How to Help the Suicidal Person to Choose Life: The Ethic of Care and Empathy as an Indispensable Tool for Intervention E-Book
Kathleen Stephany
32,18 €
Mehr erfahren.
- Herausgeber: Bentham Science Publishers
- Kategorie: Fachliteratur
- Sprache: Englisch
Suicide is a complex problem which is linked to socioeconomic problems as well as mental stress and illness. Healthcare professionals now know that the essential component of the suicidal person’s state of crisis is of a psychological and emotional nature.
How to Help the Suicidal Person to Choose Life is a detailed guide to suicide prevention. The book recommends ethic of care and empathy as a tool for suicide intervention. Readers will learn about approaches that focus on suicide prevention that address the despairing emotional mind set of the suicidal person.
Key features:
Features easy to understand learning guides for students
Emphasizes on suicide intervention strategies rather than identification of risk factors
Highlights information from narrative case studies and psychological autopsies
Includes practice and simulation exercises designed to enhance therapeutic modalities such as empathy, compassion, unconditional positive regard, connection, therapeutic alliance, the narrative action theoretical approach and mindful listening
Contains guidelines prescribed by the Aeschi working group for clinicians
Provides a list of bibliographic references and an appendix for other resources of information useful for suicide prevention
This book is recommended for students and practicing professionals (in medicine, psychiatry, nursing, psychiatric nursing, psychology, counselling, teaching, social work, the military, police, paramedics etc.), and other first responders, volunteers or outreach workers who are confronted with situations where they have to assist people who are known or suspected of being suicidal.
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 296
Veröffentlichungsjahr: 2017
Ähnliche
How to Help the Suicidal Person to Choose Life:
The Ethic of Care and Empathy as an Indispensable
Tool for Intervention
Authored by
Kathleen Stephany
Faculty of Health Sciences,Douglas College, BC,
Canada
DEDICATION
To every person who has lost someone to suicide, I dedicate this book to you.
BENTHAM SCIENCE PUBLISHERS LTD.
End User License Agreement (for non-institutional, personal use)
This is an agreement between you and Bentham Science Publishers Ltd. Please read this License Agreement carefully before using the ebook/echapter/ejournal (“Work”). Your use of the Work constitutes your agreement to the terms and conditions set forth in this License Agreement. If you do not agree to these terms and conditions then you should not use the Work.
Bentham Science Publishers agrees to grant you a non-exclusive, non-transferable limited license to use the Work subject to and in accordance with the following terms and conditions. This License Agreement is for non-library, personal use only. For a library / institutional / multi user license in respect of the Work, please contact: [email protected].
Usage Rules:
All rights reserved: The Work is the subject of copyright and Bentham Science Publishers either owns the Work (and the copyright in it) or is licensed to distribute the Work. You shall not copy, reproduce, modify, remove, delete, augment, add to, publish, transmit, sell, resell, create derivative works from, or in any way exploit the Work or make the Work available for others to do any of the same, in any form or by any means, in whole or in part, in each case without the prior written permission of Bentham Science Publishers, unless stated otherwise in this License Agreement.You may download a copy of the Work on one occasion to one personal computer (including tablet, laptop, desktop, or other such devices). You may make one back-up copy of the Work to avoid losing it. The following DRM (Digital Rights Management) policy may also be applicable to the Work at Bentham Science Publishers’ election, acting in its sole discretion:25 ‘copy’ commands can be executed every 7 days in respect of the Work. The text selected for copying cannot extend to more than a single page. Each time a text ‘copy’ command is executed, irrespective of whether the text selection is made from within one page or from separate pages, it will be considered as a separate / individual ‘copy’ command.25 pages only from the Work can be printed every 7 days.3. The unauthorised use or distribution of copyrighted or other proprietary content is illegal and could subject you to liability for substantial money damages. You will be liable for any damage resulting from your misuse of the Work or any violation of this License Agreement, including any infringement by you of copyrights or proprietary rights.
Disclaimer:
Bentham Science Publishers does not guarantee that the information in the Work is error-free, or warrant that it will meet your requirements or that access to the Work will be uninterrupted or error-free. The Work is provided "as is" without warranty of any kind, either express or implied or statutory, including, without limitation, implied warranties of merchantability and fitness for a particular purpose. The entire risk as to the results and performance of the Work is assumed by you. No responsibility is assumed by Bentham Science Publishers, its staff, editors and/or authors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products instruction, advertisements or ideas contained in the Work.
