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Erschienen in: European Child & Adolescent Psychiatry 4/2021

13.07.2020 | Original Contribution

Will you agree to treat a suicidal adolescent? A comparative study among mental health professionals

verfasst von: Y. Gvion, H. Rozett, T. Stern

Erschienen in: European Child & Adolescent Psychiatry | Ausgabe 4/2021

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Abstract

The effect of a therapist’s personal and professional variables on their decision to treat or refer a suicidal adolescent was studied. 242 mental health professionals were randomly exposed to one of four case descriptions of an adolescent in crisis. The cases shared a common background story, however differed in suicidal condition (high vs. low) and gender. The questionnaires employed aimed to reflect the subject’s evaluation of the patient’s suicidal severity, countertransference, suicidal ideation, depression, professional competence, and seniority. Subjects were asked about their willingness to treat or likeliness to refer the case. Results indicate a lower willingness to treat and higher tendency to refer highly suicidal adolescents regardless of gender. Professional factors, countertransference, and trait-like suicide ideations positively contributed to willingness to accept the patient. Mental health professionals are unwilling to accept adolescents at risk for suicide for treatment. Nevertheless, professional factors contribute to the willingness to treat such adolescents, thereby underlining the importance of improving skills and tools with regard to the treatment of suicidal behavior. Acquaintance with a similar adolescent is a positive contributor for accepting a potentially suicidal adolescent patient to therapy.
Literatur
2.
Zurück zum Zitat Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, Kessler RC (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry 70(3):300–310PubMed Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, Kessler RC (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry 70(3):300–310PubMed
3.
Zurück zum Zitat Nock MK, Borge G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, Bruffaerts R et al (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. BJPsych 192(2):98–105PubMed Nock MK, Borge G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, Bruffaerts R et al (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. BJPsych 192(2):98–105PubMed
4.
Zurück zum Zitat Waddell M (2006) Narcissism—an adolescent disorder? J Child Psychotherpy 32(1):21–34 Waddell M (2006) Narcissism—an adolescent disorder? J Child Psychotherpy 32(1):21–34
5.
Zurück zum Zitat Goldblatt M, Briggs S, Lindner R, Schechter M, Ronningstam E (2015) Psychodynamic psychotherapy with suicidal adolescents. Psychoanal Psychother 29(1):20–37 Goldblatt M, Briggs S, Lindner R, Schechter M, Ronningstam E (2015) Psychodynamic psychotherapy with suicidal adolescents. Psychoanal Psychother 29(1):20–37
7.
Zurück zum Zitat Dexter-Mazza ET, Freeman KA (2003) Graduate training and the treatment of suicidal clients: the students’ perspective. Suicide Life Threat Behav 33(2):211–218PubMed Dexter-Mazza ET, Freeman KA (2003) Graduate training and the treatment of suicidal clients: the students’ perspective. Suicide Life Threat Behav 33(2):211–218PubMed
8.
Zurück zum Zitat Gulfi A, Dransart DC, Heeb JL, Gutjahr E (2010) The impact of patient suicide on the professional reactions and practices of mental health caregivers and social workers. Crisis 31(4):202–210PubMed Gulfi A, Dransart DC, Heeb JL, Gutjahr E (2010) The impact of patient suicide on the professional reactions and practices of mental health caregivers and social workers. Crisis 31(4):202–210PubMed
9.
Zurück zum Zitat Deutsch CJ (1985) A survey of therapists’ personal problems and treatment. Prof Psychol Res Pract 16(2):305 Deutsch CJ (1985) A survey of therapists’ personal problems and treatment. Prof Psychol Res Pract 16(2):305
10.
Zurück zum Zitat Ting L, Jacobson JM, Sanders S (2011) Current levels of perceived stress among mental health social workers who work with suicidal clients. Soc Work 56(4):327–336PubMed Ting L, Jacobson JM, Sanders S (2011) Current levels of perceived stress among mental health social workers who work with suicidal clients. Soc Work 56(4):327–336PubMed
11.
