Suicidal patients develop a crisis when they view problems as unsolvable and suicide as the only solution. They feel hopelessness about enduring or solving difficulties and see suicide as relief. Those at higher risk have schemas involving vulnerability and a belief that others are rejecting or have high expectations. It is important to comprehensively assess recent stressors, diagnoses, and feelings of hopelessness. Treatment includes crisis intervention with a focus on identifying high-risk individuals and hospitalization when needed, as well as continuing therapy viewing suicidal behavior as a problem-solving style. Ongoing assessment of suicide risk is crucial.

1. THE SUICIDAL PATIENT
Suicidal patients

2. Development of a Suicidal Crisis:
 1.) faced with a problem that is preceived as unsovable
 2.) view problem as continuing despite best efforts to solve it
 3.) see suicide as only solution
 4.) disregard all other problem solving options
 5.) believe that dealth will bring relief

3. Hopelessness and suicide:
 Suicidal individuals tend to believe that their difficulties as
both unendurable and unsolvable.
 View difficulties as insurmountable and feel hopeless in the
face of these problems

4. Schemata of suicidal patients:
 1.) vunerability to loss or abandonment in conjunction with a
belief that others are rejecting, judgemental, and hold
unreasonably high expectations for them
 2.) perceptions of personal incompetence and helplessness
 3.) poor distress tolerance
 4.) a perception of defectiveness and unlovability
 5.) a belief that it is important to impress others

7.  who are fighting any of these things are at a higher risk for
suicide:





psychiatric disorder
life event stressor,
physical illness,
personality disorder,
social problems
 Any individual who presents with suicide symptoms is at risk
 Prior suicide attempts is a major predictor of suicide
 Suicide is sometimes an impulsive act
 Its not only the life event that is intolerable it is the emotional state
that accompanies it

9.  High risk patients need a safe environment and it is the
responsibility of the practitioner to ensure and assess that. A
patient who have lethal, immediate, and precise suicidal
plans will require a safe environment or hospitalization.
 Questions about suicide plan, method, and when intended
outcome with a precise plan with lethal means arranged for
the next 24-48 hours constitutes high risk

10. Factors to Assess Routinely:
 A comprehensive suicide risk assessment evaluation of
demographic characteristics, recent life stressors, psychiatric
diagnosis, and family history of suicide
 Feelings of hopelessness and helplessness and if the client
believes that living another day is an endless cycle of
emotional pain and distress that will only end by taking their
life

11. Assessments & Qestionaires:
 1.reasons for living scale (Linehan, 1985) to measure adaptive
characteristics in suicide;
 scale for suicide ideation (Beck et al., 1971);
 hopelessness scale/Beck Hopelessness Scale (Beck, 1993;
Beck et al., 1974b) to assess degree of suicide risk;
 prediction of suicide scale (Beck et al., 1974a);
prevention
 Los Angeles suicide 1973); scale (Los Angeles Center for
Suicide Prevention,
II (Beck, 1978; Beck & Steer 1987;
 Beck Depression Inventory al., 1996);
Beck et al., 1961; Beck et
 Scale for Assessment of Suicidal Potentiality (Battle, 1985);
 PATHOS screening questionnaire (following adolescent
deliberate self-harm)
 (Kingsbury, 1993).

12. Treatment Modalities:
Crisis-intervention model:
assumption is that feeling
 "primaryis an acute crisis that will
suicidal
pass, the second assumption is
that it is possible to prevent
suicide" (Pulakos,1993).
 "the idea that suicide can be
prevented leads to an emphasis
on assessment and identifying
those at high risk" (Pulakos, 1993).
should assess for
 therapists in depth and repeat idly
suicidality
, hospitalization is an important
therapy adjunt to this therapy.
Continuing therapy
model:
 focuses more on suicidal behavior
and attempted suicide
an assumption that
 "there isthoughts and behavior
suicidal
may result from chronic behavior
pattern rather than an acute crisis.
chronic suicidal behavior is viewed
as an interpersonal or problem
solving behavior that reflects a
persons style of realting to the
world" (Pulakos, 1993)."this is an
assumption that suicidality is a part
of the persons life style" (Pulakos,
1993).
the suicidal
 "emphasizesareframingsolving
behavior as problem
behavior and working with it as
you would any maladaptive
behavior" (Pulakos,1993).

13. http://www.youtube.com/watch?v=z6idLnw4DY8

14. References:
 Overholser, J. C., Braden, A., & Dieter, L. (2012). Understanding suicide
risk: identification of high-risk groups during high-risk times.
Journal Of Clinical Psychology, 68(3), 349-361.
doi:10.1002/jclp. 20859

 Pulakos, J. (1993). Two models of suicide treatment: Evaluation and

recommendations. American Journal Of Psychotherapy, 47(4),
603

 Ruddell, P., & Curwen, B. (2002). Understanding suicidal ideation and
assessing for risk. British Journal Of Guidance & Counselling,
30(4), 363-372. doi:10.1080/0306988021000025583
 Yufit, R., & Lester, D. (2005). Assessment, treatment, and prevention of
 suicidal behavior. Hoboken, New Jersey: John Wiley & Sons, Inc.