E-Sim

Assessment of suicide risk and management of deliberate self-harm (OUP, 2012) are the most important steps towards restoring mental balance in patient. Suicide risk assessment may imply open discussion, share observations, or discussion of suicidal thoughts (Sharon, 2010) approach. Most often, counselors use several or all these approaches altogether; like in Bill’s case when counselor encourages his patient to discuss current situation and share his suicidal thoughts.

The mentioned approaches are important for assessing dynamic suicide risk-factors, which, unlike static ones, change over time (OUP, 2012). Assessing Bill’s predisposition to suicide or violent actions, the counselor should take in consideration several major factors.

1. The nature of suicide/violence risk (OUP, 2012). Currently, Bill has no opportunity to meet with his children, and this is the most significant stress-factor for him.

2. The probability of risk in short/long term (OUP, 2012). Bill himself assesses this probability as six of ten. His words should be taken seriously, as pronounced suicide ideation increases the risk of self-harm among patients (Coryell & Young, 2005).

3. The factors increasing/reducing risk. In Bill’s case, the lack of contact with his children is the most significant risk-factor increasing self-harm risk; while availability of work and hobby, family and friends, and the patient’s religiosity are the most important factors decreasing the probability of self-harm.

Intervention is the second step towards treating suicidal patients. It is based on previous assessment and may include hospitalization or routine screening of a suicidal individual (Sharon, 2010). Analyzing Bill’s responses to the counselor’s assessment questions, it is recommended that the latter applies routine screening approach. It is obvious that the factors decreasing suicidal risk outweigh the factors increasing it, so, the counselor should introduce the list of interventions aimed at restoring mental balance in his patients. Below, is the list of the most probable interventions for Bills case.

1. Articulation of convincing reasons for living (Raue, et. al., 2006). As long as Bill demonstrates suicide ideation, but has no detailed plan (Raue, et. al., 2006) the counselor should help him to find good reasons for not implementing it. For instance, Bill has already mentioned that the thoughts about his children and his family keep him from committing a suicide.

2. Counselor is recommended to encourage Bill’s family and friends to take an active part in his therapy. Their active involvement is important for the patient to find good reasons for living. The same involvement can provide counselor with important information about his patient’s suicidal comments and warnings (Sharon, 2010). This intervention should be taken with the patient’s permission (Raue, et. al., 2006), though.

3. Increase of patient’s social contacts (Raue, et. al., 2006) is also an important step towards restoring mental balance in patient. Counselor should encourage his patient to take part in the life of his family and community, which can distract Bill from suicidal thoughts.

Further patient’s follow-up is important to assess efficiency of the therapy. This stage may include schedule visit with the patient (Raue, et. al., 2006). The main objective of these visits is …
Posted by: Mariana Galipeau

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