Zurück zum Zitat Hendin H, Haas AP, Maltsberger JT, Szanto K, Rabinowicz H (2004) Factors contributing to therapists’ distress after the suicide of a patient. Am J Psychiatry 161:1442–1446PubMed Hendin H, Haas AP, Maltsberger JT, Szanto K, Rabinowicz H (2004) Factors contributing to therapists’ distress after the suicide of a patient. Am J Psychiatry 161:1442–1446PubMed
12.
Zurück zum Zitat Maltsberger JT (1994) Calculated risks in the treatment of intractably suicidal patient. Psychiatry 57(3):199–212PubMed Maltsberger JT (1994) Calculated risks in the treatment of intractably suicidal patient. Psychiatry 57(3):199–212PubMed
13.
Zurück zum Zitat Reeves A, Mintz R (2001) Counsellors’ experiences of working with suicidal clients: an exploratory study. Couns Psychother Res 1(3):172–176 Reeves A, Mintz R (2001) Counsellors’ experiences of working with suicidal clients: an exploratory study. Couns Psychother Res 1(3):172–176
14.
Zurück zum Zitat Hendin H, Lipschitz A, Maltsberger JT, Haas AP, Wynecoop S (2000) Therapists’ reactions to patients’ suicides. Am J Psychiatry 157(12):2022–2027PubMed Hendin H, Lipschitz A, Maltsberger JT, Haas AP, Wynecoop S (2000) Therapists’ reactions to patients’ suicides. Am J Psychiatry 157(12):2022–2027PubMed
15.
Zurück zum Zitat Gvion Y, Fachler A (2017) When suicide is at stake: some thoughts on the therapeutic space between therapists and adolescents. JICAP 16(4):267–278 Gvion Y, Fachler A (2017) When suicide is at stake: some thoughts on the therapeutic space between therapists and adolescents. JICAP 16(4):267–278
16.
Zurück zum Zitat Ellis TE, Schwartz JA, Rufino KA (2018) Negative reactions of therapists working with suicidal patients: a CBT/mindfulness perspective on ‘countertransference’. Int J Cognit Ther 11(1):80–99 Ellis TE, Schwartz JA, Rufino KA (2018) Negative reactions of therapists working with suicidal patients: a CBT/mindfulness perspective on ‘countertransference’. Int J Cognit Ther 11(1):80–99
17.
Zurück zum Zitat Gabbard GO (2003) Miscarriages of psychoanalytic treatment with suicidal patients. Int J Psycho-Anal 84(2):249–261 Gabbard GO (2003) Miscarriages of psychoanalytic treatment with suicidal patients. Int J Psycho-Anal 84(2):249–261
18.
Zurück zum Zitat Bearse JL, McMinn MR, Seegobin W, Free K (2013) Barriers to psychologists seeking mental health care. Prof Psychol Res Pract 44(3):150–157 Bearse JL, McMinn MR, Seegobin W, Free K (2013) Barriers to psychologists seeking mental health care. Prof Psychol Res Pract 44(3):150–157
19.
Zurück zum Zitat Tsiantis J, Sandler AS, Anastasopoulous D, Martindale B (1996) Countertransference in psychoanalytic psychotherapy with children and adolescents. International Universities Press, Madison Tsiantis J, Sandler AS, Anastasopoulous D, Martindale B (1996) Countertransference in psychoanalytic psychotherapy with children and adolescents. International Universities Press, Madison
20.
Zurück zum Zitat Almaliach-Raucher S, Etinger N, Levi-Belz Y, Gvion Y (2020) Will you treat me? I’m suicidal!” The effect of patient gender, suicidal severity, and therapist characteristics on the therapist’s likelihood to treat a hypothetical suicidal patient. Clin Psychol Psychother. https://doi.org/10.1002/cpp.2426CrossRef Almaliach-Raucher S, Etinger N, Levi-Belz Y, Gvion Y (2020) Will you treat me? I’m suicidal!” The effect of patient gender, suicidal severity, and therapist characteristics on the therapist’s likelihood to treat a hypothetical suicidal patient. Clin Psychol Psychother. https://​doi.​org/​10.​1002/​cpp.​2426CrossRef
21.
