Treating Suicidal Behavior: An Effective, Time-Limited Approach.

Abstract

Treating Suicidal Behavior: An Effective, Time-Limited Approach is a well-written, thorough, and comprehensive review of an important topic. While providing more information than many primary care providers may be willing to review or are able to utilize, the authors appear to make a conscious effort to present the contents of this volume as accessibly as possible by thoughtfully dividing the text into 2 major sections. The first section, “Establishing a Foundation for Treatment,” contains 3 chapters that review the literature related to suicidality, present an overview of cognitive-behavioral theory (CBT), and summarize the treatment process. These 3 chapters provide a useful orientation to providers wishing to increase their comfort level when dealing with suicidal patients prior to referral for more intensive psychiatric treatment. An understanding of the complexity of primary care is acknowledged by the authors' recognition and consideration of issues related to medical as well as psychiatric comorbidity. The second section, which includes the remaining 7 chapters, provides extensive detail, suggestions, and treatment advice for practitioners interested in learning more about the actual mechanics of the therapeutic process. The standard treatment framework presented is based on a series of 20 sessions that would typically take place over a 6-month time period. Guidelines are provided for topics and tasks to be addressed at each session, which are illustrated with a longitudinal case example. Individual chapters expand on topics introduced earlier such as initial evaluation, risk assessment, crisis intervention, behavioral management, and cognitive restructuring. The authors' obvious interest in providing clinically relevant information is seen throughout the text. Research reviews are chosen on the basis of their clinical orientation and are followed by summary statements discussing implications for clinical practice. CBT and its application to suicide prevention are presented in a clear yet concise manner, with a thoughtful recognition of the tension between theory and practice. Numerous clinical examples, tables, acronyms, and case studies are used to enhance retention and illustrate working concepts. In summary, this is a thoughtfully organized and well-developed text that is structured in such a way as to allow professionals with various levels of interest to improve their understanding of suicidal behavior and treatment. Information is clearly presented and organized in a manner that facilitates quick reference. Treating Suicidal Behavior is a useful guide for clinicians at any level of practice and an excellent tool for those interested in improving their psychotherapeutic skills in this area.