Category Archives: Clinical Interviewing

Last Call for the Suicide Assessment and Intervention Psychotherapy.net Video Training

Hi All.

Below is the link for the $139 deal for the 7.5 hour Assessment and Intervention with Suicidal Clients training video with Psychotherapy.net.

Please share this information with other professionals who might want or need to sharpen their skills for working with clients who are or might become suicidal. This is a hard topic and I hope this resource can help clinicians feel more confident and competent in their suicide assessment and intervention skills.

https://academy.psychotherapy.net/p/suicide-promo?utm_source=ActiveCampaign&utm_medium=email&utm_content=LAST+CHANCE%3A+Suicide+Assessment+and+Intervention&utm_campaign=suicide+course+email%233

 

 

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Assessment and Intervention with Suicidal Clients: A Brand New 7.5 Hour Video Training

Yellow Flowers

Suicide rates in the U.S. are at a 30 year high. Beginning in 2005, death by suicide in America began rising, and it hasn’t stopped, rising for 12 consecutive years.

Worldwide (and at the CDC) suicide rates are tracked using the number of deaths per 100,000 individuals. Although the raw numbers listed above are important (and startling), calculating deaths per 100,000 individuals provides a consistent per-capita measure that allows for systematic comparison of suicide rates across different populations, geographic regions, sexual identity, seasons of the year, and other important variables. For 2000, the CDC reported an unadjusted death by suicide rate of 10.4 persons per 100,000. For 2016, they reported 13.7 suicides per 100,000 Americans. This represents a 31.7% increase over 16 years.

As suicide rates have risen, federal, state, and local officials haven’t been idly standing by, wringing their hands, and wondering what to do. To the contrary, they’ve been actively engaged in suicide prevention. In 2001, the Surgeon General established the first National Suicide Prevention Strategy, revising it in 2012. All the while, there have been big pushes by federal and state governments, community organizations, schools, private businesses, and nonprofits to fund and promote suicide prevention programming. For the most part, the suicide specialists who run these programs are fantastic. They’re dedicated, knowledgeable, and passionate about saving lives. In addition to all the prevention programs available today, currently there are more evidence-based psychotherapies for suicidal people than ever before in the history of time.

But even in the face of these vigorous suicide prevention and intervention efforts, suicide rates continue to relentlessly rise . . . at an average rate of nearly 2% per year.

At this point it’s clear that prevention efforts may not have a direct influence on overall suicide rates. It’s tough to move the big needle that measures U.S. suicide rates. Some solutions may be more sociological and political. Of course, that doesn’t mean we should stop doing prevention. But, given the numbers, it’s important for us to try to find alternative methods for reducing and preventing suicide.

All this leads up to an announcement. Today, Psychotherapy.net published a three volume 7.5 hour video training titled, Assessment and Intervention with Suicidal Clients. This project was a collaboration between Rita, me, and Victor Yalom (along with his amazing staff at Psychotherapy.net). Although watching this video won’t automatically make suicide rates decrease, gaining awareness, knowledge, and skills on suicide assessment and intervention is one way counselors and psychotherapists can contribute to suicide prevention.

Psychotherapy.net is offering an introductory offer for the 7.5 hour video, with CEUs included. You can click here for details on the introductory offer and a sneak peek at the video.

I hope you find the video training helpful, and I look forward to hearing comments and feedback from you about how we can keep working together to help prevent suicide.

Internship Class Reflections

Evening in M 1

Due to my poor time management skills, I ran out of time for comments during my Tuesday internship class. This error provided a sudden inspiration to continue making comments to my students via email. I asked their permission and they seemed interested. It reminded me of a technique Rita used to use when running groups. Following every group, she would write her own insightful reflective comments and send them out to the group members.

Here’s what I shared with me students . . . with . . . of course . . . all identifying information removed.

***********

In class I mentioned that I wanted to email you some ideas I didn’t have time to share . . . so here we go.

Based on the small amount of recording we listened to together, it sounded like our rock star counselor-in-training (aka “Rocky”) has established an excellent “relationship” or working alliance with her client. That being the case, many things are possible.

The first thing is what I already mentioned at the very end of class. Using her relational connection as a foundation, Rocky can use any of a number of strategies to open up a discussion about her changing her approach to less listening and more engagement. This doesn’t mean I think Rocky “should” be more active, but because Rocky feels it to some degree and brought it up with us, it’s a signal to me that it might be an issue worth exploring. Here’s an example:

“I’ve been thinking about how I act during our counseling sessions. Sometimes I notice myself sitting back and listening as you tell me a story about your life. I think the stories are important, so I mostly just stay quiet and listen. But I’m also wondering if, because the stories are important parts of your life, if maybe I should be more active and engaged with you as you share your stories with me. It might be better for me to ask questions, make comments, or try to identify patterns. If it’s okay with you, I’d like to talk a bit more. Would you be okay with that? If I try it and you don’t like it, we can always switch back.”

This way of bringing up the issue places the focus on Rocky’s behavior and it models how part of counseling involves self-reflection/analysis. It also introduces the idea as an experiment that both Rocky and her client can comment on.

The second issue I wanted to discuss more is the client’s reluctance to “get into her emotions.” Of course, this is a very common reluctance. If we look at it through a motivational interviewing lens, it’s very possible for her to be ambivalent about getting emotional. Part of her can see the value and part of her is afraid or reluctant.