Zurück zum Zitat Zalsman G, Hawton K, Wasserman D, van Heeringen K, Arensman E, Sarchiapone M et al (2016) Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry 3(7):646–659PubMed Zalsman G, Hawton K, Wasserman D, van Heeringen K, Arensman E, Sarchiapone M et al (2016) Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry 3(7):646–659PubMed
22.
Zurück zum Zitat Maltsberger JT, Buie D (1974) Countertransference hate in the treatment of suicidal patients. Arch Gen Psychiatry 30:625–633PubMed Maltsberger JT, Buie D (1974) Countertransference hate in the treatment of suicidal patients. Arch Gen Psychiatry 30:625–633PubMed
23.
Zurück zum Zitat Wasserman D, Cheng Q, Jiang GX (2005) Global suicide rates among young people aged 15-19. World Psychiatry 4:112–114 Wasserman D, Cheng Q, Jiang GX (2005) Global suicide rates among young people aged 15-19. World Psychiatry 4:112–114
24.
Zurück zum Zitat Canetto SS, Sakinofsky I (1998) The gender paradox in suicide. Suicide Life Threat Behav 28(1):1–23PubMed Canetto SS, Sakinofsky I (1998) The gender paradox in suicide. Suicide Life Threat Behav 28(1):1–23PubMed
25.
Zurück zum Zitat Maris RW, Berman AL, Silverman MM (2000) Comprehensive textbook of suicidology. Guilford, New York Maris RW, Berman AL, Silverman MM (2000) Comprehensive textbook of suicidology. Guilford, New York
26.
Zurück zum Zitat Hatfield E, Cacioppo J, Rapson R (1994) Emotional contagion. Curr Dir Psychol Sci 2(3):96–99 Hatfield E, Cacioppo J, Rapson R (1994) Emotional contagion. Curr Dir Psychol Sci 2(3):96–99
27.
Zurück zum Zitat Freud S (1915) Observations on transference-love (further recommendations on the technique of psycho-analysis III). In: Strachey J (ed) The standard edition of the complete psychological works of Sigmund Freud (vol. [1911–1913]: The case of Schreber, papers on technique and other works, pp. 157–171). Hogarth Press and the Institute of Psychoanalysis, London Freud S (1915) Observations on transference-love (further recommendations on the technique of psycho-analysis III). In: Strachey J (ed) The standard edition of the complete psychological works of Sigmund Freud (vol. [1911–1913]: The case of Schreber, papers on technique and other works, pp. 157–171). Hogarth Press and the Institute of Psychoanalysis, London
28.
Zurück zum Zitat Hayes JA, Nelson DL, Fauth J (2015) Countertransference in successful and unsuccessful cases of psychotherapy. Psychotherapy 52:127–133PubMed Hayes JA, Nelson DL, Fauth J (2015) Countertransference in successful and unsuccessful cases of psychotherapy. Psychotherapy 52:127–133PubMed
29.
Zurück zum Zitat Blos P (1976) On adolescence: a psychoanalytic interpretation. Free Press of Glencoe, New York Blos P (1976) On adolescence: a psychoanalytic interpretation. Free Press of Glencoe, New York
30.
Zurück zum Zitat Pope KS, Tabachnick BG (1994) Therapists as patients: a national survey of psychologists’ experiences, problems, and beliefs. Prof Psychol Res Pract 25(3):247–258 Pope KS, Tabachnick BG (1994) Therapists as patients: a national survey of psychologists’ experiences, problems, and beliefs. Prof Psychol Res Pract 25(3):247–258
31.