Limitation of Liability:
In no event will Bentham Science Publishers, its staff, editors and/or authors, be liable for any damages, including, without limitation, special, incidental and/or consequential damages and/or damages for lost data and/or profits arising out of (whether directly or indirectly) the use or inability to use the Work. The entire liability of Bentham Science Publishers shall be limited to the amount actually paid by you for the Work.
General:
Any dispute or claim arising out of or in connection with this License Agreement or the Work (including non-contractual disputes or claims) will be governed by and construed in accordance with the laws of the U.A.E. as applied in the Emirate of Dubai. Each party agrees that the courts of the Emirate of Dubai shall have exclusive jurisdiction to settle any dispute or claim arising out of or in connection with this License Agreement or the Work (including non-contractual disputes or claims).Your rights under this License Agreement will automatically terminate without notice and without the need for a court order if at any point you breach any terms of this License Agreement. In no event will any delay or failure by Bentham Science Publishers in enforcing your compliance with this License Agreement constitute a waiver of any of its rights.You acknowledge that you have read this License Agreement, and agree to be bound by its terms and conditions. To the extent that any other terms and conditions presented on any website of Bentham Science Publishers conflict with, or are inconsistent with, the terms and conditions set out in this License Agreement, you acknowledge that the terms and conditions set out in this License Agreement shall prevail.Bentham Science Publishers Ltd. Executive Suite Y - 2 PO Box 7917, Saif Zone Sharjah, U.A.E. Email: [email protected]
FOREWORD
I believe we are all, in one way or another, affected by suicide, be it the suicide of a patient, a client, or a loved one. I am constantly looking for resources and research that can provide an answer to how we can deliver better care to people who are at risk for suicide. As a practitioner educated, trained and practiced in three different continents, I am keenly aware that suicide is a worldwide phenomenon, affecting people from all cultures and countries. This knowledge underlies healthcare providers' search to mitigate the alarming increase in suicide and its disastrous toll on societies across the globe. At this time, awareness of mental health is increasing and there is an opportunity to re-focus and commit more resources towards stemming this terrible epidemic.
Healthcare has evolved steadily over the years and with the rise of modern technology we have the ability to diagnose and treat individuals, even when the symptoms are many and varied. However, when it comes to caring for people at risk of suicide, our progress is limited.
This book, How to Help the Suicidal Person to Choose Life: The Ethic of Care and Empathy as an Indispensable Tool for Intervention by Dr. Kathleen Stephany, provides unequivocal, current, evidence-based considerations on ways we can care for people at risk of suicide. It provides comprehensive and practical strategies for healthcare practitioners, mental health professionals, parents, and other family members who are striving to make a difference in the life of a person who may be at risk for suicide.
For each reader, the goal of reading this book may be different. Whether it is to prevent the death of a loved one, improve patient outcomes and experience or provide the best possible professional care, I believe that anyone who reads this book will be equipped with strategies that could ultimately save a life.
PREFACE
“What is suicide anyway? How can we understand it and prevent it?” Shneidman, SuicidologistThe Ethic of Care & Empathy
This book is the third book, or trilogy, in a series of textbooks published by Bentham Science that I have written that features the ethic of care as the theoretical premise (Stephany, 2012; Stephany, 2015). The ethic of care emphasizes the interconnectedness of all of life and values lived experience with specific emphasis on the important relationship between the caregiver and patient. The ethic of care involves the action of caring for and about others, demonstrating compassion and doing what we can to end human suffering (Stephany, 2012; Stephany, 2015). This current book is also the second book that features empathy as an important therapeutic tool (Stephany, 2015). Empathy is closely aligned with the ethic of care (Stephany, 2015). Empathy is the capacity to understand and to identify with the experiences felt by another person (Shafir, 2008; Stephany, 2015). In this current textbook, the ethic of care in conjunction with empathetic responses coming from caregivers are presented as a tool for suicide intervention.
Where My Interest in Suicide Prevention Began?
