A solution-focused approach to working with clients who are suicidal

The Solution-Focused Therapy Model: The First Session, Part 1 The Solution-Focused Therapy Model: Part II Case Study Ethical Issues in Therapy The Historical Roots of Solution-Focused Brief Therapy The Research and Evidence Base for Solution-Focused Brief Therapy Applying Solution-Focused Brief Therapy within Mental Health Services Solution-Focused Approaches to Severe Mental Illness Solution-Focused Approaches in the Workplace Future Directions in Solution-Focused Therapy

Solution-Focused Brief Therapy (SFBT) is gaining recognition in healthcare for its emphasis on client strengths, resources, and future goals rather than dwelling on past problems. While its effectiveness has been demonstrated across various settings, including mental health and medical contexts, the patient's lived experience and perception of SFBT in nursing practice remain underexplored. This qualitative study aims to explore the perspectives of patients who have received SFBT from nurses, shedding light on what aspects of the approach they find helpful, how it impacts their perceived recovery, and their overall satisfaction. Understanding these patient voices is crucial for optimizing the application of SFBT in nursing, enhancing patient-centered care, and informing nursing education and clinical guidelines.

Clients of drug and alcohol treatment services represent a high-risk group for attempted and completed suicide. The current study sought to examine suicide risk assessment practices in Australian generalist residential rehabilitation services. Semistructured interviews were conducted with managers of residential rehabilitation services and with volunteers from staff responsible for the case management/treatment of clients. Ninety per cent of services participated. In total, 64 managers and 142 staff were interviewed. One-third of services had no documented policy for the assessment and management of suicide risk, and one-quarter of staff had never received formal training in risk assessment. In more than one-third of agencies staff were not expected to use a structured suicide risk assessment tool when assessing a client's acute risk. To varying degrees agencies were gathering information about psychiatric comorbidity, but this information did not appear to be routinely integrated into the client's suicide risk assessment. The development of clearly documented polices, standardised assessment tools and the provision of annual training for all staff would help to address some of the gaps identified in current practice.

The possibilities for using solution-focused brief therapy (SFBT) during trauma therapy are presented in this article. First, “trauma” and related constructs used in psychotherapy are defined, as well as some misconceptions about trauma. The second part introduces the basic tenets of SFBT and the adapted “river of integration” model (Siegel, 2010), which helps to reflect the various ways SFBT practices are used in trauma therapy. Methods for solution-development in trauma therapy (e.g., work with preferred future, exceptions, personal growth, identity change, and re-connecting) are introduced in the next section. This is followed by methods for change in rigid patterns (e.g., experiential and “bottom-up” work) and for managing overwhelming chaos (coping and playful meaning-making techniques). Case examples are also available to illustrate those methods.

The connection between suicide and incarceration is well documented, in particular after recent arrest. Criminal defense attorneys may be one of the few people in meaningful contact with this population, and lawyers have a unique window into their clients' well-being. In this Viewpoint, we explore the experiences of attorneys who work with clients with suicidal thoughts and behaviors. We developed and administered a survey to criminal defense attorneys in the State of Washington, ascertaining their experiences with client suicide. A total of 44 responses were collected, with over 95% of respondents having been concerned about a client's risk for suicide. We conclude that client suicide widely impacts criminal defense attorneys, and lawyers' role with justice-involved clients uniquely positions them to be a potential asset in suicide prevention efforts.

This randomized control trial study evaluated the effectiveness of the solution-focused approach in addressing academic, motivational, and socioemotional needs of 14 children with reading difficulties. The intervention group received five 40-min solution-focused sessions. The control group received academic homework support. Results showed advantages for the intervention condition in 26 out of 38 measures. The mean eta-squared effect size for intervention was .20 (very) large. For the control group, there were only 10 effects favoring it and the mean was .09, a medium sized effect, both significantly greater than 0 (p < .01). Comparisons of the solution-focused brief therapy (SFBT) effect sizes to the mean of the control showed it was significantly larger (p < .001), confirming that SFBT was an efficacious intervention in this sample.

