Case Study How To Improve Anna's Ability To Regulate Suicidal Thoughts

There are several risk factors that put Joanne at High Risk for suicide. She states that she did not want to stay and talk, but that she “just wanted to go for a drive” and has a gun in the car, so she is at a high risk given the methods and accessibility to those methods (Jackson-Cherry & Erford, 2018). She has previous suicide attempts, while there is no time frame on when those prior attempts took place, it places her in at a moderate risk at the very least (if 1 to 5 years ago) (Jackson-Cherry & Erford, 2018). She does not report loneliness or hopelessness at this current moment, but given her history of depression, past divorce and no significant other, admissions of guilt over an affair, having no hobbies and getting “all her satisfaction” from work, it is likely that she has or current is experiencing some level of loneliness, and her past attempts are potentially indicative of hopelessness; all these factors put her at a minimum of a moderate risk, but further information would probably lead to a high risk. The divorce, lack of relationship or mention of friendships does put the loneliness at a high risk due to having limited support (Jackson-Cherry & Erford, 2018). There is no mention of substance abuse. There is also no point that she states suicidal plans or ideation, but her behaviors show some ideation present. Her risk factors for chance of intervention are dependent on

CM conducted a CFT meeting for Alexia Taylor (youth) at Daytop Treatment. In attendance were Jasmine Alexander (CM), Alexia (youth), Kelly Hennebry (Case Manager), Lisa Marshall (caregiver) and Jaimie Coviello (therapist). The strength and needs assessment was completed. The Family Crisis plan was reviewed and the Family Vision was reviewed. The team discussed transition plan and after care services for youth.

The first thing the therapist needs to do in this situation, beyond the obvious need to form a therapeutic alliance, is determine the lethality Allison’s suicidal intent. This could perhaps be accomplished by administering the Children’s Global Assessment Scale, or CGAS. This is an assessment tool that rates the general mental functioning of minor children, on a scale from 1-100 (Shaffer, 1983). This would have to be the first step, as it poses risk to the client and carries an obvious urgency prohibit lengthy therapeutic visits, depending on the severity of the crisis situation. On the surface, it appears that Allison’s score is within the 40-31 range, due to the history of suicidal attempts and self-cutting. However, a determination is made that Allison did not have “clear lethal intent” (Shaffer, 1983), placing her in the 50-41 range. Because there is no immediate risk of harm, therapy can commence.

SES met with Lindsay Burke and her mother, Kim Burke at their home in Takoma Park, MD to discuss CM vocational programs and services. SES notes that Lindsay was extremely anxious during this meeting stating that she has been worked up over small things like trying to sort out issues with her laptop. SES asked had she had any irrational thoughts. Lindsay replied that although she does have suicidal thoughts, but they are merely thoughts and not serious contemplation. She went on to state that she would never act on her thoughts because she does see suicide as realistic alternative to solving her behavioral problems. SES stated that if here feelings ever changed and became more immediate that she should call 911 or SES. Lindsay stated that

Through this approach Jessica could most benefit. The therapist would conduct a evaluation using the five axes of DSM-IV. Using examples from patients' recent distressing experiences, therapists conceptualize and help patients understand how their thinking has influenced their emotions and behavior. They emphasize that patients get better by making small, daily changes in their thinking and behavior and that the overall goal of treatment is to teach patients to become their own therapist. Therapists elicit feedback from the patient about the treatment plan and modify it, if needed. They then elicit specific behavioral goals that the patient wishes to accomplish as a result of treatment (Judith S. Beck 2010). Jessica would most likely respond well because of the small life changes and steps to reaching hers goals, but also may have difficulties pulling herself out of her current patterns of

Suicide has always been looked down upon and people would do just about everything in their willpower to prevent it. There are plenty methods to avert people from committing suicide such as the suicide health prevention hotline, support groups, friends, and family. However, all these methods are not as resourceful when the person is already dying. And, if the one who wants to commit suicide is lying in their death bed enduring an excruciating pain, then do the people who oppose suicide have the right to intervene with the dying person’s last wishes? Physician-assisted suicide is a practice where doctors decide to help end their hopelessly ill patient’s life painlessly even if he or she requests for it (Assisted Suicide). If doctors do follow the patient’s desired death, then are the doctors sending subliminal message saying these patients’ lives are now meaningless. Many believe the doctors treating the patients do not have the right to take lives instead save them, which leads to the religious factor in this situation. They believe the only way someone can be taken from this world is through the hands of God and any other way is simply wrong and immoral. Death is a delicate topic many try to ignore for however long they are able to. Humans have a very difficult time coping with the death of a loved one, so it is much harder for the friends and family to accept than the terminally ill. Although physician-assisted suicide permanently relieves the pain of a dying patient, PAS

The nurse should respond by telling this man that there are no bugs on him and explain to him that hallucinations can occur when you are detoxifying from alcohol. That this is not real and it is just a symptom of withdrawal.