My interest in the important topic of suicide prevention began when I was working as a Coroner in charge of Special Investigations for the Office of the Chief Coroner in the province of British Columbia (BC). A Coroner is a death investigator. A Coroner’s job is to identify the deceased and their cause of death (BC Coroner’s Service (BCCS), 2015). However, another integral role of the Coroner is to make recommendations to prevent death under similar circumstances based on the evidence gathered during the investigation (BCCS, 2015). One of my roles in this position as a Coroner was to lead investigations into deaths due to suicide. Over the course of time what became evident in my research was that many adults reached out to a health care professional shortly before taking their life, often within 72 hours prior to death (Stephany, 2007). As a result I began my journey to find out, what if anything, could the health professional have done differently, to help to change the suicidal person’s mind about wanting to die. The beginning of my inquiry came up with a surprising result. Many of these individuals (68 % of 118 cases over the course of a decade) had admitted to someone close to them, prior to taking their life, that they did not feel cared for by the professional they reached out to for help (Stephany, 2007). Some of these suicidal people also disclosed that they felt judged by the care provider (Stephany, 2007). This finding was consistent with the findings of other researchers (Bailey, 1994; Gairin et al., 2003; Pompili et al., 2005; Betz et al., 2013). Therefore, I decided to conduct further research into what health professionals were doing well and what they could do better to prevent death by suicide. What I discovered was that, even though people who are suicidal often reach out to health professionals for help before taking their life, there is evidence that we often do not adequately train practitioners in how to intervene in these situations (Feldman & Freedenthal, 2006; Schmitz, et al., 2012; Motto & Bostrom, 2014). In fact there are gaps in the curriculum for many health professionals in the area of suicide prevention (WHO, 2012). This book has been written to address some of those gaps in information and the application of knowledge. The content is aimed at teaching everyone who cares for suicidal people to better understand the mindset of the suicidal person and how to help them to choose life.
Why this Book was Written?
Why did I write this book? I wrote this book because what it proposes is important information for caregivers to know, especially if they want to help prevent some people from ending their lives through suicide. Traditionally there has been a greater focus in the literature on risk factors for suicide with less emphasis on strategies of intervention (Gairin et al., 2003; Betz et al., 2013; Pompili, 2015). We now know that the essential component of the suicidal person’s state of crisis is psychological and emotional. Therefore, we need to acknowledge and address those aspects of their experience especially if we want to gain their trust and help them (Shneidman, 1998; Pompili, 2015). In fact, approaches that focus on suicide prevention that do not address the despairing emotional mind set of the suicidal person, may not be as helpful as ones that do (Shneidman, 1998; Pompili, 2015).
Learning from Other People’s Experiences
Throughout this book, I share heart felt stories. What these people had to tell me was extremely informative and can assist us in doing a better job of helping others to climb out of their psychological dungeon of despair. Useful information was derived from narrative case studies and psychological autopsies. Practice exercises and simulation were also included to help the care provider to practice how to be more empathetic. (Note that all the names of the people in this book and many details of the cases have been altered to preserve confidentiality).
Who Should Read this Book?
This book is ideal for any student or practicing professional who is confronted with trying to help people who are suicidal. Family members and others who have lost someone close to them due to suicide may also experience a sense of solace in some of the contents of this book. The recommended readership for this book may include students or actual practitioners in the following disciplines and vocations.
