Understanding Therapists’ Work with Suicidal Patients: An Examination of Qualitative Data
By Maureen Monahan, M.A.
Project Overview
Among the few empirically supported interventions for treating suicidal ideation is the collaborative assessment and management of suicidality approach (CAMS; Jobes, 2006), which serves as a framework for maintaining a collaborative relationship between the therapist and patient. Crowley’s (2014) quantitative investigation of therapist adherence to CAMS found strong adherence to the framework, with some moderating effects for intensity of CAMS training, therapist gender, and theoretical orientation. The present study used an original coding manual to examine responses to 14 open-ended questions included in Crowley’s questionnaires, in order to gain a better understanding of the ways in which therapists use CAMS collaboratively as well as their reasons for adhering (or not adhering) to certain aspects of the framework. Analyses revealed that less- experienced and male therapists, as well as those who received less intensive training, were more likely to use the SSF/follow the CAMS protocol to cultivate a sense of purpose or meaning with clients, while more-experienced therapists were more likely to identify goals or explore values. Conversely, female therapists were found to be more likely to engage in an interactive exchange to help identify drivers of suicidal thoughts and behavior and to not use CAMS Outcome Forms for reasons related to the therapist, such as not liking the forms. Furthermore, male therapists and those who had had a patient make a suicide attempt were significantly more likely to end CAMS at a subjective point in time rather than at the time indicated in the manual, and future research should investigate if experiencing a client suicide attempt leads to therapist apprehension about ending suicide tracking with other patients whose suicidality has resolved.