One possible strategy, among many, is for Rocky to affirm that it’s okay to avoid talking about emotions (at least for now), but that in the meantime, it might be helpful to explore what makes talking about emotions feel so challenging. The point is to focus on “what gets in the way” of talking about the emotions directly first, and only then, after greater understanding is obtained, possibly move forward and experience the emotions.

Using this strategy, the assumption is that there are negative expectations (cognitions) linked to directly feeling/experiencing emotion. One of the following could be possible: (a) “I’m afraid once I open the emotional box, I won’t be able to stop” (then you explore if this has happened and examples of how she has recovered after being emotional in the past); (b) “I’m worried that you’ll judge me” (then you explore the possibility of that happening; (c) “I feel weak when I get emotional” (this might inspire a discussion about whether facing emotions directly is an example of being weak or being strong, or something else).

These are just some examples of the thoughts/expectations that can interfere with emotional processing. Many other unique scenarios are possible. In my experience, if you use collaborative empiricism to explore negative expectations, sometimes the expectations can be managed . . . and sometimes clients will spontaneously start talking about the benefits of emotional expression.

My last idea is related to a component part of EMDR. When clients have an image or situation linked to a specific trauma, EMDR practitioners employ two questions that are IMHO quite powerful. Here they are, using a made up scenario:

  1. “When you imagine the scene at your mother’s funeral, what negative belief about yourself comes into your mind?”

You might have to repeat that question because it’s complicated. The assumption here is that the trauma memory is linked to a core negative belief about the self.

Then you move to the opposite question:

  1. “When you imagine the scene at your mother’s funeral, what positive belief about yourself would you rather have come into your mind?”

You don’t have to be using EMDR to find your client’s answers to these questions very useful. The first answer is the disturbing or dysregulating belief. It needs desensitizing or disputing or something. The second answer is a new belief about the self that may constitute a major therapeutic goal. It needs supporting; it needs to become a possibility.

So . . . how do you get there? Well, I’d go on, but we need to have something to talk about next week:).

Have a great evening.

John

 

Aotearoa New Zealand Conference Keynote

NZ Tree and John

Kia ora.

Today is the future in New Zealand where I have the distinguished and humbling honor to present the closing keynote speech at the New Zealand Psychological Society’s Jubilee Conference.

Attached here are two things:

  1. The Brainstormed powerpoint slides from my workshop last Wednesday. These include a list of resources that New Zealand professionals and students have found useful in their suicide assessment, intervention, and prevention work. NZ 2018 Workshop Brainstorming
  2. The powerpoint slides for today’s keynote:NZ 2018 Suicide Keynote Final

New Zealand Jubilee Resources!

Kia ora.

I’m in New Zealand to present at their 50th Anniversary Jubilee Psychology Society Conference. . . which is way cool. Below are two resource links.

First, the Powerpoint Slides: NZ 2018 Suicide Workshop

Second, a link to my 2018 Journal of Health Service Psychology article on suicide assessment and intervention: https://www.nationalregister.org/pub/the-national-register-report-pub/journal-of-health-service-psychology-winter-2018/conversations-about-suicide-strategies-for-detecting-and-assessing-suicide-risk/

Have a fabulous week!

John

My Slate Article on Donald Trump’s Dangerous Personality Dimensions

Hi All.

The Slate Magazine article where I use Theodore Millon’s personality descriptions to articulate possible challenges linked to Trump and the U.S. Presidency is out. Here’s the link: https://slate.com/technology/2018/08/no-matter-how-bad-it-gets-trump-will-never-give-up.html

As always, feel free to comment. You can do that here or on the Slate article itself.

John SF

The Rest of the Story on Trump’s Personality

AOIP6519

The Slate article on Donald Trump and his personality is coming out tomorrow morning. Of course, as with all things writing, it was wonderful and challenging. Writing for a popular online magazine like Slate is a new venue for me, so I learned plenty, and was honored to work with Slate’s Health and Science editor, Susan Matthews. She helped me be more focused and more articulate.

I’ll post a link to the article here tomorrow.

The main focus of the article was to look at Donald Trump’s personality through the lens of Theodore Millon’s antisocial personality formulations. Millon’s perspective is fascinating and I think some of his descriptive phrases fit Trump “beautifully,” but one of the  points of the article is for you to be the judge.

In the meantime, I want to share a paragraph that got cut. As we made revisions, it fell slightly outside the focus, but it was one of my favorite paragraphs. . . so here it is:

Recruiting independent actors to resist Trump is difficult. Trump skillfully uses intimidation, direct and indirect threats, and offers of power to recruit new supporters who will walk to the microphone, as Brett Kavanaugh did, and speak to the world of Trump’s unprecedented greatness. Exhibiting a glaring lack of judicial independence, Kavanaugh opened his nomination speech with a no holds barred endorsement of Trump’s character, stating, “No president has ever consulted more widely, or talked with more people from more backgrounds, to seek input about a Supreme Court nomination.” Never mind that reflective consultation is anathema to antisocial personalities or that Kavanaugh would have had to review 230 years of Supreme Court nominations to support his statement. Soliciting others to lie for them is a common antisocial strategy. Kavanaugh‘s genuflection to Trump is a foreboding example of how far and deep Trump’s power and influence run.

After the article is out, I’ll be posting more content that wasn’t quite ready for prime time.