MedicinePsychiatryNursingPsychiatric NursingPsychologyCounsellingTeachingSocial WorkThe MilitaryThe Police ForceParamedicsOther first responders (e.g., Fire Fighters)VolunteersOutreach WorkersAbout the Author
Dr. Kathleen Stephany PhD is a practicing registered nurse (RN) with the College of Registered Nurses in BC (CRNBC) and a Psychologist who is certified with the Canadian Counselling & Psychotherapy Association (CCPA). She is also a nurse educator, published author, ethicist, ethic of care theorist and suicidologist. Kathleen has conducted both quantitative and qualitative research on suicide. As a psychiatric nurse, clinician and Psychologist she has experience assessing persons for suicide risk. Kathleen also teaches suicide risk assessment and prevention to nursing students. She is a member of the International Association for Suicide Prevention (IASP) and a member of the Canadian Association for Suicide Prevention (CASP). Kathleen speaks publicly in both academic and non-academic venues about the important subject of suicide prevention. Kathleen obtained her doctorate in Counselling Psychology from Breyer State University in Alabama. The topic of her doctoral Dissertation was entitled, Suicide Intervention: The Importance of Care as a Therapeutic Imperative. She also previously earned a MA in Counselling Psychology from Simon Fraser University (SFU), a BA in Psychology from SFU, a BSN from the University of Victoria and a Diploma in Nursing from the British Columbia Institute of Technology (BCIT). In addition to being a member of IASP and CASP, Kathleen is a member of other professional associations. For example, Kathleen is a member of The Canadian Mental Health Association (CMHA), BC Branch, and a member of the Xia Eta Chapter of Sigma Theta Tau International, Honor Society of Nursing, and an associate member of the Western Northern Region of the Canadian Association of Schools of Nursing (WNRCASN). Kathleen Stephany is employed full-time as a Nurse Educator in the Bachelor of Science in Nursing (BSN) Program at Douglas College in Coquitlam, BC. She is also a motivational and inspirational speaker and a passionate gardener.ACKNOWLEDGEMENTS
Dr. Kathleen StephanyI would like to acknowledge all of the people who work with people suffering from suicidal ideation. Thank-you for your compassion, devotion and care. Your work is not easy but extremely important. I also want to thank all of the people who so willingly shared their experiences with me. Thank-you for helping me to better understand what it feels like to lose all hope and to not feel understood by others, but also sharing how important it is for us to acknowledge your pain and offer you hope. You have enlightened me and have made me a better practitioner. This book could not have been written without you.
I want to extend a special thank-you to my husband, Dr. Harold Stephany for encouraging me to write this book even though the topic is not very uplifting. You constantly reminded me that this message was important and that it needed to be shared. I am grateful for your unending patience as you watched and waited while I hid away in my office for countless hours working on this project. Thank-you Bentham Science for publishing this book. I also wish to extend my sincere gratitude to those who made helpful suggestions on how to make this book even better.
CONFLICT OF INTEREST
The author confirms that this ebook contents have no conflict of interest.
The Importance of Teaching Suicidal Prevention Strategies to Gatekeepers
Kathleen StephanyAbstract
The purpose of this current book was to add to what is already scientifically and experientially known, about the important role that gatekeepers play in suicide prevention. A gatekeeper is defined as a person, who due to the type of work they are involved in, may come into contact with persons who are at risk of suicide. The therapeutic relationship between the gatekeeper and suicidal person was presented as key to helping the suicidal person. Instillation of hope was also promoted because, while persons who are suicidal are in the midst of their despair they cannot see clearly. They may therefore, benefit from a gatekeeper helping them to re-discover their hope. Some hard facts about suicide on a global level were reviewed. It was pointed out that suicide is a complex issue and never occurs in isolation. Therefore, taking into consideration relevant issues that either contribute to, or are associated with suicide were discussed, such as social stressors and cultural issues. Religion was identified as a potential protective factor against suicide. Reasons were given in support of doing more to train gatekeepers. The ethic of care was presented as the theoretical premise for this book and both the ethic of care and empathy were introduced as a tool for suicide prevention. Quantitative and qualitative research were acknowledged as important in enhancing what we know about suicide prevention. This current manuscript draws quite significantly from evidence based data that is quantitative and qualitative. Two modes of qualitative methodologies were utilized to specifically analyze the case studies presented in this book, the narrative case study approach and the psychological autopsy. In this current Chapter, key themes were identified from the narrative case study of a suicidal person who was admitted to the Emergency Room (ER). Placing a suicidal person is a secure room for a lengthy period of time may increase their sense of being alone, and perceived neglect from a gatekeeper may be interpreted by the suicidal person as a lack of care. It was advised that when caregivers do not act in empathetic ways, instead of being self-critical, they must strive to be more self-compassionate. We were made aware of some of the ethical issues associated with caring for the suicidal person. For example, it was established that there is a risk of clinicians experiencing a violation of their moral agency, or their ability to act on their own moral beliefs.
