Treatment Alliance, Goals, and Interventions

therapist 's role is to listen, teach, and encourage, while the client 's roles is to express concerns,

Each therapeutic relationship is unique in that for each client, it is possibly the first intimate connection they have had with another person where profound feelings, beliefs and thoughts are exposed.

In 2014, suicide was the tenth leading cause of death overall in the United States. According to the National Institute of Mental Health (NIMH, 2015), there were twice as many suicides than there were homicides. Suicidal ideation (SI), defined as an individual thinking about, considering, or planning their suicide, is established before the act of committing suicide. Research suggests that adverse childhood experiences (CDC, 2015) will put an individual at risk for developing a mental illness that could result in SI and suicide attempt (SA). It is important for the psychiatric mental health nurse practitioner (PMHNP) to recognize the signs of SI and SA while assessing their client.

There is at least 113 suicides each day or 1 every 13 minutes. Suicide among males is the seventh leading cause of death and the fourteenth leading cause in females. Most suicides are with a firearm and are carried out with a “ Saturday night special”. (Dilaura,Cynthia DiLaura) “More than 90 percent of suicide attempts with a gun are fatal. “ (Brady Campaign) There are a number of reasons why suicide occurs. Stress is the number one cause among our youth, bullies, peer pressure, depression, and abuse. 41,100 people committed suicide in the United States in 2013. Our young teens today does not take time to look deeper into there problem and to seek out a better solution. They are looking for a quick fix but not realizing once the trigger is pulled the result is final with no turning back. Most people who has attempted suicide is more likely to try a second attempt and most have an underlying mental illness. There is many warming that someone may be in a suicide crisis. We most learn how to see things through their eyes. No matter what one is facing in life or the difficult that lie ahead of them Nothing is worth taken your own

“Suicide occurs when a person ends their life. It is the 11th leading cause of death among Americans. But suicide deaths are only part of the problem. More people survive suicide attempts than actually die. They are often seriously injured and need medical care” (Suicide, 2010). It is important to know the risk factors involved as well as ways to prevent suicide form occurring. As case managers, or any health care professional, it is equally important for us to know what the signs may be in order to properly address them and it is also very beneficial to know HOW to address such a sensitive issue. We have to know that not every suicidal case will be prevented but knowing it will definitely lessen the cases of those that do decide to commit

There are many models of risk assessment available to clinicians. The National Suicide Prevention Lifeline (NSPL, 2006) recommends assessment based on the individual’s desire to harm themselves or others. Additionally, the capability to attempt should involve the clients: past history of suicide attempts; violent behaviors; having the means; current substance abuse; loss of reality; extreme agitation, aggression or rage. Suicidal intent is reflected by: an attempt in progress; a known plan to carry out the suicide; preparatory behaviors.

Suicide is the third leading cause of death today among teens and young adults. It is preventable yet thousands of people die of it each year. It is an act of intentionally causing one’s own death. According to SAVE, suicide is the 10th leading cause of death in the United States and takes around 40,000 lives each year in the U.S. and 800,000 lives worldwide. There are a variety of reasons why people resort to suicide as a way to help themselves. Major events or negative changes in life can cause someone to think that suicide is the only way they can solve the problem. People with these thoughts often act differently than usual. There are a number of ways to help prevent suicidal thoughts simply by just talking to them. Suicide is wrong and

The therapeutic alliance is the foundation for successful or unsuccessful treatment engagement (Sprenkle et al., 2009). The extent to which clients are able to engage with the therapist, will likely determine the expanse of participation and commitment they will attribute to therapy (Sprenkle et al., 2009), or social work intervention in its entirety. To elaborate, consider patients diagnosed with CKD. CKD is a primarily asymptomatic, but progressive and physiologically degenerative disease; if specific protocols to maintain sufficient kidney function are not adhered to (Collins et al., 2003). One may assume, these patients may feel intrinsically oppressed by their diagnosis, because they are typically advised to make specific

The suicide lethality assessment has some strengths in that it identifies important suicide risk factors. The risk factors includes age, sex, stress, suicidal plan, feelings, behavioral changes, network, future outlook, perceived reactions

The article specifically identifies the person who collects the data as “a doctoral level clinical psychology graduate student,” and is qualified and trained to work in the field (DeJong et al, 2010). Researchers use various instruments to collect specific information about suicide attempters and suicidal completers such as Suicidal checklists and Risk-rescue rating scale. Suicidal checklists gather information regarding patient’s “suicidal behaviors, life stressors, and historical variables” (DeJong et al, 2010). Risk-rescue rating scale is also used to rate the lethality of suicide attempters. With the result from Risk-rescue rating scale, the researchers classify the suicidal attempters into two groups: low-lethality and high lethality (DeJong et al, 2010). Even though the instruments are identified in the method section, researchers do not thoroughly describe the instruments. It would be appropriate to further discuss the type of scale, the outcome of scores, and the meaning of scores in

The Center for Disease Control is responsible for keeping track and providing facts and figures for suicide. They describe suicide as a serious problem and a leading cause of death in the United States. It is in fact the 10th leading cause of death across all age groups. In 2013, an estimated 41,149 people successfully committed suicide (Understanding). In contrast, 494,169 attempted to harm or kill themselves but failed (Understanding). Many more people are thought to have tried and not sought out help, leaving them an unknown factor in the equation. All in all, suicide and its attempt are responsible 6.1 billion dollars in medical and work loss costs in the United States annually (Understanding).

I chose to review Beck Scale for Suicide Ideation (BSS; Beck & Steer, 1993). The BSS was developed from Beck and Steer’s (1993) clinical rating version The SSI which is a 19-item measurement that is used to assess an individual’s traits as it relates to suicidal thoughts. The BSS is the self-report version is based on 21-items but only 19 of the items are used in scoring the test results. The test kit consists of an Administration and Scoring Manual and a Record form. The Beck Scale for Suicide Ideation is a widely used instrument to assess suicidality. Suicidal behaviors consist of but not limited to the planning for suicide, suicidal ideation (thoughts of harming or killing oneself) and/or gestures.

specializes in prevention health care. “Adolescence and old age are the times in life when suicide

At some point in one’s life they may believe that the only solution to their physical or mental problem is suicide. Although, we think that the majority of people who try to commit suicide just want attention. Suicide is the 10th leading cause of death in the in the United States in 2013, bypassing homicide which came in at 16th place (Facts & Figures, 2014). The facts indications by the CDC estimate that someone will commit suicide in the United States every 13 minutes (Facts & Figures, 2014). Unlike most common disease’s suicide does not discriminate against age, or sex, or social class, it is estimated that males represent 79 percent of the people who do commit suicide in the United States (Facts & Figures, 2014).

Suicide is a main source of death around the world and ranks among the three main causes of death among young adults aged between 15-45 years. Indeed, a response to this continuous worldwide issue, the World Health Organization called for the prevention of suicide (WHO, 2015). Several studies have evaluated some of the contributing factors, however, the connection between suicide and the evaluated factors is conclusively positive or negative.