GENERAL COURSE DESCRIPTION

We engraved my mother's gravestone, as she had requested many years prior to her death, "Trees Die Erect", testifying to her refusal to retire from her role as an educator, psychologist and social activist.  She chose to die at the top of her career in what my sister and I called "Suicide by work."  The question of suicide reared its head to me again when I worked in East Africa as a fish-ponds expert and was shocked to notice how so many rural tribesmen did not hesitate to chop down the few palm trees left in the oasis and let the cattle defecate in the only water hole in an arid area.  It looked normal to them but pretty suicidal to me.  Part of this experience helped me shift my focus from fish to people.  Early in my career as a psychologist, I encountered suicide when I worked in a mental health clinic in a local jail and was ordered to conduct a suicide assessment on a death row inmate.  My bafflement quickly turned to outrage at how ludicrous it was for me to determine whether a prisoner should be placed on suicide watch so he would not kill himself before the state had a chance to execute him.  Then, like most clinicians, I have encountered many situations, in which depressed, psychotic, disillusioned, hopeless or depleted clients felt desperately suicidal and where suicide prevention was necessarily and often welcomed by them.  (OZ)

Suicide has become an increasing social challenge in today’s stressful world. As clinicians, we are faced with the need to balance quality care and respect for the choices and desires of our clients with the need to avoid liability and blame for those choices. While suicide will always remain a personal choice, we can heighten appropriate efforts at suicide prevention by arming ourselves with adequate knowledge of the issue and awareness of risk factors for suicide.

This intermediate course is comprised of 13 articles that provide statistics regarding the extent and scope of suicide; guidelines for identification, assessment and treatment planning for suicidality; and a sample of a "No Suicide" contract.  The course emphasizes the principle that despite therapists' or anyone else's attempt to contract with clients not to do self-harm, contracts are only as useful as the paper on which they are printed.  The course also provides an extensive Suicidality Checklist for use during client assessment; reviews concerns that arise in the process of treating suicidal clients, both for the client, and for the clinician; identifies the unique effects of depression and anxiety on suicide potential; and reviews the data available for suicide risk in special populations, such as youth, elderly, LGBT, military and prison populations.  Then the course offers an alternative view by discussing suicide as a choice and as a moral issue rather than a legal issue.  Finally, the course provides a list of resources and links for those who are considering suicide and/or working towards suicide prevention.

 
Educational Objectives:

This course will teach psychotherapists to
• Summarize relevant facts and statistics for suicide.
• Assess for suicide risk and lethality.
• Utilize appropriate forms for the documentation of clinical information associated with suicide risk.
• Design and implement treatment plans for clients who are actively suicidal.
• Identify increased risk for suicide in vulnerable populations.
• Compare medical, public health and philosophical approaches to suicidality.

Course Syllabus:

• Introduction, Demographics & Statistics
• Clinical Considerations
  • Risk factors
  • Assessment of dangerousness/lethality
  • Diagnosis
  • Guidelines for clinical management of Suicidality
  • Interventions & Treatment
  • Risk Management of the suicidal client
• Suicide and Special Populations
  • Young People & the Elderly
  • Mood Disorders & Personality Disorders Patients
  • Chronically Mentally Ill Patients
  • Minority Groups, Including the LGBT
  • Prisoners & Military Populations
• Alternative perspectives: Suicide as a choice rather than a crime or mental illness
• End of life issues
• Clinical Forms: No-Suicide Contract & Assessment Template
• Online Resources (hotlines)

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