Suicide Assessment and Treatment Planning. John Sommers-Flanagan. Читать онлайн. Newlib. NEWLIB.NET

Автор: John Sommers-Flanagan
Издательство: John Wiley & Sons Limited
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Жанр произведения: Учебная литература
Год издания: 0
isbn: 9781119783619
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self-care mantra should be to use what works for you—and then keep expanding your repertoire.

      What most people find especially health enhancing is to flex their personal choice-making muscles. The exact thing you do hardly matters. What matters is that you intentionally override natural tendencies toward lethargy, inactivity, or self-destructive choices. Free online apps that promote healthy behaviors include (a) 7 Minute Workout, (b) Happy Habits: Choose Happiness, (c) Sleep Better, (d) Headspace, (e) Calm, (f) Happy Now, (g) Pzizz, and (h) Inner Balance.

      Positive psychology researchers have identified at least a dozen evidence-based activities that increase happiness and well-being. Martin Seligman (2002) developed one of the first and most well-known happiness activities; he called it Three Good Things. Three Good Things can work for you or for your clients.

      The Three Good Things assignment is implemented each night, before going to bed, and goes like this: “Write down three good things that happened and why you think they happened” (Seligman et al., 2006, p. 776). (You can find a 1-minute video of Seligman describing the activity at https://www.youtube.com/watch?v=ZOGAp9dw8Ac.)

      According to Seligman, after doing this for a week, most people continue doing the Three Good Things activity because it feels so good. Intentionally focusing on good things helps orient people toward the positive, but perhaps even more important, asking individuals to reflect on why the good things happen seems to remedy the human tendency to ruminate on daily mistakes. Contemplating why good things happen initiates a process of ruminating on the positive.

      Clients who are deeply depressed may reject the idea that anything good could be happening. If so, we recommend you consider shifting the language to something your client views as more possible. For example, instead of monitoring for three good things, clients can be asked to monitor for three “not so bad” things. However you frame it, we recommend that you experiment with this positive psychology activity for yourself and for your clients.

       Manage Your Environment

      Achieving complete control of your environment is impossible, but there is solid research on stimulus control as a tool for resisting temptation and triggering healthy behaviors (Quinn et al., 2010). Stimulus control means making sure your environment prompts positive behaviors; it might mean a pair of running shoes by the door, healthy snacks in your desk, or your best friend in your Favorites or on your speed-dial. Because you know yourself best, strive to create an environment that not only is comfortable but also will prompt you to engage in healthy behaviors.

       Accept Your Distress and Engage in Self-Soothing Behaviors

      If you are feeling distressed, one healthy response is to find a safe time and place to accept and explore the emotion. First, notice the distress and accept it. There is no shame in being distressed. Then, when you are ready, ask yourself, “When I’m upset, what helps me calm down?” The answer might include going for a walk, breathing deeply, coloring, or holding hands with a friend or romantic partner. Several forms of counseling require that clients find their safe space before facing difficult or traumatic memories (Shapiro, 2001; J. Sommers-Flanagan & Sommers-Flanagan, 2018). As you read this material, consider what you can do to soothe and calm yourself when the content gets intense. One caveat here: We recommend that you remove the use of mind-altering substances for self-soothing from your list. Although using substances for recreational purposes is a reasonable personal choice, relying on substances for self-comfort is a bad idea in the long run.

       Practice What You Preach

      Many school and mental health professionals benefit from obtaining their own personal counseling or therapy. We recall listening with great interest to a famous behavior therapist speak of his preference for the emotional focus of gestalt therapy. He used behavioral approaches in his own clinical practice, but when he went for personal therapy, he chose experientially oriented counselors and psychotherapists who helped him explore deep emotions in the here and now. We hope that like this unusual behavior therapist who liked gestalt therapy, you will be open to pursuing whatever form of counseling you believe might be helpful to you and your situation.

      Counselors and other helping professionals are consistently exposed to interpersonal and emotional stressors. In addition, perhaps more than ever, emotional stability is constantly affected by the global pandemic, social distancing, disrupted social networks (including networks of family and counseling peers), heightened awareness of racial and social injustice, sociopolitical upheaval, and other sources of uncertainty. To cope with common and uncommon stressors of professional counseling, you should consider whether you might benefit from engaging in personal counseling, creating peer support groups, or obtaining supervision. If you are working regularly with clients who are suicidal, your need for counseling support is magnified.

      Examining and Bracketing Attitudes and Beliefs

      Ethical counselors cannot allow personal values and attitudes to interfere with the provision of professional services (American Counseling Association, 2014; Corey, 2020). For example, let us say you believe that death by suicide is a mortal sin. You may feel pressured to push clients to banish their sinful suicidal thoughts. Although in most cases, counselors are ethically mandated to help prevent suicide, suicide researchers emphasize that competent suicide assessment and interventions begin with the acceptance of suicidal impulses. If you advocate too hard and too soon against suicide, you may activate client resistance (Brehm & Brehm, 1981; J. Sommers-Flanagan & Shaw, 2017). Instead of saving lives, you may end up alienating clients, thus putting them at greater risk.

      The opposite extreme can occur when professionals believe fervently in the right to die by suicide. This belief can be communicated in destructive ways. For example, if your client leaves the session thinking, “My counselor seems to be an advocate for suicide” or “I didn’t get the sense that my counselor wants me to live,” then you have done your client a disservice and probably engaged in malpractice.

      If your personal, religious, or philosophical beliefs about suicide interfere with your ability to provide competent and nonjudgmental assessment services, develop a therapeutic relationship, establish a collaborative treatment plan, or provide ongoing management of suicidal behaviors and implement research-supported interventions, then you are engaging in unprofessional and unethical practice. Professionals must be cognizant of their sometimes less than helpful attitudes and beliefs about suicide. Awareness allows professionals to ethically bracket attitudes, beliefs, and biases that could potentially interfere with competent care.

       What Is Ethical Bracketing?

      Ethical bracketing is defined as “the intentional separating” or “setting aside” of personal values to “provide ethical . . . counseling to all clients” (Kocet & Herlihy, 2014, p. 182). Ethical bracketing requires that counseling practitioners honor their commitment to working in the best interests of their clients—even when doing so conflicts with their religious values or beliefs.

       Staying Focused When Strong Emotions Rise Up

      As a Catholic, Mateo had deep moral values and an especially strong belief that suicide was morally wrong. As a graduate student in counseling, Mateo was learning about the need to bracket his values and not impose them on his clients. In his second year of training, Mateo worked with two clients who talked a lot about suicide. Whenever the word suicide came up in counseling, Mateo felt himself