Harvard Medical School Guide to Suicide Assessment and Intervention / Edition 1

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Overview

More than 30,000 deaths in the United States each year-more than 80 per day-are a result of suicide. Suicide is the primary cause of early death among psychiatric patients and an issue in one quarter of all psychiatric malpractice lawsuits.
The fundamental question is, How can clinicians identify patients who may be at risk for suicide and take the necessary steps to reduce that risk?

This essential resource-edited by Douglas G. Jacobs, Harvard Medical School's nationally recognized expert on suicide and depression-is a compendium of the most current research and authoritative thought on the topic of suicide. Each of the volume's forty-eight contributors is an expert on an aspect of suicide assessment and intervention. The breadth of knowledge offered in this handbook speaks to the fact that suicide is a complex, multidimensional clinical problem that requires a wide range of methods for effective assessment and treatment.

This hands-on guide is written for those who have the common yet complex task of assessing suicidality in a patient or client-psychiatrists, primary care physicians, school counselors, psychologists, psychotherapists, and other mental health professionals. The book helps professionals determine the risk level for suicidal or at-risk patients and recommends a suicide assessment protocol that can be effectively incorporated into clinical practice. The authors also provide guidelines for intervening when a person is at risk for harming himself or herself.
Comprehensive in scope, the book offers a wealth of information and practical advice on specific topics, including working with special at-risk populations such as adolescents, the physically ill, and those with major mental illness, alcoholism, or borderline personality disorder. The book also addresses the somatic treatment of the suicidal patient, including important new findings about the possible antisuicidal effect of lithium. In addition, the guide contains important cautions regarding suicide contracts and offers timely information about liability prevention from an authority in the field of suicide and malpractice lawsuits. On a personal note, one chapter is an honest and intimate account from a professional who has attempted suicide herself.

The Harvard Medical School Guide to Suicide Assessment and Intervention is the definitive guide for assisting clinicians in their crucial and continual task-determining the risk for and intervening against suicide.

A Handbook for Assessing and Treating the Suicidal Patient

Is your patient suicidal?

Knowing when a person is suicidal and intervening to reduce the risk of his or her death is one of the most stressful, difficult, yet vitally important tasks faced by counselors and health care providers everywhere.

Written by the top experts in the field, this definitive guide is the first in a new series of books developed in cooperation with the Department of Psychiatry at Harvard Medical School. The Harvard Medical School Guide to Suicide Assessment and Intervention is an essential reference that provides clinicians with information and strategies for appropriate responses to patients or clients who are at risk for suicide.

"The Harvard Guide puts the best and the brightest of consulting suicidologists on the practicing clinician's bookshelf, offering an invaluable resource for understanding and treating the at-risk suicidal patient. Our patients will benefit greatly from the insights and directives in the book. I urge caregivers to make this a must read." Lanny Berman, executive director, American Association of Suicidology

"The threat of suicide is riveting; its reality is devastating; it is our life-or-death clinical challenge. This volume is the singularly comprehensive, authoritative, definitive, and useful text on suicide. We are now strengthened for our work." Jerrold F. Rosenbaum, Massachusetts General Hospital, Harvard Medical School

"[This book] presents the most up-to-date material and combines this framework with practical suggestions for the clinician. This is sure to become a classic."'Alan F. Schatzberg, Kenneth T. Norris, Jr. Professor and chairman, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

"For the clinician needing help with a suicidal patient-this is your book. For the student or researcher seeking the state of the art on suicide-this is your book."?Robert M. A. Hirschfeld, Titus Harris Distinguished Professor and chair, Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch at Galveston

The book contains black-and-white illustrations.

The definitive guide by the top people in the field to a crucial, continuous, and constantly recurring clinical task:a matter of life and death: determining the risk for and preventing suicide.

