Staff Voices: A Look at an Important Book for Therapists

Staff Voices: A Look at an Important Book for Therapists

One of the greatest stigmas that I have witnessed in the military as well as in community mental health settings is the stigma surrounding death by suicide. Unlike other untoward events that therapists go through, this is one event that can be lonely, litigious, and career changing. “Therapist and Legal Issues for Therapists Who Have Survived a Client Suicide: Breaking the Silence” edited by Kayla Miriyam Weiner is a collection of 8 different articles on issues related to surviving the death of a patient.

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I originally got this book more than six months ago and was finally able to finish it last week. Books and papers on suicide can be very depressing, but on the other hand, I personally felt more hopeful after reading this book. I found the book’s subtitle very appropriate because it is very important to break the silence and stigma related to death by suicide. This book delivers on that title.

There were several aspects of this book that I thoroughly enjoyed. The case examples were very touching and clear. The frankness of the authors when describing this difficult topic was also refreshing. One of the areas I liked the best, were some of the material by (Dunne, 1987a) that was quoted by Schultz. I particularly liked the discussion surrounding the challenge of changing the belief that suicide is an acceptable option for survivors. This statement could really be applied to both patient survivors and therapist survivors.

Some of the areas that I found less helpful in this book were some of the outdated terms used when quoting findings from earlier studies. Many of these earlier writings were written prior to the changes in suicide vocabulary, but I found myself scratching my head and saying “This should not be said that way.” For example, in the second chapter, some of the quoted papers used jargon such as “committing suicide” or “self murder”. These terms are still used by some, but not up-to-date with latest lexicon in suicide prevention literature. There was also a reference to the use of a safety contract in the Schultz chapter. These contracts have not been found to be effective in suicide prevention and at times can increase the risk of losing a patient to suicide. This risk of liability was clearly described in later chapters. Finally, I was surprised to read about the use of Critical Incident Stress Debriefing in the Schultz chapter as a final consideration. There has been some controversy surrounding this procedure and one might want to be very careful about using such a treatment modality. I wish there was more empirical research that would support some of the assertions made in this book. However, the dearth of empirically validated studies surrounding death by suicide has been a problem for years. Nonetheless, I was glad to see such serious consideration of this difficult topic.

While reading this book I felt like I could really identify with the provider’s near misses and felt like so many of the stories could have been my own patients. I found the book was very honest and refreshing about staying with the truth and admitting that in many circumstances there are no good or clear answers to working with patients that have severe suicide ideation. The arguments for and against contacting family left me thinking that this decision should be a carefully considered clinical decision that needs to be made at the time of the incident and not dictated by a company rule or state law.

I was also impressed with the consideration of legal aspects surrounding suicide. It was very helpful to review some actual cases describing the therapists that were held accountable for a patient suicide and therapists that were freed from blame.

There is more literature on the prevention and management of suicide related behaviors, but this book gives an honest view of how one can manage their practice after a patient dies by suicide and offers helpful tips and suggestions for how one can manage their own feelings after losing a patient to suicide. I found several convincing arguments for the benefits of therapist getting their own therapy and possibly attending survivors group meetings.

In the future, I would like to see a similar book that looks at near misses and success stories related to therapists working with patients that made suicide attempts or suffered from severe ideation. This field can be very challenging and to read about stories of patients that were very close to death by suicide, but decided to choose life could be very helpful.

I would definitely recommend this book to providers working with patients suffering from severe suicide ideation or who have had previous suicide attempts. I would also recommend this book to providers that have recently had a patient die by suicide. Suicide is a significant problem for therapists working with the military. In order to stem of the tide of death by suicide, it is imperative that therapists working with this military population are knowledgeable about the latest research, treatments and prevention strategies.

One of the greatest stigmas that I have witnessed in the military as well as in community mental health settings is the stigma surrounding death by suicide. Unlike other untoward events that therapists go through, this is one event that can be lonely, litigious, and career changing. “Therapist and Legal Issues for Therapists Who Have Survived a Client Suicide: Breaking the Silence” edited by Kayla Miriyam Weiner is a collection of 8 different articles on issues related to surviving the death of a patient.

View more "Staff Voices" entries
Visit CDP's Blog

I originally got this book more than six months ago and was finally able to finish it last week. Books and papers on suicide can be very depressing, but on the other hand, I personally felt more hopeful after reading this book. I found the book’s subtitle very appropriate because it is very important to break the silence and stigma related to death by suicide. This book delivers on that title.

There were several aspects of this book that I thoroughly enjoyed. The case examples were very touching and clear. The frankness of the authors when describing this difficult topic was also refreshing. One of the areas I liked the best, were some of the material by (Dunne, 1987a) that was quoted by Schultz. I particularly liked the discussion surrounding the challenge of changing the belief that suicide is an acceptable option for survivors. This statement could really be applied to both patient survivors and therapist survivors.

Some of the areas that I found less helpful in this book were some of the outdated terms used when quoting findings from earlier studies. Many of these earlier writings were written prior to the changes in suicide vocabulary, but I found myself scratching my head and saying “This should not be said that way.” For example, in the second chapter, some of the quoted papers used jargon such as “committing suicide” or “self murder”. These terms are still used by some, but not up-to-date with latest lexicon in suicide prevention literature. There was also a reference to the use of a safety contract in the Schultz chapter. These contracts have not been found to be effective in suicide prevention and at times can increase the risk of losing a patient to suicide. This risk of liability was clearly described in later chapters. Finally, I was surprised to read about the use of Critical Incident Stress Debriefing in the Schultz chapter as a final consideration. There has been some controversy surrounding this procedure and one might want to be very careful about using such a treatment modality. I wish there was more empirical research that would support some of the assertions made in this book. However, the dearth of empirically validated studies surrounding death by suicide has been a problem for years. Nonetheless, I was glad to see such serious consideration of this difficult topic.

While reading this book I felt like I could really identify with the provider’s near misses and felt like so many of the stories could have been my own patients. I found the book was very honest and refreshing about staying with the truth and admitting that in many circumstances there are no good or clear answers to working with patients that have severe suicide ideation. The arguments for and against contacting family left me thinking that this decision should be a carefully considered clinical decision that needs to be made at the time of the incident and not dictated by a company rule or state law.

I was also impressed with the consideration of legal aspects surrounding suicide. It was very helpful to review some actual cases describing the therapists that were held accountable for a patient suicide and therapists that were freed from blame.

There is more literature on the prevention and management of suicide related behaviors, but this book gives an honest view of how one can manage their practice after a patient dies by suicide and offers helpful tips and suggestions for how one can manage their own feelings after losing a patient to suicide. I found several convincing arguments for the benefits of therapist getting their own therapy and possibly attending survivors group meetings.

In the future, I would like to see a similar book that looks at near misses and success stories related to therapists working with patients that made suicide attempts or suffered from severe ideation. This field can be very challenging and to read about stories of patients that were very close to death by suicide, but decided to choose life could be very helpful.

I would definitely recommend this book to providers working with patients suffering from severe suicide ideation or who have had previous suicide attempts. I would also recommend this book to providers that have recently had a patient die by suicide. Suicide is a significant problem for therapists working with the military. In order to stem of the tide of death by suicide, it is imperative that therapists working with this military population are knowledgeable about the latest research, treatments and prevention strategies.