Zurück zum Zitat Oquendo MA, Sullivan GM, Sudol K, Baca-Garcia E, Stanley BH, Sublette ME, Mann JJ (2014) Toward a biosignature for suicide. Am J Psychiatry 171(12):1259–1277PubMedPubMedCentral Oquendo MA, Sullivan GM, Sudol K, Baca-Garcia E, Stanley BH, Sublette ME, Mann JJ (2014) Toward a biosignature for suicide. Am J Psychiatry 171(12):1259–1277PubMedPubMedCentral
32.
Zurück zum Zitat Wurst FM, Kunz I, Skipper G, Wolfersdorf M, Beine KH, Vogel R, Thon N (2013) How therapists react to patient’s suicide: findings and consequences for health care professionals’ wellbeing. Gen Hosp Psychiatry 35(5):565–570PubMed Wurst FM, Kunz I, Skipper G, Wolfersdorf M, Beine KH, Vogel R, Thon N (2013) How therapists react to patient’s suicide: findings and consequences for health care professionals’ wellbeing. Gen Hosp Psychiatry 35(5):565–570PubMed
33.
Zurück zum Zitat Neimeyer RA, Fortner B, Melby D (2001) Personal and professional factors and suicide intervention skills. Suicide Life Threat Behav 31(1):71–82PubMed Neimeyer RA, Fortner B, Melby D (2001) Personal and professional factors and suicide intervention skills. Suicide Life Threat Behav 31(1):71–82PubMed
35.
Zurück zum Zitat Groth T, Boccio DE (2018) Psychologists’ willingness to provide services to individuals at risk of suicide. Suicide Life Threat Behav 49(5):1251–1254 Groth T, Boccio DE (2018) Psychologists’ willingness to provide services to individuals at risk of suicide. Suicide Life Threat Behav 49(5):1251–1254
36.
Zurück zum Zitat Posner K, Brown GK, Stanley B, Brent DA, Yershova K, Oquendo MA, Currier GW et al (2011) The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 168(12):1266–1277PubMedPubMedCentral Posner K, Brown GK, Stanley B, Brent DA, Yershova K, Oquendo MA, Currier GW et al (2011) The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 168(12):1266–1277PubMedPubMedCentral
37.
Zurück zum Zitat Beck AT, Steer RA, Carbin M (1988) Psychometric properties of the beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev 8(1):77–100 Beck AT, Steer RA, Carbin M (1988) Psychometric properties of the beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev 8(1):77–100
39.
Zurück zum Zitat Gvion Y, Apter A (2011) Aggression, impulsivity, and suicide behavior: a review of the literature. Arch Suicide Res 15(2):93–112PubMed Gvion Y, Apter A (2011) Aggression, impulsivity, and suicide behavior: a review of the literature. Arch Suicide Res 15(2):93–112PubMed
40.
Zurück zum Zitat Singh PK, Rao VR (2018) Explaining suicide attempt with personality traits of aggression and impulsivity in a high-risk tribal population of India. PLoS ONE 13(2):e0192969PubMedPubMedCentral Singh PK, Rao VR (2018) Explaining suicide attempt with personality traits of aggression and impulsivity in a high-risk tribal population of India. PLoS ONE 13(2):e0192969PubMedPubMedCentral
41.
Zurück zum Zitat Arnett JJ (1992) Reckless behavior in adolescence: a developmental perspective. Dev Rev 12:339–373 Arnett JJ (1992) Reckless behavior in adolescence: a developmental perspective. Dev Rev 12:339–373
42.
Zurück zum Zitat Gökçe S, Yusufoğlu C, Akin E, Ayaz M (2017) Effect of gender differences on impulsivity in adolescents with attention-deficit/hyperactivity disorder. Anadolu Psikiyatri Dergisi 18:379–386 Gökçe S, Yusufoğlu C, Akin E, Ayaz M (2017) Effect of gender differences on impulsivity in adolescents with attention-deficit/hyperactivity disorder. Anadolu Psikiyatri Dergisi 18:379–386
43.