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Editorial Reviews

Doody's Review Service
Reviewer: Howard M. Kravitz, DO, MPH (Rush University Medical Center)
Description: This book is a rather large handbook of current work on suicide. It was written to serve as both a basic reference resource and a hands-on practice guide.
Purpose: The text evolved from a two-day suicide conference in 1997 that brought together Harvard faculty and outside experts. Its purpose is to help clinicians assess and treat suicidal patients, an unequivocally laudable goal. An important feature of the book that demonstrates the editor's sincerity in achieving this purpose is the inclusion of an "implications for the clinician" section at the end of almost every chapter, which serves to summarize and highlight key points and ties together the clinical and evidence-based aspects of each presentation.
Audience: The broad audience includes practitioners who need to assess suicidal persons: psychiatrists, primary care physicians, school counselors, psychologists, psychotherapists, and other mental health professionals. The editor has assembled an all-star line-up of contributors who comprise a virtual who's who in suicidology, ranging from A to Z (actually only A to W: Arango to Weiss).
Features: This guide is divided into three parts: assessment, intervention, and special issues. The result is an interesting blend of experiential and empirical views on suicide, its assessment, and practical management guidelines. The writing style emphasizes simple language and lucidity, which make an easy read of this weighty subject. The editor indicates points of overlap and/or alternative views and cross-references the reader to the appropriate chapter(s). Controversies and speculations are underplayed; the main thrust is to provide usable information for practitioners. Tables and exhibits (another term for tables in some chapters) highlight important facts; figures are presented sparingly. Vignettes are used to highlight clinical points. Quite impressively, most chapters are quite up-to-date, with a large number of references from the 1990s, up to and including 1998. Non-glossy, acid-free, and chlorine-free paper adds to user-friendliness.
Assessment: This book represents an attempt to cover assessment and intervention comprehensively from both evidence-based and state-of-the-art clinical practice perspectives. Although largely successful, it more convincingly achieves the latter than the former; the presentations tend more toward anecdotal and experiential than data-driven and evidence-based. Removing the anecdotal and overly personalized chapters would have shortened the text, but perhaps made it less interesting. Furthermore, the contributors' expertise adds an aura of authoritativeness and credibility to the chapters. One caveat is that this is a book for practitioners, not for suicide researchers, unless they also see patients. It is competitively priced and will be a well-used addition to the library of any practitioner who evaluates or treats potentially suicidal individuals, or provides clinical supervision for someone who does.
Howard M. Kravitz
This book is a rather large handbook of current work on suicide. It was written to serve as both a basic reference resource and a hands-on practice guide. The text evolved from a two-day suicide conference in 1997 that brought together Harvard faculty and outside experts. Its purpose is to help clinicians assess and treat suicidal patients, an unequivocally laudable goal. An important feature of the book that demonstrates the editor's sincerity in achieving this purpose is the inclusion of an ""implications for the clinician"" section at the end of almost every chapter, which serves to summarize and highlight key points and ties together the clinical and evidence-based aspects of each presentation. The broad audience includes practitioners who need to assess suicidal persons: psychiatrists, primary care physicians, school counselors, psychologists, psychotherapists, and other mental health professionals. The editor has assembled an all-star line-up of contributors who comprise a virtual who's who in suicidology, ranging from A to Z (actually only A to W: Arango to Weiss). This guide is divided into three parts: assessment, intervention, and special issues. The result is an interesting blend of experiential and empirical views on suicide, its assessment, and practical management guidelines. The writing style emphasizes simple language and lucidity, which make an easy read of this weighty subject. The editor indicates points of overlap and/or alternative views and cross-references the reader to the appropriate chapter(s). Controversies and speculations are underplayed; the main thrust is to provide usable information for practitioners. Tables and exhibits (another term for tablesin some chapters) highlight important facts; figures are presented sparingly. Vignettes are used to highlight clinical points. Quite impressively, most chapters are quite up-to-date, with a large number of references from the 1990s, up to and including 1998. Non-glossy, acid-free, and chlorine-free paper adds to user-friendliness. This book represents an attempt to cover assessment and intervention comprehensively from both evidence-based and state-of-the-art clinical practice perspectives. Although largely successful, it more convincingly achieves the latter than the former; the presentations tend more toward anecdotal and experiential than data-driven and evidence-based. Removing the anecdotal and overly personalized chapters would have shortened the text, but perhaps made it less interesting. Furthermore, the contributors' expertise adds an aura of authoritativeness and credibility to the chapters. One caveat is that this is a book for practitioners, not for suicide researchers, unless they also see patients. It is competitively priced and will be a well-used addition to the library of any practitioner who evaluates or treats potentially suicidal individuals, or provides clinical supervision for someone who does.
Booknews
A massive compendium of current research and thought to help clinicians identify patients who may be at risk for suicide and take appropriate steps to reduce the risk. Explains methods for determining the risk level for suicidal or at-risk patients, recommends a suicide assessment protocol that can fold easily into clinical practice, and provides guidelines for intervening when people risk harming themselves. Ranges through such populations as adolescents; the physically ill; and those with major mental illness, alcoholism, and borderline personality disorder. Also considers somatic treatment, highlighting new findings about lithium. One chapter is an intimate account by a professional who once attempted suicide; another looks at assisted suicide and euthanasia. Annotation c. by Book News, Inc., Portland, Or.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780787943035
  • Publisher: Wiley
  • Publication date: 12/28/1998
  • Series: Health and Psychology Series
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 736
  • Sales rank: 1,409,742
  • Product dimensions: 7.19 (w) x 9.37 (h) x 2.13 (d)