Managing high-risk suicidal clients in private practice requires clinical skills to manage and treat suicide risk within a framework of care. This chapter reviews and recommends practices for the therapeutic assessment, initial management, and collaborative treatment of suicide risk. Management of suicide risk is differentiated from treatment of suicide risk. Guidelines are provided for ending care and avoiding abandonment under conditions that are noncollaborative. Other topics covered are management of malpractice liability, documentation of clinical work, and the importance of clarifying personal limits when working with suicidal clients. This chapter outlines decision-making principles for facilitating hospitalization and breaking confidentiality. With a set of skills for assessment, management, and treatment of suicide risk, the prepared practitioner can play a key role in clinically saving lives.

The present study examined the usability and effectiveness of the Linehan Suicide Safety Net (LSSN), a web-based, multimedia tool designed to support clinicians working with individuals who are suicidal. The core feature of LSSN is the Linehan Risk Assessment and Management Protocol (LRAMP), an empirically derived protocol that provides a structured checklist for assessing, managing, and documenting suicide risk. Mental health professionals (N = 44) completed assessments at baseline and monthly during a 3-month evaluation period. The LSSN was rated as acceptable and highly usable. Use of the LSSN was associated with a significant increase in confidence in conducting suicide risk assessment and management and a decrease in concerns related to treating suicidal clients. The LSSN appears to be a promising tool for clinicians working with suicidal clients.

Counselling is increasingly available in a wide variety of contexts, including mental health and psychiatric services. As a consequence, counsellors increasingly work with clients who present with suicidal ideation, expressing either suicidal thought and/or intent in the counselling session. This paper describes an exploratory study that examined the experience of counsellors when working with suicidal clients. The paper considers counsellors' behavioural, cognitive and emotional responses to such suicidal expression, both on a personal and professional level. The research employed semi‐structured interviews. A constant comparative method was used in analysing the transcribed interview text. Results suggest that counsellors experience a range of responses when their clients express suicidal thought, including fear, anxiety, anger and professional impotence. The interviewees also expressed self‐doubts about their professional competence. In addition, they identified the threat of litigation for negligent practice and the lack of confidence in appropriate risk assessment approaches as significant causes for concern. The implications for further research, and practice, are discussed.

Aim: The aim of this study was to compare the effectiveness of solutionfocused approach and compassion-focused therapy on emotional cognitive regulation and post-traumatic stress disorder in female-headed households.&#x0D; Methods: The research method was quasi-experimental having pre-test and posttest with a control group. The statistical population included female-headed households who referred to the Welfare Center of Tehran province in 2021. Thirty-six female-headed households were selected through simple random sampling and randomly assigned to three groups of 12 (two experimental groups and one control group). The research instruments were Mississippi (2006) Post Traumatic Stress Disorder Scale and Garnfsky, Grich &amp; Spinhaven (2002) Cognitive Emotion Regulation Questionnaire. Participants in the experimental group received Grant’s (2011) Solution-focused counseling sessions and Gilbert’s (2010) Compassionate Therapy sessions, both for 8 sessions. In addition to descriptive statistics, analysis of covariance and Benferoni pair comparison were used to analyze the data&#x0D; Findings: The results of data analysis showed that the differences between the three groups in the variables of adaptive emotion regulation (F=30.61, P &lt;0.001), uncompromising emotion regulation (F=22.73, P&lt;0.001) and post-traumatic stress disorder (F=37.45, P &lt;0.001), is significant. There is no significant difference between solution-focused therapy and compassion-focused therapy on the regulation of compromised emotion and post-traumatic stress disorder, but there is a significant difference in the noncompromised variable.&#x0D; Conclusion: The findings of this study shows that solution-focused therapy and compassion-focused therapy were both effective in improving cognitive emotion regulation and stress disorder (PTSD), and of the two approaches can be used to reduce emotional regulation and post-traumatic stress disorder in female-headed Households.

