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Pragmatic guidelines for imperfect assessments

I love the title of J. Christopher Fowler’s article that was published in the current issue (vol 49, issue 1) of Psychotherapy, “Suicide Risk Assessment in Clinical Practice: Pragmatic Guidelines for Imperfect Assessments.” This practice review is thorough and wise. Fowler strikes just the balance between encouraging completeness and responsibility, and acknowledging the limits inherent in [...]

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Unintended consequences of antidepressant black box warning?

An article by Charles Nemeroff and colleagues in the Archives of General Psychiatry this month reports reports on the “Impact of Publicity Concerning Pediatric Suicidality Data on Physician Practice Patterns in the United States.” (If you don’t have access to the journal, you can read a report on the article here.)   The authors show [...]

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Clinician response to violation of the “social contract”

I had a stimulating conversation with a senior colleague in the CSPS yesterday. One part of the conversation centered around what happens for us, as clinicians, when the patient does not fulfill his/her end of the “social contract” that is implied when someone goes to a mental health professional. The assumed contract is that the [...]

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Clinician anxiety–what’s it about?

When the “S” word comes up, many clinicians feel on edge. I’m sure that more than one factor (and different factors for different people) that contributes to the anxiety, but they are different enough that it affects how we would target training. Here are some possibilities: Uncomfortable with the pain and despair of another. Squemish [...]

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Post from AAS/SPRC Workshop-Thoughts about staying therapeutic

I’m in Ohio this week at a “train the trainer” workshop developed by the American Association for Suicidology (AAS) and the Suicide Prevention Resource Center (SPRC). The workshop is called “Assessing and Managing Suicide Risk: Core competencies for mental health professionals.” The training has been excellent so far. The material focuses a lot on the [...]

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