Clinicians’ Experience of Collaboration in the Treatment of Suicidal Clients Within the Collaborative Assessment and Management of Suicidality Framework

Introduction There is little known about the clinicians’ experience of collaboration using the Collaborative Assessment and Management of Suicide (CAMS) framework. This study aimed to give voice to the clinician experience. Method A qualitative design utilised semi-structured interviews with ten psychologists who worked in a Suicide Assessment and Treatment Service (SATS) in Ireland which utilises the CAMS framework. Results An Interpretative Phenomenological Analysis (IPA) approach revealed several important findings. The superordinate themes included ‘Finding Safety’, ‘Regulation of the Self’, ‘Connecting’, and ‘Systemic Challenges’. Discussion The CAMS framework plays an important role in providing a safe base for the clinician (in terms of understanding suicidality, in addition to the structures of the framework). It provides a mechanism in which to process difficult emotions, and a way of communicating a formulation of suicide to the treating team. Importantly, the CAMS emerged as facilitating a collaborative, therapeutic way of working.

[1]  D. Jobes,et al.  A Stepped Care Approach to Clinical Suicide Prevention , 2018, Psychological services.

[2]  David C. Atkins,et al.  A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality versus Enhanced Care as Usual With Suicidal Soldiers , 2017, Psychiatry.

[3]  J. Repper,et al.  The collaborative assessment and management of suicide (CAMS): a recovery-oriented approach to working with suicidal people , 2017 .

[4]  Jon G. Allen,et al.  A controlled comparison trial of the Collaborative Assessment and Management of Suicidality (CAMS) in an inpatient setting: Outcomes at discharge and six-month follow-up , 2017, Psychiatry Research.

[5]  M. Nordentoft,et al.  EFFECTIVENESS OF DIALECTICAL BEHAVIOR THERAPY VERSUS COLLABORATIVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY TREATMENT FOR REDUCTION OF SELF‐HARM IN ADULTS WITH BORDERLINE PERSONALITY TRAITS AND DISORDER—A RANDOMIZED OBSERVER‐BLINDED CLINICAL TRIAL , 2016, Depression and anxiety.

[6]  S. Schwab,et al.  A Novel Brief Therapy for Patients Who Attempt Suicide: A 24-months Follow-Up Randomized Controlled Study of the Attempted Suicide Short Intervention Program (ASSIP) , 2016, PLoS medicine.

[7]  Jon G. Allen,et al.  Impact of a Suicide-Specific Intervention within Inpatient Psychiatric Care: The Collaborative Assessment and Management of Suicidality. , 2015, Suicide & life-threatening behavior.

[8]  M. Large,et al.  Meta‐analysis of suicide rates among psychiatric in‐patients , 2015, Acta psychiatrica Scandinavica.

[9]  C. Mcdonald,et al.  Psychiatric and psycho-social characteristics of suicide completers: a comprehensive evaluation of psychiatric case records and postmortem findings , 2014, Irish Journal of Psychological Medicine.

[10]  Gregory K Brown,et al.  Evidence-based psychotherapies for suicide prevention: future directions. , 2014, American journal of preventive medicine.

[11]  J. Maltsberger,et al.  The Therapeutic Alliance and Suicide: When Words Are Not Enough , 2013 .

[12]  G. Andersson,et al.  The effects of psychotherapy for adult depression on suicidality and hopelessness: a systematic review and meta-analysis. , 2013, Journal of affective disorders.

[13]  Jon G. Allen,et al.  Collaborative assessment and management of suicidality in an inpatient setting: results of a pilot study. , 2012, Psychotherapy.

[14]  David C. Atkins,et al.  Collaborative assessment and management of suicidality (CAMS): feasibility trial for next‐day appointment services , 2011, Depression and anxiety.

[15]  B. Rosenbaum,et al.  Collaborative assessment and management of suicidality method shows effect. , 2011, Danish medical bulletin.