Zurück zum Zitat Weinstein A, Dannon P (2015) Is impulsivity a male trait rather than female trait? Exploring the sex difference in impulsivity. Curr Top Behav Neurosci 2:9–14 Weinstein A, Dannon P (2015) Is impulsivity a male trait rather than female trait? Exploring the sex difference in impulsivity. Curr Top Behav Neurosci 2:9–14
44.
Zurück zum Zitat Levi-Belz Y, Gvion Y, Horesh N et al (2014) Mental pain, communication difficulties, and medically serious suicide attempts: a case-control study. Arch Suicide Res 18(1):74–87PubMed Levi-Belz Y, Gvion Y, Horesh N et al (2014) Mental pain, communication difficulties, and medically serious suicide attempts: a case-control study. Arch Suicide Res 18(1):74–87PubMed
45.
Zurück zum Zitat Dindia K, Allen M (1992) Sex differences in self-disclosure: a meta-analysis. Psychol Bull 112(1):106–124PubMed Dindia K, Allen M (1992) Sex differences in self-disclosure: a meta-analysis. Psychol Bull 112(1):106–124PubMed
46.
Zurück zum Zitat Horesh N, Zalsman G, Apter A (2004) Suicidal behavior and self-disclosure in adolescent psychiatric inpatients. J Nerv Mental Dis 192(12):837–842 Horesh N, Zalsman G, Apter A (2004) Suicidal behavior and self-disclosure in adolescent psychiatric inpatients. J Nerv Mental Dis 192(12):837–842
47.
Zurück zum Zitat Foley SR, Kelly BD (2007) When a patient dies by suicide: incidence, implications and coping strategies. Adv Psychiatry Treat 13(2):134–138 Foley SR, Kelly BD (2007) When a patient dies by suicide: incidence, implications and coping strategies. Adv Psychiatry Treat 13(2):134–138
48.
Zurück zum Zitat Morse G, Salyers MP, Rollins AL, Monroe-DeVita M, Pfahler C (2012) Burnout in mental health services: a review of the problem and its remediation. Adm Policy Ment Health 39(5):341–352PubMedPubMedCentral Morse G, Salyers MP, Rollins AL, Monroe-DeVita M, Pfahler C (2012) Burnout in mental health services: a review of the problem and its remediation. Adm Policy Ment Health 39(5):341–352PubMedPubMedCentral
49.
Zurück zum Zitat Kumar S, Hatcher S, Huggard P (2005) Burnout in psychiatrists: an etiological model. Int J Psychiatry Med 35(4):405–416PubMed Kumar S, Hatcher S, Huggard P (2005) Burnout in psychiatrists: an etiological model. Int J Psychiatry Med 35(4):405–416PubMed
51.
Zurück zum Zitat Fatter DM, Hayes JA (2013) What facilitates countertransference management? The roles of therapist meditation, mindfulness, and self-differentiation. Psychother Res 3(5):502–513 Fatter DM, Hayes JA (2013) What facilitates countertransference management? The roles of therapist meditation, mindfulness, and self-differentiation. Psychother Res 3(5):502–513
52.
Zurück zum Zitat Dahl HSJ, Hoglend P, Ulberg R, Amlo S, Gabbard GO, Perry JC, Christoph PC (2017) Does a therapist’s disengaged feelings influence the effect of transference work? A study on countertransference. Clin Psychol Psychother 24(2):462–474PubMed Dahl HSJ, Hoglend P, Ulberg R, Amlo S, Gabbard GO, Perry JC, Christoph PC (2017) Does a therapist’s disengaged feelings influence the effect of transference work? A study on countertransference. Clin Psychol Psychother 24(2):462–474PubMed
Metadaten
Titel
Will you agree to treat a suicidal adolescent? A comparative study among mental health professionals
verfasst von
Y. Gvion
H. Rozett
T. Stern
Publikationsdatum
13.07.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Child & Adolescent Psychiatry / Ausgabe 4/2021
Print ISSN: 1018-8827
Elektronische ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-020-01581-w

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