Second Edition
by John A. Chiles (Author), Kirk D. Strosahl (Author), Laura Weiss Roberts (Author)
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.