in response to changes that occur in an individual’s life (e.g., div loss of job) that disrupt feelings of relatedness to the group. An interruption in the custo
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Exploratory Essay
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suicidal behavior. Some studies have revealed a deficiency of serotonin (measured decrease in the levels of 5- hydroxyindole acetic acid of the cerebrospinal fluid) in depr clients who attempted suicide (Sadock & Sadock, 2003). Some changes in the noradren system of suicide victims have also been reported. Classification of suicide Self-harm
Self-harm is not a suicide attempt; however, initially self-harm was erroneously classified as suicide attempt. There is a non-causal correlation between self-harm and suicide; both are m commonly a joint effect of depression. Euthanasia and assisted suicide
Euthanasia machine invented by Dr. Philip Nitschke, on display at Science Museum, Londo
Individuals who wish to end their own lives may enlist the assistance of another person to achieve death. The other person, usually a family member or physician, may help carry out act if the individual lacks the physical capacity to do so even with the supplied means. Assis suicide is a contentious moral and political issue in many countries, as seen in the scandal You're Reading a Previewsupported euthanasia, was foun surrounding Dr. Jack Kevorkian, a medical practitioner who have helped patients end their own lives, was with sentenced to prison time. Unlock and full access a free trial. Murder–suicide
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A murder–suicide is an act in which an individual kills one or more other persons immediat before or at the same time as him or herself.
The motivation for the murder in murder–suicide can be purely criminal in nature or be perceived by the perpetrator as an act of care for loved ones context oftitle severedepressi Signinupthe to vote on this Suicide attack
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Suicide pact Sheet Music
A suicide pact describes the suicides of two or more individuals in an agreed-upon plan. Th plan may be to die together, or separately and closely timed. Suicide pacts are generally dist from mass suicide. The latter refers to incidents in which a larger number of people kill themselves together for the same ideological reason, o ften within a religious, political, milit or paramilitary context. Suicide pacts, on the other han d, usually involve small groups of pe (such as married or romantic partners, family members, or friends) whose motivations are intensely personal and individual. Metaphorical suicide
The metaphorical sense of "willful destruction of one's self-interest", for example political suicide. Causes
A number of factors are associated with the risk of suicide including: mental illness, drug addiction, and socio-economic factors. While external circumstances, such as a traumatic may trigger suicide it does not seem to be an independent cause. Thus suicides are more like occur during periods of socioeconomic, family and individual crisis. You're Reading a Preview Mental illness
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Mental disorders are frequently present at the time of suicide with estimates from 87%to 98 Download With Free Trial When broken down into type mood disorders are present in 30%, substance abuse in 18%, schizophrenia in 14%, and personality disorders in 13.0% of suicides. About 5% of people w schizophrenia die of suicide. Depression, one of the most commonly diagnosed psychiatric disorders is being diagnosed in increasing numbers in v arious segments of the population worldwide, and is often a precipitating factor in suicide. Depression in the United States alo affects 17.6 million Americans each year or 1 in 6 people.Sign Within twenty up to the votenext on this title years depression is expected to become the second leading cause of disability worldwide and the Useful Not useful leading cause in high-income nations, including the United States.
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alcoholics commit suicide. In adolescents the figure is higher with alcohol or drug misuse playing a role in up to 70% of suicides. It has been recommended that all drug addicts or alcoholics are investigated for suicidal thoughts due to the high risk of suicide.
Misuse of drugs such as cocaine have a high correlation with suicide. Suicide is most likely occur during the "crash" or withdrawal phase of cocaine in chronic abusers. Polysubstance misuse has been found to more often result in suicide in younger adults whereas suicide from alcoholism is more common in older adults. In San Diego it was found that 30% of suicides people under the age of 30 had used cocaine. In New York City during a crack epidemic one five people who committed suicide were found to have recently consumed cocaine. The "co down" or withdrawal phase from cocaine can result in intense depressive symptoms coupled other distressing mental effects which serve to increase the risk of suicide. It has been found drinking 6 drinks or more per day results in a sixfold increased risk of suicide.