LEARNING GUIDE
After Completing this Chapter, the Reader Should be Able to:
Define the terms suicide, suicidology and the role of the suicidologist.Explain how suicide differs from many other disease processes.Describe the function of a gatekeeper.Understand why conveying hope is important when trying to help a suicidal person.Be aware that suicide is still a leading cause of death in the developed world.Gain an understanding of some of the relevant issues that either contribute to, or are associated with suicide, such as the role that specific social stressors play in suicide.Be able to identify the 25 countries that have the highest suicide rates in the world along with some of the social factors that contribute to high suicide numbers.Discuss cultural aspects associated with suicide.Understand how religion sometimes acts as a protective factor against suicide.Describe the four key premises that support better training of gatekeepers.Appreciate that the ethic of care is the theoretical premise for this book.Explain why the ethic of care and empathy are an important tool for suicide prevention.Recognize the importance of both quantitative and qualitative research in enhancing what we know about suicide prevention.Gain an understanding of the qualitative methodologies utilized in this book, the narrative case study approach and the psychological autopsy.Explore themes from the Narrative Case Study: Admission to a Secure Room.Understand the importance of being more self-compassionate.Be aware of ethical issues associated with caring for the suicidal person.Understand that an ethical violation of a clinician’s moral agency may occur when caring for a suicidal person and may cause moral residue and moral disengagement.INTRODUCTION
“Sorrow comes in great waves but it rolls over us and though it may almost smother us it leaves us on the spot and we know that if it is strong, we are stronger inasmuch as it passes and we remain.” Henry James, American Writer
This book is concerned with the topic of preventing suicide. Suicide is the act of a person choosing to end his/her life voluntarily and intentionally (Merriam-Webster Dictionary, 2016). The subject matter of this textbook draws quite significantly from suicidology. Suicidology is the study of suicide, suicidal behavior and suicide prevention, and a suicidologist is someone who researches the subject of suicide (The Free Dictionary, 2016). It is important to note that suicide differs from many other disease processes in that its causes are multi-dimensional. Gunnell (2015), a suicidologist, asserts that there is a wide-range of factors that contribute to suicide. For example, suicide is the fatal outcome of a behavior, rather than a single disease process” (p. 155). Gunnell points out that, “suicidal behavior occurs in vulnerable individuals in the context of a range of different mental illnesses and social stresses and may be influenced by help-seeking behaviors and cultural attitudes” (p.155). Gunnell, therefore, subsequently recommends that prevention strategies focus on a wide range of areas.
The purpose of this current book is to add to what is already scientifically and experientially known, about the important role that gatekeepers play in suicide prevention. A gatekeeper is a person, who due to the type of work they are involved in may come into contact with persons who are at risk of suicide (Ghoncheh, Koot & Kerkhof, 2014). The therapeutic relationship between the gatekeeper and suicidal person is presented as key to helping the suicidal person. Subsequently, this book teaches practical, therapeutic and hopeful prevention strategies for gatekeepers to implement.
Overview of Chapter 1
This introductory Chapter introduces the notion of instillation of hope, followed by a brief overview of some of the hard facts about suicide. The multi-dimensional issues that either contribute to, or are associated with suicide are reviewed. For example, two specific social stressors are identified in relationship to suicide. The 25 countries that have the highest suicide rates in the world are presented along with some of the social factors that contribute to high suicide numbers. Cultural aspects associated with suicide are explored. Attitudes of various world religions toward suicide are presented and religion was identified as a potential protective factor against suicide. A comprehensive explanation is made as to why we need to be doing more to train gatekeepers. The ethic of care is presented as the theoretical premise for this book and both the ethic of care and empathy are put forward as a tool for suicide prevention. Two qualitative methodologies for case study analysis are introduced, the narrative case study and the psychological autopsy. A case study of a suicidal person’s experience in seclusion is analyzed and themes identified. Gatekeepers are admonished to be more self-compassionate. Emerging ethical challenges facing clinicians who work with suicidal persons is also discussed.
INSTILLATION OF HOPE
Often someone who is suicidal has lost all hope. (Shneidman, 1998). Hope is about having goals for the future and a belief that life can get better than it presently is (The Free Dictionary, 2016). Hopelessness is defined as having no hope, feeling despair and resignation (The Free Dictionary, 2016). It is the feeling that is expressed in the form of, “I have nothing to live for.”