Meet the Author

DOUGLAS G. JACOBS M.D., is associate clinical professor of psychiatry at the Harvard Medical School and executive director of the nonprofit National Mental Illness Screening Project. He has edited two textbooks on suicide, Suicide: Understanding and Responding and Suicide and Clinical Practice.

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Table of Contents

Foreword, Joseph T. Coyle, M.D.

Preface, Douglas G. Jacobs, M.D.

ASSESSMENT.

Suicide Assessment: An Overview and Recommended Protocol (D. Jacobs, et al.).

Epidemiology of Suicide (E. Moscicki).

A Community Psychiatry Approach to Preventing Suicide (R. Dorwart & M. Ostacher).

The Psychodynamic Understanding of Suicide (J. Maltsberger).

Perturbation and Lethality: A Psychological Approach to Assessment and Intervention (E. Shneidman).

The Neurobiology of Suicidal Behavior (J. Mann & V. Arango).

Profiles of Completed Suicides (J. Fawcett).

Self-Mutilation (A. Favazza).

Standard Protocol for Assessing and Treating Suicidal Behaviors for Patients in Treatment (M. Linehan).

Murder Suicide: Phenomenology and Clinical Implications (M. Nock & P. Marzuk).

Excerpts from Academic Conference and Recognition of Suicidal Risks Through the Psychologic Examination (L. Havens).

Critical Points in the Assessment and Management of Suicide Risk (J. Motto).

Can Suicide Ever Be Eradicated?: A Personal Journey (P. Cantor).

INTERVENTION.

Suicide and Manic-Depressive Illness: An Overview and Personal Account (K. Jamison).

Lifetime Risk of Suicide in Major Affective Disorders (D. Clark & A. Goebel-Gabbri).

Suicide and Schizophrenia (M. Tsuang, et al.).

Substance Abuse and Suicide (R. Weiss & M. Hufford).

Borderline Personality Disorder (T. Davis, et al.).

Trauma and Suicide (J. Chu).

Antisuicidal Effect of Lithium Treatment in Major Mood Disorders (R. Baldessarini & L. Tondo).

Treatment of the Suicidal Patient with Psychotropic Drugs and ECT (C. Salzman).

The Inpatient Management of Suicidality (G. Jacobson).

ECT and Suicide (E. Metzger).

SPECIAL ISSUES.

Suicide in Children and Adolescents (S. Goldman & W. Beardslee).

Suicide in the Elderly (D. Steffens & D. Blazer).

Suicide-Prevention Contracts: Advantages, Disadvantages, and and Alternative Approach (M. Miller).

Guidlines for Conducting a Suicide Review (S. Stelovich).

Medical Settings and Suicide (M. Kelly, et al.).

Suicide Assessment in the Primary Care Setting (M. Miller & R. Paulsen).

Suicide, Assisted Suicide, and Euthanasia (H. Hendin).

Liability Issues and Liability Prevention in Suicide (T. Gutheil).

Appendix A: Guidelines for Identification, Assessment, and Treatment for Suicidality.

Appendix B: Risk Management Foundation of the Harvard Medical Institutions.

References.

About the Authors.

Name Index.

Subject Index.

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