Alcohol misuse is associated with a number of mental health disorders, and alcoholics have very high suicide rate. High rates of major depressive disorder occur in heavy drinkers and t who abuse alcohol. Controversy has previously surrounded whether those who abused alcoh who developed major depressive disorder were self medicating (which may be true in some cases) but recent research has now concluded that chronic excessive alcohol intake itself dir causes the development of major depressive disorder in a significant number of alcohol ab Cigarette smoking
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There have been various studies done showing a positive link between smoking, suicidal ide and suicide attempts. In a study conducted among nurses, those smoking between 1-24 ciga Download With Free Trial per day had twice the suicide risk; 25 cigarettes or more, 4 times the suicide risk, than those had never smokedIn a study of 300,000 male U.S. Army soldiers, a definitive link between suicide and smoking was observed with those smoking over a pack a day having twice the suicide rate of non-smokers. Problem gambling
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Problem gambling is often associated with increased suicidal ideation and attempts compare the general population.
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Judicial suicide Sheet Music
A person who has committed a crime may commit suicide to avoid prosecution and disgrace such as in murder–suicides. Nazi leader Hermann Göring, a high-ranked Nazi and head of th Luftwaffe, committed suicide with cyanide capsules rather than be hanged after his convicti the Nuremberg Trials. Some school shootings, including the Virginia Tech massacre, conclu with the perpetrator committing suicide. Suicide as an escape In situations where continuing to live is intolerable, some pe ople use suicide as a means of escape. Some inmates in Nazi concentration camps are known to have killed themselves by delibertely touching the electrified fences. According to a report by Tata Institute of Social Sciences in Mumbai, 150,000 debt-ridden farmers in India have committed suicide in the past decade. Other factors
Socio-economic factors such as unemployment, poverty, homelessness, and discrimination trigger suicidal thoughts. Poverty may not be a direct cau se but it can increase the risk of su You'reAdvocacy Reading aofPreview as it is a major risk group for depression. suicide has sometimes been cited as a contributing factor. Unlock full access with a free trial. Suicide Prevention
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The view that suicide cannot be prevented is commonly held even among health professiona Many beliefs may explain this negative attitude. Chief among these is that suicide is a perso matter that should be left for the individual to decide. Another belief is that suicide cannot b prevented because its major determinants are social and environmental factors suchas Sign up to vote on this title unemployment over which an individual has relatively littleUseful control. However, for the Not useful overwhelming majority who engage in suicidal behaviour, there is a probably an appropriate alternative resolution of the precipitating problems. Suicide is often a permanent solution to
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major health problems and hence, suicide is accorded low priority in the competition for me resources. The mental health services are inadequ ate for the needs of the country. For a population of over a billion, there are only about 3,500 psychiatrists. Rapid urbanization, industrialization and emerging family systems are resulting in social upheaval and distress. T diminishing traditional support systems leave people vulnerable to suicidal behavior. Henc there is an emerging need for external emotional support. The enormity of the problem com with the paucity of mental health service has led to the emergence of NGOs in the field of suicide prevention.
The primary aim of these NGOs is to provide support to suicidal individuals by befriending them. Often these centers function as an entry point for those needing professional services. Apart from befriending suicidal individuals, the NGOs have also un dertaken education of gatekeepers, raising awareness in the public and media and some intervention programmes. However, there are certain limitations in the activities of the NGOs. There is a wide variabil the expertise of their volunteers and in the services they provide. Quality control measures a inadequate and the majority of their endeavors are not evaluated.
The World Health Organization's (WHO's) suicide prevention multisite intervention study o suicidal behaviors (SUPRE-MISS), an intervention study, has revealed that it is possible to reduce suicide mortality through brief, low-cost intervention in developing coun tries.
Reading a Preview There is an urgent need to develop aYou're national plan for suicide prevention in India. The priori areas are reducing the availability ofUnlock and full access to pesticide, reducing alcohol availability an access with a free trial. consumption, promoting responsible media reporting of suicide and related issues, promotin and supporting NGOs, improving the capacity of primary care workers and specialist menta Download Freeby Trial health services and providing support to those With bereaved suicide and training gatekeepers teachers, police officers and practitioners of alternative system of medicine and faith healers Above all, decriminalising attempted suicide is an urgent need if any suicide prevention stra is to succeed in the prevailing system in India.
was 10 th September - World Suicide Prevention Day: The World Suicide Prevention Day Sign up to vote on this title th formally announced on 10 September, 2003. Each year the International Association for Useful Not useful Suicide Prevention (IASP) in collaboration with WHO uses this day to call attention to suici a leading cause of premature and preventable death. The theme for the year 2007 is "Suicide Prevention-Across the Life Span". It calls attention to the fact that suicide occurs at all ages
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history, and coping strategies. The Surgeon General, in his “Call to Action to Pr Suicide.” Speaks of risk factors and protective factors (U.S Public Health Services, 1 Risk factors are associated with a greater potential for suicide and suicidal behavior, wh protective factors are associated with reduced potential for suicide. These risk and prote factors are given below in tables presents some additional guidelines for determinin degree of suicide potential.
