When a therapist has many weeks or months to work with a patient at risk for suicide, there are a variety of approaches that have proven to be effective in lowering the risk. One is traditional psychotherapy, in which a therapist works with a patient over time to understand his or her problems and to help the patient feel better. During such treatment as usual the patient is typically supplied with a list of sources of support, such as suicide hotlines, for times of crisis. An additional technique that has been found to be effective is to provide the patient with an individualized crisis response plan, written on a note card, with a list of warning signs things to try in a crisis. It may, for example, remind the patient to try a certain relaxation technique that has worked in the past.
Another extra technique which has worked exceptionally well with patients from the military is to put together a list, again written on a note card that the patient keeps, of things that make the patient’s life worth living. These can be loved ones, happy memories, hopes and dreams—anything that reminds the patient of why he or she would wish to keep living and that could counteract the hopelessness and lack of connection that typically precedes a suicide a attempt.
Unfortunately, it is often the case that the only contact a suicidal person has with a clinician is at a moment of crisis, perhaps during a visit to an emergency room after a suicide attempt. Then a clinician has only a short period of time to deal with the patient, and there is no guarantee the patient will go somewhere for treatment later.
Thus Craig Bryan is seeking to determine if some of the same techniques that work well in multi-session psychotherapy could also be effective in these single, crisis-triggered sessions. In particular he and his coworkers will be testing the effectiveness of providing patients with note cards containing individualized crisis response plans and reasons for living. If the approach is anywhere near as effective for suicidal patients coming into emergency rooms as it is for patients in psychotherapy, it could be a big step in helping members of the military deal more effectively with suicidal thoughts and urges.