Seven Dimensions of Suicide Assessment and Treatment

Here’s a glimpse of what the garden looks like this morning.

In most of life, most of the time, there’s not much completely new or original. People tend to gather inspiration from others and build on or rediscover old ideas. This my way of acknowledging that, although I wish I always had a boatload of original ideas to share in the blog, more often than not, I’m embracing the green new deal and . . . re-using, recycling, and repurposing old ideas.

The following Table describes the seven dimension model that Rita and I use to aid clinicians in conducting assessments and interventions with clients or patients who are suicidal. These seven dimensions aren’t original, but the idea that suicide drivers (and risk/protective factors) can emerge and influence people from any or all of these dimensions is helpful in a more or less original way. Check out the Table to see if it’s useful for you.

Dimension: In this column, we define the dimensionsEvidence-Based Suicide Drivers: In this column, we identify risk factors or suicide drivers that can push or pull individuals toward suicidality. The key to this model is to identify and treat the main sources of distress (aka psychache). In the next columns (not included here), you would find wellness goals and specific interventions.
Emotional: all human emotions.Excruciating emotional distress

Specific disturbing emotions (guilt, shame, anger, sadness)

Emotional dysregulation
Cognitive: All forms of human thought, including imagery.Hopelessness

Problem-solving impairments

Maladaptive thoughts

Negative core beliefs
Interpersonal: All human relationships.Social disconnection and perceived burdensomeness

Interpersonal loss and grief

Social skill deficits

Repeating dysfunctional relationship patterns
Physical: All human biogenetics and physiology.Biogenetic predispositions and physical illness

Sedentary lifestyle; poor nutrition

Agitation, arousal, anxiety

Trauma, nightmares, insomnia
Spiritual-Cultural: All religious, spiritual, cultural values that provide meaning and purpose.Religious or spiritual disconnection

Cultural disconnection or dislocation

Meaninglessness
Behavioral: All human action and activity.Using substances or self-harm for desensitization

Suicide planning, intent, and preparation

Impulsivity
Contextual: All factors outside of the individual that influence human behavior.No connection to place or nature

Chronic exposure to unhealthy environmental conditions

Socioeconomic oppression or resource scarcity (e.g., poverty)

If you’re interested in learning more, our suicide book is available through the American Counseling Association https://imis.counseling.org/store/detail.aspx?id=78174 or through the usual booksellers.

Have a great weekend.

JSF

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