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Suicide Risk Factors and Protective Factors
• •
•
• • • •
• • •
•
•
RISK FACTORS PROTECTIVE FACTORS Previous suicide attempt Effective and appropriate clinical • for mental, physical, and substance Mental disorders-particularly mood disorders disorders such as depression and bipolar disorder Easy access to a variety of • interventions and support for help seeki Co-occurring mental and alcohol and substance abuse disorders Restricted access to highly • methods of suicide Family history of suicide Family and community support • Hopelessness Support from ongoing medica • Impulsive and/or aggressive tendencies health care relationships You'rehealth Reading amental Preview Barriers to accessing mental Learned skills in problem • treatment Unlock full access with a free trial. conflict resolution, and nonviolent han Relational, social, work, or financial loss of disputes Physical illness Download With Free Trial Cultural and religious belief • Influence of significant people-family discourage suicide and suppor members, celebrities, peers who have died by suicide- both through direct personal preservation instincts.
contact or inappropriate media representations Cultural and religious beliefs-for instance, the belief that suicide is a noble resolution of a personal dilemma Isolation, a feeling of being cut off from
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Daily functioning
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Suicide Risk Assessment and
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Fairly good in most activities Resources Several Coping strategies Generally being used constructive significant others Psychiatric help in None, or positive past attitude toward Lifestyle Stable Alcohol or drug use Infrequently to excess Previous suicide None, or of low attempts lethality Disorientation; None disorganization Hostility Little or none Suicidal plan Vague, fleeting thoughts but no plan
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Moderately good in some activities Some Some that are constructive
Not good in activities Few or none Predominantly destructive
Yes, and moderately Negative view satisfied with results help received Moderately stable Unstable Frequently to excess Continual abuse One or more of Multiple attempts moderate lethality high lethality Some Marked Some Frequently thoughts, occasional ideas about a plan
Marked Frequent or constan thought with specific plan
You're Reading a Preview Demographics:
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The following demographics areDownload assessed: With Free Trial Age. Suicide is highest in persons older than 50. Adolescents are also at high risk. Gender. Males are at high risk than females.
Ethnicity. Caucasians are at higher risk than are Native Americans, who are at highe Sign up to vote on this title than African Americans.
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Marital status. Single, divorced, and widowed are at higher risk than married.
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Assessment data must be gathered regarding any psychiatric or physical condition for w the client is being treated. Mood disorders (major depression and bipolar disorders) ar most common disorders that precede suicide. Individuals with substance use disorde also at high risk. Other psychiatric disorders in which suicide may be a risk include an disorders, schizophrenia, and borderline and antisocial personality disorders (To Baldessarini, 2001).
Suicidal Ideas or Acts: How serious is the intent? Does the person have a plan? If so, he or she have the means? How lethal are the means? Has the individual ever attem suicide before? These are all questions that must be answered by the person conductin suicidal assessment.
Individuals may leave both behavioral and verbal clues as to the intent of their Examples of behavioral clues include giving away prized possessions, getting fin affairs in order, writing suicide notes, or sudden lifts in mood.
Verbal clues may be both direct and indirect. Examples of direct statements include “I to die” or “I’m going to kill myself.” Examples of indirect statements include “This is th time you’ll see me,” “I won’t be around much longer for the doctor to have to worry ab or “I don’t have anything worth living for anyone.” Interpersonal Support System:
You're Reading a Preview Does the individual have support persons on whom he or she can rely during a Unlock full accessof withsatisfactory a free trial. situation? Lack of a meaningful network relationships may impli individual at high risk for suicide during an emotional crisis. Download With Free Trial Analysis of the Suicidal Crisis:
The precipitating Stressor. Adverse life events in combination with other risk factors as depression may lead to suicide (NIMH,2002). Life stresses accompanied by an increa emotional disturbance include the loss of a loved person either by death or by div problems in major relationships, changes in roles, or serious physical illness. Sign up to vote on this title
Useful failures Notoruseful Relevant History. Has the individual experienced numerous rejections that w increase his or her vulnerability for a dysfunctional response to the current situation?