This article provides a solution-focused approach for working with adolescents in residential treatment. The content areas include: (1) a discussion of why solution-focused therapy is a salient treatment modality, (2) a review of the philosophical underpinnings of solutionfocused therapy, (3) casting a vision for the therapist’s disposition toward the client, (4) a solution focused understanding of mental illness and medications, (5) a discussion of solution-focused therapy techniques, and (6) a brief discussion regarding how to talk about setbacks.

In recent years, a move away from traditional conceptualizations of recovery from severe mental illness has been observed. This has resulted in a more dimensional approach to recovery, with a broader focus on psychological well-being and functional outcomes, as opposed to a sole emphasis on symptom reduction. Much of this development has been stimulated by the recovery movement, a service user-led approach that supports each individual's potential for recovery and emphasizes the importance of hope, meaningful outcomes, and personal experience ( 1 ). The importance of social outcomes is also highlighted in the position statement on recovery by the American Psychiatric Association ( 2 ), which states that "the concept of recovery emphasizes a person's capacity to have hope and lead a meaningful life" and suggests that treatment should be guided by "attention to life goals and ambitions."

Palmer, Preface. Cooper, Foreword. Palmer, Introduction Suicide: Strategies and Interventions for Reduction and Prevention. Part I: Suicide: Statistics, Research, Theory and Interventions. Palmer, Suicide: definitions, statistics and interventions at the international level. Palmer, Suicide statistics for the UK and the national suicide prevention strategy. Stark, Suicide in Rural Areas. Sheehy, O'Connor, Cognitive style and suicidal Behaviour. Ruddell, Curwen, Understanding suicidal ideation and assessing for risk. Part II: Personal Experience of Suicide. Walen, It's a Funny thing about suicide. Cooke, Suicide: A friend's view. Kapoor, Client Suicide and its effect on the therapist. Part III: Three Therapeutic Approaches to Prevent Suicide. Froggatt, Palmer, Cognitive-Behavioural and Rational Emotive Management of Suicide. Lees, Stimpson, A Psychodynamic Approach to Suicide. Sharry, Darmody, Madden, A Solution-focused Approach. Part IV: Group Interventions. Pietila, Support groups. Seguin, Goulard, Bergmans, Links, Group interventions for adolescents and young adults with recurrent suicide attempts.Part V: Appendices. Appendix 1 Personal self-harm management plan. Appendix 2 Assessment checklist. Appendix 3 Useful organisations. Appendix 4 Useful books. Appendix 5 WHO document for health professionals. Palmer, Postscript.

Pulmonary arterial hypertension (PAH) is a chronic, progressive, and incurable disease with significant morbidity and mortality. Despite increasingly available treatment options, PAH patients continue to experience disease progression and increased rates of hospitalizations due to right heart failure. Physician's ability to comprehensively assess PAH patients, determine prognosis, and monitor disease progression and response to treatment remains critical in optimizing outcomes. Risk assessment in PAH should include a range of clinical, hemodynamic, and exercise parameters, performed in a serial fashion over the course of treatment. Approaches to risk assessment in PAH patients include the use of risk variables, scores, and equations that stratify the impact of both modifiable (e.g., 6-min walk distance, functional class, brain natriuretic peptide), and non-modifiable (e.g., age, gender, PAH etiology) risk factors. Such tools allow physicians to better determine prognosis, allocate treatment resources, and enhance the consistency of treatment approaches across providers. Comprehensive and accurate risk prediction is essential to make individualized treatment decisions and optimizing outcomes in PAH.

Research has repeatedly demonstrated that religiosity can potentially serve as a protective factor against suicidal behavior. A clear understanding of the influence of religion on suicidality is required to more fully assess for the risk of suicide. The databases PsycINFO and MEDLINE were used to search peer-reviewed journals prior to 2008 focusing on religion and suicide. Articles focusing on suicidality across Buddhism, Native American and African religions, as well as on the relationship among Atheism, Agnosticism, and suicide were utilized for this review. Practice recommendations are offered for conducting accurate assessment of religiosity as it relates to suicidality in these populations. Given the influence of religious beliefs on suicide, it is important to examine each major religious group for its unique conceptualization and position on suicide to accurately identify a client's suicide risk.