The interpersonal theory of suicide : guidance for working with suicidal clients

Why do people die by suicide? Thomas E. Joiner and his colleagues attempt to answer this age-old question by exploring two obvious yet insightful assumptions: -People die by suicide because they can--that is, they become desensitized to pain and habituated toward violence. -People die by suicide because they want to--they typically have no sense of belonging to a valued group or relationship, and they feel that they have become a burden to loved ones. This book offers a new theoretical framework for diagnosis and risk-assessment of a patient's entry into the dark and obscure mental world of suicidality, and for the creation of preventive and public-health campaigns aimed at the disorder. More important, though, the book provides new, effective clinical guidelines for crisis intervention and for therapeutic alliances in psychotherapy and suicide prevention. "The purpose of this book is to demystify clinical work with suicidal patients by grounding this work within a model of suicidal behavior, the interpersonal theory of suicide (Joiner, 2005). The theory is ambitious in that it attempts a comprehensive and empirically defensible answer to the question, Why do people die by suicide? This book focuses on issues that we argue have been resolved, such as aspects of suicidal behavior that heretofore have not received adequate attentionindeed, in some theories have received no mention whatsoeverand that nonetheless are necessary for a full understanding of the phenomenon. The theory's emphasis of these constructs allows clinical work with suicidal patients a new level of rigor and focus. The book is meant as a "guidebook" of sorts. Each chapter in this guidebook addresses a component of clinical work with suicidal patients. The first two chapters address aspects of assessment. In chapter 1, we focus on diagnoses associated with suicide. In chapter 2, we offer theory-based recommendations on what information should be gathered in the process of suicide risk assessments as well as how to optimally obtain and analyze this information. We also provide an overview of available risk assessment frameworks through the lens of the interpersonal theory. The next three chapters address aspects of treatment. In chapter 3, we describe crisis intervention strategies and techniques through the lens of the theory. In chapter 4, we focus on treatments that work for suicidal behavior, surveying various treatment approaches through the lens of the theory and describing in detail one approach that directly targets all components of the interpersonal theory. In chapter 5, we focus on the therapeutic relationship, including a more detailed exploration of the optimal therapeutic stance. We also address between-sessions accessibility by the therapist. The final two chapters use a broader perspective to examine clinical implications of the interpersonal theory. In chapter 6, we address suicide prevention and public health campaigns. In the concluding chapter, we provide an integrative statement on a comprehensive, theory-based protocol for clinical work with suicidal patients"--Introduction. (PsycINFO Database Record (c) 2009 APA, all rights reserved) Contents List of Figures and Exhibits Preface Introduction: The Interpersonal Theory of Suicide—Concepts and Evidence Chapter 1 Diagnoses Associated With Suicide Chapter 2 Risk Assessment Chapter 3 Crisis Intervention Chapter 4 Treatment Chapter 5 The Therapeutic Relationship Chapter 6 Prevention and Public Health Campaigns Conclusion: The Interpersonal Theory of Suicide's Role in Facilitating Hope References Author Index Subject Index About the Authors Why do people die by suicide? Here, Dr Thomas Joiner and his colleagues attempt to answer this age-old question by exploring two obvious yet insightful assumptions: people die by suicide because they can, and people die by suicide because they want to.