Clinical Manual for Assessment and Treatment of Suicidal Patients

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The cornerstone of any intervention approach with suicidal patients is the recognition and treatment of psychiatric disorders. For many patients, however, treating the mental illness is not enough -- that is, suicidal behavior is not necessarily reduced by treatments that target those illnesses. Something more is needed.

In this provocative and insightful work, Drs. Chiles and Strosahl offer a concrete, practical framework to fill this gap. In doing so, they challenge one of the chief underlying assumptions of traditional approaches to suicide assessment and treatment -- that suicidal behavior can be predicted and controlled. In its place, they propose a new conceptualization of suicidality -- as learned, reinforced problem-solving behaviors that an individual uses when all other options seem to have failed. Rather than focusing on risk prediction and management, interventions in this learning model target the problems that the suicidal behavior is being used to solve. The assumption is that a patient's suicidal behavior represents his or her best attempt at that moment in time to deal with life's difficulties. The clinician's initial task is therefore not to judge or criticize but rather to acknowledge the struggle and pain the patient is experiencing and to help the patient begin to explore other ways of dealing with the overwhelming troubles. Efforts to reduce suicidal risk are accomplished by techniques that maximize individual autonomy and encourage positive behaviors -- the person's unique resources for addressing and modifying the suicidal behavior.

Designed to be used both for personal instruction and as a training manual, this comprehensive guide • Presents an evidence-based model for understanding and treating suicidal behavior in all its forms.

• Features self-evaluation exercises to help clinicians develop an enhanced awareness of their own emotional reactions, moral/religious responses, and personal values about suicidality.

• Provides interactive checklists and patient assessment tools designed for easy use by the typical clinician in daily practice.

• Includes case vignettes and narratives highlighting key assessment and intervention principles.

In Clinical Manual for the Assessment and Treatment of Suicidal Patients, the authors -- a psychiatrist and clinical psychologist -- have combined their diverse training and disciplinary backgrounds to create a workable approach to dealing with suicidal patients. Much more than merely an academic text on suicide, this thought-provoking handbook provides detailed guidance and a true sense of what to do to help suicidal patients. Practitioners in all domains of health care -- clinicians, residents, therapists, and graduate students in psychiatry, psychology, social work, and nursing -- will benefit from this valuable and accessible work.

American Psychiatric Publishing

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Editorial Reviews


This comprehensive text covers everything from the basic causes and diagnosis of suicidality, to treatment strategies and suggestions for comprehensive set-up of community and hospital based services for the suicidal patient and their family.... It is highly recommended as an excellent, readable resource for clinicians and administrators in the mental health and medical fields. It deserves a place on the bookshelves of any educational or professional library serving students or practitioners in the fields of medicine, psychiatry, social work, psychology, or counseling.

Doody's Review Service
Reviewer: Regina Rosa Lopez, MD (University of Illinois at Chicago College of Medicine)
Description: This is a comprehensive, clinically-applicable guide to dealing with suicidal behavior. This book's unique approach to suicidal behavior as problem-solving behavior makes the clinician feel less helpless facing this difficult issue.
Purpose: According to the authors, the purpose of this book is to serve as a guide to the individual assessment and treatment of suicidal patients and as a training manual. These objectives are worthy for such a complex subject. The book has done a superb job meeting the author's objectives.
Audience: I agree with the authors that this book is for practitioners in all domains of health care, particularly psychiatry, psychology, and social work. The authors, a psychiatrist and clinical psychologist, have joined their diverse training and backgrounds in writing this book. They have had previous publications on suicidal behavior, and therefore seem to be credible authorities.
Features: The book provides a better understanding of suicidal behavior, both the act itself and the individual. Also, the assessment and treatment of the different forms of suicidal behavior in the various clinical settings are covered in depth. The book also helps clinicians to examine and deal with their emotions and attitudes towards suicidal behavior. Finally, legal issues regarding suicide are covered. The best feature of this book is the organization. The Helpful Hints provide the most relevant information from each chapter in a succinct manner. The appendixes are unique tools for teaching various aspects of the management of suicidal behavior.
Assessment: This is a well written, comprehensive, clinically-applicable book on suicidal behavior. I know I will find this book useful in my own practice.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9781585621408
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 9/28/2004
  • Edition description: New Edition
  • Pages: 360
  • Sales rank: 524,283
  • Product dimensions: 5.50 (w) x 8.25 (h) x 0.75 (d)

Meet the Author

John A. Chiles, M.D., is Clinical Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, Sound Psychiatry Consulting Group, in Port Townsend, Washington.

Kirk Strosahl, Ph.D., is a Clinical Psychologist at Mountainview Consulting Group Inc., in Moxee, Washington.

American Psychiatric Publishing

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Table of Contents

Preface. Introduction: the dimensions of suicidal behavior. The clinician's emotions, values, legal exposure, and ethics: global issues in the treatment of suicidal patients. A basic model of suicidal behavior. Assessment of suicidal behavior and predisposing factors: blending your assessment with treatment. Outpatient interventions with suicidal patients. The repetitiously suicidal patient: evaluation, psychotherapy, and basic case management. Managing suicidal emergencies: more on crisis and case management. Hospitals and suicidal behavior: a complex relationship. Working with special populations: substance-abusing, psychotic, young, and elderly patients. Suicidal patients in general health care. Understanding and providing care to survivors of suicide. Appendix A: philosophies about suicide. Appendix B: consequences of suicidal behavior questionnaire. Appendix C: reasons for living inventory. Appendix D: suicidal thinking and behaviors questionnaire. Appendix E: malpractice management assessment. Index.

American Psychiatric Publishing

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