Family recognizes need to support Sarah while addressing previous abuse (mom) and depressive/anxiety biological tendencies.

CM conducted a CFT meeting for Alexia Taylor (youth) at Daytop Treatment. In attendance were Jasmine Alexander (CM), Alexia (youth), Kelly Hennebry (Case Manager). Lisa Marshall (caregiver) participated via phone. The strength and needs assessment was completed and the Family Crisis plan was reviewed. After CFT meeting, CM took youth on a day pass for 2 hours in the local community.

The goal counseling to help Ana with her major stressors will be to first find a proper theory to help with her stressors. The counselor will first do an initial assessment and diagnosis Ana to see what theory to use. The counselor has conducted the initial assessment and had decided to use Klerman and Weissman’s Interpersonal psychotherapy. The goal will be to help Ana with her depression and anxiety. The counselor will refer Ana to an agency where she can apply for job and also refer her to a housing agency where they can assist Ana to look for temporary housing and permanent home. The counselor will also give Ana strategies to work when she is feeling depressed or is anxious because she is on her own raising her child.

Results: This therapy was more successful as compared to normal care system or anti-depressants used.

Raelynn is a 7-year-old Caucasian girl who lives with her mother, stepfather and younger sister. Raelynn’s parents divorced when she was 3 years old. Raelynn was brought to the clinic because her mother found a journal depicting suicidal ideation. Raelynn wrote things like: “I want to die, I think about it all the time. I think about running into traffic, as fast as I can”. Her mother also reported that Raelynn had been talking about wanting to die and killing herself daily. Raelynn increasingly found comfort in her thoughts of dying. Upon initial assessment, the psychologist uses the Collaborative Assessment and Management of Suicidality (CAMS) and follows with the other questions that need to be attached like family environment. Raelynn’s

Suicide and accidental death from self-harm were the third leading cause of mortality in adolescents aged 10- 19 years of age in 2015, resulting in 67,000 deaths (world health organization). Many cases have have been reported in the local news, online, and through use of social media websites such as: Facebook and snap chat. There have also been multiple cases of youths that have posted their suicide live online. This is clearly a cry for help, if only someone was there to provide some form of assistance, could these cases have been prevented? This is a very important crisis that affect families, communities, and health care professionals worldwide and therefore deserves to be further discussed.

Ms. Kamara is a twenty-nine year old African American female who was referred herself for Mental Health Skills Building services. Ms. Kamara reported within the last thirty days she has exhibited the following psychiatric problems: depressed mood (daily); auditory hallucinations (daily); diminished emotional expression (daily); anxiety (3-5x daily); isolation (daily); feelings of worthlessness (3-5x weekly); intrusive thoughts (3-5x weekly); sleep disturbance (1-2x weekly); suicidal thoughts (1-2x weekly but no active plan), suspects others deceiving her (Daily); preoccupied with unjustified doubt (daily); and reluctant to confide in others (daily). The above-mentioned symptoms have impacted Ms. Kamara’s level of functioning at as evidenced by her not being able to hold employment because of paranoid thinking and her interpersonal relations

Working with a client who reports suicidal ideations can come in different forms, but can potentially lead to a crisis if left unaddressed. Monaghan and Harris (2015) discussed suicide intervention from the beginning of a therapeutic relationship by building a working and trusting relationship, collaborating with the client, conducting regular risk assessments, involving social support, and establishing a specific intervention style. There are three specific intervention styles were reported by Monaghan and Harris (2015): solution-focused therapy, cognitive behavioral therapy, and dialectical behavior therapy. Solution-focused therapy helps the client focus on the solution rather than the problem, strengths rather than weaknesses, and the positives instead of the negatives. Cognitive behavioral therapy helps the clients alter their way of thinking about their situation with the goal of altering the client’s feelings and behaviors. Dialectical behavior therapy challenges dysfunctional behaviors to help the clients change patterns of behaviors that are not