[16]  D. Jobes,et al.  Building a Therapeutic Alliance With the Suicidal Patient , 2010 .

[17]  A. Reeves Counselling Suicidal Clients , 2010 .

[18]  D. Jobes,et al.  Clinical Improvements of Suicidal Outpatients: Examining Suicide Status Form Responses as Predictors and Moderators , 2009, Archives of suicide research : official journal of the International Academy for Suicide Research.

[19]  L. Christiansen,et al.  [Treatment of suicidal patients: The Collaborative Assessment and Management of Suicidality]. , 2008, Ugeskrift for laeger.

[20]  S. Ball,et al.  Fluoxetine and Adult Suicidality Revisited: An Updated Meta-Analysis Using Expanded Data Sources From Placebo-Controlled Trials , 2007, Journal of clinical psychopharmacology.

[21]  D. Jacobs Managing Suicidal Risk: A Collaborative Approach , 2007 .

[22]  Robin D. Everall,et al.  Healing from suicide: adolescent perceptions of attachment relationships , 2007 .

[23]  A. Leenaars Psychotherapy with Suicidal People: The Commonalities , 2006, Archives of suicide research : official journal of the International Academy for Suicide Research.

[24]  D. Jobes,et al.  The collaborative assessment and management of suicidality versus treatment as usual: a retrospective study with suicidal outpatients. , 2005, Suicide & life-threatening behavior.

[25]  D. Jobes,et al.  The CAMS Approach to Working with Suicidal Patients , 2004, Journal of Contemporary Psychotherapy.

[26]  Richard A. Young,et al.  Discovering the truth in attempted suicide. , 2002, American journal of psychotherapy.

[27]  A. Reeves,et al.  Counsellors' experiences of working with suicidal clients: An exploratory study , 2001 .

[28]  B. Richards Impact upon therapy and the therapist when working with suicidal patients: Some transference and countertransference aspects , 2000 .

[29]  L. Appleby,et al.  Suicide within 12 months of contact with mental health services: national clinical survey , 1999, BMJ.

[30]  D. Jobes,et al.  Assessment and treatment of suicidal clients in a university counseling center. , 1997 .

[31]  J. Lönnqvist,et al.  The last appointment before suicide: is suicide intent communicated? , 1995, The American journal of psychiatry.

[32]  A. Leenaars Crisis intervention with highly lethal suicidal people , 1994 .

[33]  A. Horvath,et al.  Relation between Working Alliance and Outcome in Psychotherapy: A Meta-Analysis. , 1991 .

[34]  J. Maltsberger,et al.  Countertransference hate in the treatment of suicidal patients. , 1974, Archives of general psychiatry.

[35]  D. Jobes,et al.  A Collaborative Approach to Working with the Suicidal Mind , 2018 .

[36]  D. Jobes Suicidal patients, the therapeutic alliance, and the collaborative assessment and management of suicidality. , 2011 .

[37]  E. Ballard,et al.  The therapist and the suicidal patient. , 2011 .

[38]  J. Maltsberger,et al.  Vicissitudes of the therapeutic alliance with suicidal patients: A psychoanalytic perspective. , 2011 .

[39]  M. Schechter,et al.  Psychodynamic therapy and the therapeutic alliance: Validation, empathy, and genuine relatedness. , 2011 .

[40]  D. Jobes The CAMS Approach to Suicide Risk: Philosophy and Clinical Procedures , 2009 .

[41]  Linda Gurrister M.S.W.,et al.  How therapists perceive and treat suicidal patients , 2004, Community Mental Health Journal.

[42]  I. Orbach Therapeutic empathy with the suicidal wish: principles of therapy with suicidal individuals. , 2001, American journal of psychotherapy.

[43]  L. Pearlman,et al.  Trauma and the Therapist: Countertransference and Vicarious Traumatization in Psychotherapy with Incest Survivors , 1995 .

[44]  W. Milch Suicidal patients' psychological attacks on the therapist. , 1990, Bulletin of the Menninger Clinic.