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Clinical Manual for the Assessment and Treatment of Suicidal Patients
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22 October 2018

Since the first edition of Clinical Manual for Assessment and Treatment of Suicidal Patients was published in 2005, advances have been made that increase our understanding of suicidal and self-destructive behavior. Although clinicians cannot unerringly predict which patients will die by suicide, they can focus more successfully on early identification of suicidal behavior and effective intervention, and this new edition of the clinical manual thoroughly explores not only assessment of suicidality but what comes after an at-risk patient has been identified. The authors argue that treating specific psychiatric disorders is not enough to prevent suicide, and they offer clinicians the necessary information and strategies to bridge that gap. The authors' main premise is that suicide is a dangerous and short-term problem-solving behavior designed to regulate or eliminate intense emotional pain—a quick fix where a long-term effective solution is needed—and this understanding is the underpinning of the assessment and treatment strategies the authors recommend.
The content of this new edition has been thoroughly
reviewed and revised, and substantive changes have been made to specific
chapters to ensure that the book represents the most current thinking and
research, while retaining the strengths of the previous edition.
• The chapter on assessment has been revised to put the fundamental
components of effective treatment in a clinical, case-oriented context and
includes an easy-to-use assessment protocol that allows clinicians to
determine where individual patients stand on seven dimensions (cognitive
rigidity, problem-solving deficits, heightened mental pain, emotionally
avoidant coping style, interpersonal deficits, self-control deficits, and
environmental stress and social support deficits).
• The many issues
involved in the use of psychotropic medications in suicidal patients are
addressed in a new chapter, which includes information on the relevant
classes of drugs (such as antidepressants and antianxiety agents) and the
issues that may arise with their use, including side effects, degree of
lethality, and tendency to aggravate suicidality on introduction and
withdrawal of the medication.
• The chapter on special populations has
been expanded to include adolescents, elders, and patients with co-occurring
substance abuse or psychosis. Because of additional vulnerabilities,
treating these groups may call for the use of added or special techniques to
ensure the best therapeutic outcomes.
• Primary care physicians are the
first point of contact for many patients, and they may require additional
preparation in order to assess and respond to those experiencing suicidal
thoughts. The chapter "Suicidal Patients in Primary Care" explores
strategies for screening, recognizing, and assessing risk; treating the
initial crisis; and developing a crisis management plan.
• "Tips for
Success" appear at intervals, and "The Essentials" are included at the end
of each chapter, highlighting the most important concepts. In addition,
there are scores of helpful charts and exercises.
Practical, accessible, and reader-friendly, the Clinical Manual for Assessment and Treatment of Suicidal Patients is not an academic book but rather is one designed to become an indispensable part of clinicians' working libraries.
MEDICAL / Psychiatry / General
This excellent resource is of great value to clinicians and suicidal patients. It is useful to the intended audience as well as those in other specialties and students.
— Valerie E Mathis-Allen, M.D.
John A. Chiles, M.D., is Professor Emeritus, Department of Psychiatry and Behavior Science, University of Washington School of Medicine, Seattle, Washington.
Kirk D. Strosahl, Ph.D., is President of HeartMatters Consulting, Portland, Oregon.
Laura Weiss Roberts, M.D., M.A., is Chair and Katharine Dexter McCormick and Stanley McCormick Memorial Professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
About the Authors
Preface
Chapter 1. Dimensions of
Suicidal Behavior
Chapter 2. The Clinician's Emotions, Values, Legal
Exposure, and Ethics: Global Issues in the Treatment of Suicidal
Patients
Chapter 3. A Basic Model of Suicidal Behavior: A Learning-Based
Problem-Solving Approach
Chapter 4. Assessment and Case
Conceptualization: Fundamental Components of Effective Treatment
Chapter
5. Outpatient Interventions With Suicidal Patients: Promoting Acceptance and
Value-Based Problem Solving
Chapter 6. Suicidal Behavior and Use of
Psychotropic Medications
Chapter 7. The Repetitiously Suicidal Patient:
An Intervention Approach for High-Risk Patients
Chapter 8. Managing
Suicidal Emergencies: Using Crisis to Create Positive Change
Chapter 9.
Hospitals and Suicidal Behavior: A Complex Relationship
Chapter 10.
Suicidality and Special Populations
Chapter 11. Suicidal Patients in
Primary Care: Responding to the Challenge
Appendix A: Philosophies About
Suicide
Appendix B: Consequences of Suicidal Behavior
Questionnaire
Appendix C: Reasons for Living Inventory
Appendix D:
Malpractice Management Assessment
Appendix E: Suicidal Thinking and
Behaviors Questionnaire
Index