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Diagnosis/ Outcome Identification Sheet Music
Nursing diagnoses for the suicidal client may include the following: 1. Risk for suicide related to feelings of hopelessness and desperation.
2. Hopelessness related to absence of support systems and perception of worthlessness
The following criteria may be used for measurement of outcomes in the care of the su client. The client:
1. Has experienced no physical harm to self. 2. Sets realistic goals for self. 3. Expresses some optimistic and hope for the future. Planning/ Implementation:
Below table provides a plan of care for the hospitalized suicidal client. CARE PLAN FOR THE SUICIDAL CLIENT: You're Reading a Preview Nursing diagnosis: Risk for Suicide
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Related to: Feelings of hopelessness and description Outcome Criteria Client will harm self.
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1. Ask client directly: “Have you plan to do? Do you have the means to carry out this plan?”
Rationales
1. The risk of suici greatly increased if client has developed a p andonexecute Sign up to vote this titlethe plan. 2. Create a safe environment for the 2. Client useful safety Useful Not client. Remove all potentially harmful nursing priority. objects from client’s access (sharp
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4. Maintain close observation of client. Depending on level of suicide precaution, provide one-to-one contract, constant visual observation, or every 15 minute checks. Place in room close to nurse’s station; do not assign to private room. Accompany to off unit activities if attendance is indicated. May need to accompany to bathroom. 5. Maintain special care in administration of medications.
of thoughts or behavior. 4. Close observatio necessary to ensure client does not harm self any way. Being aler suicidal escape attem facilitates being able prevent or in harmful behavior.
5. Prevents saving up overdose or discarding a not taking. 6. Encourage client to express 6. Depression honest feelings, including anger. suicidal behaviors may Provide hostility release if needed. viewed as anger tu inward On the self. If this anger c be verbalized i nonthreatening environme You're Reading a Preview the client may be ab eventually resolve Unlock full access with a free trial. feelings.
Download With Free Trial Nursing diagnosis: Hopelessness Related to: Absence of support systems and perception of worthlessness
Evidenced By: verbal cues; decreased affect; lack of initiative; suicidal ideas or attempt Sign up to vote on this title
Outcome criteria Nursing Intervention Rationales Useful Not useful Client will 1.Identify stressors in client’s life that 1.Important to ide verbalize a precipitated current crisis. causative or contribu of ho f i d
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4.Help client identify areas of life 4. The client’s emot situation that are under own control. condition may interfere w ability to problem so Assistance may be req to perceive the benefits a consequences of ava alternatives accurately. 5.Identify sources that client may use after discharge when crisis occur or feelings of hopelessness and possible suicidal ideation prevail.
5.Client should be aware of local su hotlines or other support services from who he or she may seek assistan following discharge hospital. A concrete provides hope in the face crisis situation.
Intervention with the Suicidal Client Following Discharge (or Outpatient Sui You're Reading a Preview Client):
Unlock full access a free trial. In some instances, it may be determined that with suicidal intent is low and that hospitalizat not required. Instead, the client with suicidal ideation may be treated in an outpatient se Guidelines for treatment of the suicidal client onFree an outpatient basis include the followin Download With Trial
1. The person should not be left alone. Arrangements must be made for the client t with family or friends. If this is not possible, hospitalization should be reconsider
2. Establish a no-suicide contract with the client. Formulate a written contract th client will not harm himself or herself in a stated period of time. Forexampl Sign up to vote on this title client writes, “I will not harm myself in any way between now and the time o Useful Not useful next counseling session,” or “I will call the suicide hotline (or go to the emerg room) if I start to feel like harming myself.” When the time period of this short contract has lapsed, a new contract is negotiated.
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Suicide Risk Assessment and
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Chapter 1 Introduction
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6. Be direct. Talk openly and matter-of-factly about suicide. Listen active encourage expression of feelings, including anger. Accept the client’s feeling nonjudgmental manner. 7. Discuss the current crisis situation in the client’s life. Use the problem approach.
8. Help the client identify areas of life situation that are within his or her cont those that client does not have the ability to control. Discuss feelings associated these control over his or her life situation in o rder to perceive a measure of self-w
9. The physician may prescribe antidepressants for an individual who is experi suicidal depression. It is wise to prescribe no more than a 3 day supply o medication with no refills. The prescription can then be renewed at the client’s counseling session.
