Abstract
Working with suicidal clients historically has placed a heavy burden of responsibility on the therapist for a successful outcome. This orientation generally has left clinicians feeling stressed and in need of controlling their clients' behavior; clients, in turn, often have developed unrealistic expectations of therapy or “resistance” of the therapist's interventions. In this context, the chance for a potentially valuable collaboration between client and therapist is often lost. This paper builds on previous work that has introduced the notion of a collaborative working relationship with suicidal clients. It is argued that the therapeutic process ideally should not only utilize the therapist's knowledge and skills in treating suicidal clients, but also cultivate self-efficacy by encouraging the client to adopt a self-help orientation to therapy. Several general principles of a collaborative/self-help orientation to working with suicidal clients are discussed and a variety of specific therapeutic strategies consistent with this orientation are described.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.
Burns, D. D. (1999). The feeling good handbook (2nd Ed.). New York: Viking Penguin.
Chambless, D. L., Sanderson, W. C., Shoham, V., Johnson, S. B., Pope, K. S., Crits-Christoph, P., Baker, M., Johnson, B., Woody, S. R., Sue, S., Beutler, L., Williams, D. A., & McCurry, S. (1996). An update on empirically validated therapies. The clinical psychologist, 49, 5-18.
Chemtob, C., Hamada, R., Bauer, G., Kinney, B., & Torigoe, R. (1988). Patients' suicides: Frequency and impact on psychiatrists. American Journal of Psychiatry, 145, 224-228.
Chiles, J. A. & Strosahl, K. D. (1995). The suicidal patient: Principles of assessment, treatment, and case management. Washington, DC: American Psychiatric Press.
Clum, G. A., & Lerner, M. (1990). A problem solving approach to treating individuals at risk for suicide. In Lester, D. (Ed.). Current concepts of suicide. Philadelphia, PA: The Charles Press.
Deutsch, D. J. (1984). Self-reported sources of stress among psychotherapists. Professional Psychology: Research and Practice, 15, 833-845.
D'Zurilla, T. J., & Nezu, A. M. (2001). Problem-solving therapies. In Dobson, K. S. (Ed.). Handbook of cognitive-behavioral therapies (2nd Ed.) (pp. 211-245). New York: Guilford.
DeReubeis, R. J., Tang, T. Z., and Beck, A. T. (2001). Cognitive therapy. In Dobson, K. S. (Ed.). Handbook of cognitive-behavioral therapies (2nd Ed.) (pp. 349-392). New York: Guilford.
Ellis, T. E. (2001). Psychotherapy with suicidal patients. In D. Lester (Ed.). Suicide prevention: Resources for the millennium (pp. 129-151). Philadelphia: Brunner-Routledge.
Ellis, T. E., & Newman, C. F. (1996). Choosing to live: How to defeat suicide through cognitive therapy. Oakland, CA: New Harbinger.
Greenberger, D., & Padesky, C. A. (1995). Mind over mood. New York: Guilford.
Hendin, H. (1995). Suicide in America: New and expanded edition. New York: Norton.
Jobes, D. A. (2000). Collaborating to prevent suicide: A clinical-research perspective. Suicide and Life-Threatening Behavior, 30, 8-17.
Kazantzis, N., & Lampropoulos, G. K. (2002). Reflecting on homework in psychotherapy: What can we conclude from research and experience? Journal of Clinical Psychology, 58, 577-585.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.
Linehan, M. M., Goodstein, J. L., Nielsen, S. L., & Chiles, J. A. (1983). Reasons for staying alive when you're thinking of killing yourself: The Reasons for Living Inventory. Journal of Consulting and Clinical Psychology, 51, 276-286.
Maltsberger, J. T., & Buie, D. H. (1973). Countertransference hate in the treatment of suicidal patients. Archives of General Psychiatry, 30, 625-633.
Maltsberger, J. T., & Goldblatt, M. J. (1996). Essential papers on suicide. New York: New York University Press.
Michel, K., Maltsberger, J. T., Jobes, D. A., Leenars, A. A., Orbach, I., Stadler, K., Dey, P., Young, R. A., & Vlach, L. (2002). Discovering the truth in attempted suicide. American Journal of Psychotherapy, 56, 424-437.
Nathan, P. E., & Gorman, J. M. (2002). A guide to treatments that work. New York: Oxford Universities Press.
Norcross, J. C. (Ed.) (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York: Oxford.
Norcross, J. C., Santrock, J. W., Campbell, L. F., Smith, T. P., Sommer, R., & Zuckerman, E. L. (2000). Authoritative guide to self-help resources in mental health. New York: Guilford.
Rudd, M. D., Joiner, T. E., & Rajab, M. H. (2001). Treating suicidal behavior: An effective, time-limited approach. New York: Guilford.
Schotte, D., & Clum, G. (1987). Problem-solving skills in suicidal psychiatric patients. Journal of Consulting and Clinical Psychology, 55, 49-54.
Straub, R. O. (2001). Health psychology. New York: Worth.
Tryon, G. S., & Winograd, G. (2002). Goal consensus and collaboration. In J. C. Norcross (Ed.). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York: Oxford.
Wampold, B. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum Associates.
Werth, J. L. (1996). Rational suicide? Implications for mental health professionals. Washington, DC: Taylor and Francis.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ellis, T.E. Collaboration and a Self-Help Orientation in Therapy with Suicidal Clients. Journal of Contemporary Psychotherapy 34, 41–57 (2004). https://doi.org/10.1023/B:JOCP.0000010912.99125.6a
Issue Date:
DOI: https://doi.org/10.1023/B:JOCP.0000010912.99125.6a