Technique Benefits Inpatients by Targeting Suicidal Ideation

Article excerpt

FROM THE ANNUAL CONFERENCE OF THE AMERICAN ASSOCIATION OF SUICIDOLOGY

PORTLAND, ORE. - Collaborative Assessment and Management of Suicidality significantly helped depressed, hopeless, and suicidal psychiatric inpatients in a small case series at the Menninger Clinic in Houston.

Although there was no control group, this was the first study to show that the technique - which had been proved to help military, college, and other outpatients - also helps hospitalized people. In all, 16 women and five men (aged 18-55 years) reported significant drops in suicidality after an average of about 11 sessions of CAMS, as the technique is known, over 6 weeks.

At the heart of CAMS is a strong, trusting bond between patients and therapists. CAMS also tackles suicidality as a problem in itself, not merely as a symptom of a disorder, said Thomas E. Ellis, Psy.D. "So often when you view suicidality as a symptom and you treat the disorder, you anticipate that as the person feels better, the suicide problem is eliminated. Research is not consistent with that model. We view suicidal ideation and behavior as a target," said Dr. Ellis, director of psychology at the Menninger Clinic.

At the outset, CAMS patients are assured that they will not be judged, and the therapist empathizes with their suicidal wish. The basic assumption is that the patient "is doing the best they can under the circumstances, and that the suicidality is there simply for lack of better coping behavior," Dr. Ellis said.

The therapeutic bond leads to accurate risk assessment plus identification and treatment of suicide drivers, such as emotional pain, stress, agitation, hopelessness, and self-hate. Patients were asked to rate their levels of those things - plus suicidal intent - throughout the study. All were admitted with significant suicidal ideation and past attempts. Mood disorders were the primary diagnoses, often comorbid with anxiety disorders, substance abuse, and personality disorders. …