Clinical Trainees’ Personal History of Suicidality and the Effects on Attitudes Towards Suicidal Patients
Abstract
Up to half of all individuals who completed suicide were in treatment at the time of death. Clinicians are thus uniquely positioned to help avert suicidal behavior, and the attitude of treating clinicians can greatly affect the quality of care of suicidal individuals. The goal of this study was to gain a preliminary understanding of how clinicians’ own personal histories may impact their interactions with and attitudes towards suicidal patients. A questionnaire was distributed to clinical psychology trainees attending a voluntary 2-day workshop on working with suicidal crises. Questions assessed history of suicidality in self or close others, history of working with suicidal patients, attitudes towards suicidal patients, and attitudes towards preparedness and willingness to work with this population. Of 44 participants, 73% personally knew somebody who was suicidal, 59% had themselves experienced suicidal ideation, and 5% had an actual plan. Personal experiences with suicide were associated with increased stigmatizing attitudes, while specific education appeared to mitigate these negative feelings. Preliminary evidence is provided that indicates high levels of personal suicidal experiences in clinical trainees’ histories which directly affect attitudes towards patients. It is suggested that specific education may increase students’ preparedness and comfort in working with this vulnerable clinical population.
References
Alexander, D. A., Klein, S., Gray, N. M., & Eagles, J. M. (2000). Suicide by patients: Questionnaire study of its effect on consultant psychiatrists. BMJ, 320, 1571-1574. doi:10.1136/bmj.320.7249.1571
Aydin, N., Yigit, A., Inandi, T., & Kirpinar, I. (2003). Attitudes of hospital staff toward mentally ill patients in a teaching hospital, Turkey. International Journal of Social Psychiatry, 49(1), 17-26. doi:10.1177/0020764003049001544
Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103(4), 670-686. doi:10.1037/0033-295X.103.4.670
Centers for Disease Control and Prevention. (2013). Suicide among adults aged 35-64 years -- United States, 1999-2010. Morbidity and Mortality Weekly Report. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6217a1.htm
de Vries, S. R., & Valadez, A. A. (2005). Counseling students’ mental health status and attitudes toward counseling. Journal of Professional Counseling: Practice, Theory, & Research, 33(2), 77-87. Retrieved from http://search.proquest.com/docview/212437235/fulltext?accountid=10932
Deans, C., & Meocevic, E. (2006). Attitudes of registered psychiatric nurses towards patients diagnosed with borderline personality disorder. Contemporary Nurse, 21(1), 43-49. doi:10.5172/conu.2006.21.1.43
Deutsch, C. J. (1985). A survey of therapists’ personal problems and treatment. Professional Psychology: Research and Practice, 16(2), 305-315. doi:10.1037/0735-7028.16.2.305
Fawcett, J. (1999). Profiles of completed suicides. In D. Jacobs (Ed.), The Harvard Medical School Guide to Suicide Assessment and Intervention. San Francisco: Jossey-Bass.
Fussell, F. W., & Bonney, W. C. (1990). A comparative study of childhood experiences of psychotherapists and physicists: Implications for clinical practice. Psychotherapy, 27(4), 505-512. doi:10.1037/0033-3204.27.4.505
Gilroy, P., Carroll, L., & Murra, J. (2002). A preliminary survey of counseling psychologists’ personal experiences with depression and treatment. Professional Psychology: Research and Practice, 33, 402-407. doi:10.1037/0735-7028.33.4.402
Grad, O. T., & Michel, K. (2005). Therapists as client suicide survivors. Women & Therapy, 28(1), 71-81. doi:10.1300/J015v28n01_06
Gulfi, A., Castelli Dransart, D. A., Heeb, J.-L., & Gutjahr, E. (2010). The impact of patient suicide on the professional reactions and practices of mental health caregivers and social workers. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 31(4), 202-210. doi:10.1027/0027-5910/a000027
Hemmings, A. (1999). Attitudes to deliberate selfharm among staff in an accident and emergency team. Mental Health Care, 2, 300-302.
Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., . . . Thornicroft, G. (2014). Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry, 1, 467-482. doi:10.1016/S2215-0366(14)00023-6
Hjorthoj, C. R., Madsen, T., Agerbo, E., & Nordentoft, M. (2014). Risk of suicide according to level of psychiatric treatment: A nationwide nested case-control study. Social Psychiatry and Psychiatric Epidemiology, 49, 1357-1365. doi:10.1007/s00127-014-0860-x
Hoyert, D. L., Heron, M. P., Murphy, S. L., & Kung, H. (2006). Deaths: Final data for 2003. National Vital Statistics Reports, 54, 1-120. Retreived from http://www.nber.org/perinatal/2003/docs/2003_Mortality_Final_Data.pdf
Hugo, M. (2001). Mental health professionals’ attitudes towards people who have experienced a mental health disorder. Journal of Psychiatric and Mental Health Nursing, 8, 419-425. doi:10.1046/j.1351-0126.2001.00430.x
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., & Henderson, S. (1999). Attitudes towards people with a mental disorder: A survey of the Australian public and health professionals. Australian and New Zealand Journal of Psychiatry, 33, 77-83. doi:10.1046/j.1440-1614.1999.00513.x
Kassam, A., Glozier, N., Leese, M., Henderson, C., & Thornicroft, G. (2010). Development and responsiveness of a scale to measure clinicians’ attitudes to people with mental illness (medical student version). Acta Psychiatrica Scandinavica, 122(2), 153-161. doi:10.1111/j.1600-0447.2010.01562.x
Kleespies, P. M. (1993). The stress of patient suicidal behavior: Implications for interns and training programs in psychology. Professional Psychology: Research and Practice, 24, 477-482. doi:10.1037/0735-7028.24.4.477
Kleespies, P. M., Van Orden, K. A., Bongar, B., Bridgeman, D., Bufka, L. F., Galper, D. I., . . . Yufit, R. I. (2011). Psychologist suicide: Incidence, impact, and suggestions for prevention, intervention, and postvention. Professional Psychology: Research and Practice, 42(3), 244-251. doi:10.1037/a0022805
Konick, L. C., & Gutierrez, P. M. (2005). Testing a model of suicide ideation in college students. Suicide and Life Threatening Behavior, 35(2), 181-192. doi:10.1521/suli.35.2.181.62875
Little, L., & Hamby, S. L. (1999). Gender differences in sexual abuse outcomes and recovery experiences: A survey of therapist-survivors. Professional Psychology: Research and Practice, 30(4), 378-385. doi:10.1037/0735-7028.30.4.378
McIntyre, S. M., & Schwartz, R. C. (1998). Therapists’ differential countertransference reactions toward clients with major depression or borderline personality disorder. Journal of Clinical Psychology, 54(7), 923-931. doi:10.1002/(SICI)1097-4679(199811)54:7<923::AIDJCLP6>3.0.CO;2-F
Middleton, J. L. (2008). Today I’m grieving a physician suicide. Annals of Family Medicine, 6(3), 267-269. doi:10.1370/afm.840
Nock, M. K. (2012). Future directions for the study of suicide and self-injury. Journal of Clinical Child & Adolescent Psychology, 41(2), 255-259. doi:10.1080/15374416.2012.652001
Nordt, C., Rossler, W., & Lauber, C. (2006). Attitudes of mental health professionals toward people with schizophrenia and major depression. Schizophrenia Bulletin, 32(4), 709-714. doi:10.1093/schbul/sbj065
Platt, M., & Freyd, J. J. (2012). Trauma and negative underlying assumptions in feelings of shame: An exploratory study. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), 370-378. doi:10.1037/a0024253
Pope, K., & Tabachnick, B. (1994). Therapists as patients: A national survey of psychologists’ experiences, problems, and beliefs. Professional Psychology: Research and Practice, 25, 247-258. doi:10.1037/0735-7028.25.3.247
Read, J., & Law, A. (1999). The relationship of causal beliefs and contact with users of mental health services to attitudes to the ‘mentally ill’. International Journal of Social Psychiatry, 45(3), 216-229. doi:10.1177/002076409904500309
Rudd, M. D., Cukrowicz, K. C., & Bryan, C. J. (2008). Core competencies in suicide risk assessment and management: Implications for supervision. Training and Education in Professional Psychology, 2(4), 219-228. doi:10.1037/1931-3918.2.4.219
Sawyer, A. (2011). Let’s talk: A narrative of mental illness, recovery, and the psychotherapist’s personal treatment. Journal of Clinical Psychology: In Session, 67(8), 776-788. doi:10.1002/jclp.20822
Schoener, G. (1999). Practicing what we preach. The Counseling Psychologist, 27, 693-701. doi:10.1177/0011000099275003
Sethi, S., & Uppal, S. (2006). Attitudes of clinicians in emergency room towards suicide. International Journal of Psychiatry in Clinical Practice, 10(3), 182-185. doi:10.1080/13651500600633543
Spiegelman, J. S., & Werth, J. L., Jr. (2005). Don’t forget about me: The experiences of therapists in- training after a client has attempted or died by suicide. Women & Therapy, 28(1), 35-57. doi:10.1300/J015v28n01_04
Strupp, H. H. (1973). Psychotherapy: Clinical, research, and theoretical issues. New York: Jason Aronson.
Swain, B. J., & Domino, G. (1985). Attitudes toward suicide among mental health professionals. Death Studies, 9, 455-468. doi:10.1080/07481188508252537
Tangney, J. P., Wagner, P., Fletcher, C., & Gramzow, R. (1992). Shamed into anger? The relation of shame and guilt to anger and self-reported aggression. Journal of Personality and Social Psychology, 62(4), 669-675. doi:10.1037/0022-3514.62.4.669
Twemlow, S. W. (1997). Exploitation of patients: Themes in the psychopathology of their therapists. American Journal of Psychotherapy, 51(3), 357-375. Retrieved from http://search.proquest.com/docview/619188253?accountid=12261
Wilcox, H. C., Arria, A. M., Caldeira, K. M., Vincent, K. B., Pinchevsky, G. M., & O’Grady, K. E. (2010). Prevalence and predictors of persistent suicide ideation, plans, and attempts during college. Journal of Affective Disorders, 127, 287-294. doi:10.1016/j.jad.2010.04.017
Wood, B. J., Klein, S., Cross, H. J., Lammers, C. J., & Elliott, J. K. (1985). Impaired practitioners: Psychologists’ opinions about prevalence, and proposals for intervention. Professional Psychology: Research and Practice, 16(6), 843-850. doi:10.1037/0735-7028.16.6.843
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This work is licensed under a Creative Commons Attribution 4.0 International License.