I am a huge fan of Craig Bryan. He, Sharon Stone, and David Rudd (another person whose work I really admire) have just published an article titled, “A Practical, Evidence-Based Approach for Means-Restriction Counseling With Suicidal Patients.” I know I will be recommending this article a lot. Questions about means restriction come up just about [...]
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Clinical reflections on Army’s approach in interactive suicide prevention video
October 22, 2008
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A colleague pointed me to a Washington Post article describing an interactive suicide prevention video the Army has produced and will make mandatory for all soldiers. I experimented with the online demo of Beyond the Front, which shows scenes from the life two soldiers and allows the viewer to make choices that either lead toward [...]
Read more“Trusting” a person at risk who agrees to transport self
September 2, 2008
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A colleague forwarded me the following excellent question posted to a listserv: One question that has been raised is how to handle an individual who reports willingness to voluntarily go to the ER for psychiatric assessment. Since trusting a questionably unstable and suicidal individual to present for treatment opens our agency and the patient up [...]
Read moreWarning: Non-family Tx may be hazardous to your (family’s) health
October 12, 2007
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A clever article in the September 2007 issue of the Journal of Family Psychology by Jose Szapocznik and Guillermo Prado suggests that “psychosocial treatments with vulnerable populations have the potential to produce negative side effects on families.” The authors reported unexpected findings from three separate studies that compared the efficacy of a family and non-family [...]
Read moreReminder from the bridge: Suicidal individuals are full of ambivalence
September 28, 2007
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Today Mike Hogan, Ph.D., the Commissioner of the New York State Office of Mental Health honored RNN-TV and the NYS Bridge authority for their work in suicide prevention. The bridge authority put up signs and installed lifeline phones with direct link to the National Suicide Prevention Lifeline. For clinicians assessing and managing suicide risk, the [...]
Read moreClinician response to violation of the “social contract”
February 7, 2007
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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 [...]
Read moreRisk and patient choice
January 25, 2007
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It’s hard enough to assess for suicidal risk, interview, reach a formulation, and develop a plan that matches the risk level. But what do you do when the client does not agree to the plan? It is difficult to manage one’s emotions, and difficult to know how to proceed. This is especially true when the [...]
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