10. Macnab (1993) suggests the following steps in crisis counseling with the su client: a)
b)
Focus on the current crisis and how it can be alleviated. Identify the appraisals of how things are, and how things will be. Note how these appr change in changing contexts. You're Reading a Preview Note the client’s reactivity to crisis and how this can be changed. Discuss stra and procedures for theUnlock management anger and frustration. full access of withanxiety, a free trial.
c)
Work toward restoration of the client’s self-worth, status, morale, and Download With Free Trial Introduce alternatives to suicide.
d)
Rehearse cognitive reconstruction –more positive ways of thinking about the events, the past, the present, and the future.
e)
Identify experiences and actions that affirm self-worth and self-efficacy.
f)
Encourage movement toward the new reality, with the coping usefulskills req Useful Not manage adaptively.
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Information for family and friends of the Suicidal Client:
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Chapter 1 Introduction
Exploratory Essay
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3. The centers for Disease Control(CDC, 2002) offer the following suggestions for famili friends of suicidal persons:
a) Be a good listener. If people express suicidal thoughts or feel depressed, h or worthless, be supportive. Let them know you are there for them and are willi help them seek professional help.
b) Many people find it awkward to put into words how another person’ important for their own well-being, but it is important to stress that the person’s l important to you and to in which the person’s suicide would be devastating to you a others.
c) Express concern for individuals who express thoughts about committing su The individual may be withdrawn and reluctant to discuss what he or she is thin Acknowledge the person’s pain and feelings of hopelessness, and encour individual to talk to someone else if he or she does not feel comfortable talking you. d) Familiarize yourself with suicide intervention sources, such as mental centers and suicide hotlines. e)
Ensure that access to firearms or other means of self-harm is restricted. You're Reading a Preview 4. The Mental Health Sanctuary (2004) offers the following tips: Unlock full access with a free trial.
a) Acknowledge and accept their feelings and be an active listener.
Download With Trial b) Try to give them hope and remind them thatFree what they are feeling is temporary. c) Stay with them. Do not leave them alone. Go to where they are, if necessary. d) Show love and encouragement. Hold them, hug them, and touch them them to cry and express anger. e) Help them seek professional help.
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f) Remove any items from the home with which the person may harm himself or hers
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Suicide Risk Assessment and
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Chapter 1 Introduction
Exploratory Essay
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3. A heightened sense of emotionality, helplessness, failure, and despair Sheet Music
4. A recurring self-searching: “If only I had done something,” If only I had no something,” If only I had not done something,” “If only…….” 5. A sense of confusion and search for an explanation: “Why did this happen?” “Wha mean?” “What could have stopped it?” “What will people think?”
6. A sense of inner injury. The family feels wounded. They do not know how they wil over it and get on with life. 7. A severe strain is placed on relationships. A sense of impatience, irritability, and anger between family members.
8. A heightened vulnerability to illness and disease exists with this added burden of emo stress. Strategies for assisting survivors of suicide victims include: 1. Encourage the clients to talk about the suicide, each responding to the other’s vie and reconstructing of events. Share memories.
2. Be aware of any blaming or scapegoating of specific family members. Discuss how You're Reading a Preview person fits into the family situation, both before and after the suicide.
full access with a free trial. move the individuals tow 3. Listen to feelings of guilt andUnlock self-persecution. Gently reality of the situation. Download With Free Trial 4. Encourage the family members to discuss individual relationships with the lost love Focus on both positive and negative aspects of the relationships. Gradually, point o irrationality of any idealized concepts of the decreased person. The family must to recognize both positive and negative aspects about the person before grief c resolved.
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5. No two people grieve in the same way. It may appear that some family members are “g Not useful Useful over” the grief faster than others. All family members must be made to understand t this occurs, it is not because they “care less,” just that they “grieve differently.” Vari that enter into this phenomenon include individual past experiences, personal relatio
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Chapter 1 Introduction
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Evaluation of the suicidal client is an ongoing process accomplished through con reassessment of the client, as well as determination of goal achievement. Once the imme crisis has been resolved, extended psychotherapy may be indicated. The long-term goa individual or group psychotherapy for the suicidal client would be for him or her to: 1. Develop and maintain a more positive self-concept. 2. Learn more effective ways to express feelings to others. 3. Achieve successful interpersonal relationships. 4. Feel accepted by others and achieve a sense of belonging.
A suicidal person feels worthless and hopeless. These goals serve to instill a sense of self-w while offering a measure of hope and a meaning for living.
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