The outpatient treatment of suicidality: An integration of science and recognition of its limitations.

Abstract

The clinical assessment of suicidality i s one of the most challenging tasks the mental health clinician ca n face. This article offers 22 recommendations for the outpatient psychotherapeutic treatment of suicidality in adults and adolescents. These recommendations cut across all domains of clinical practice. A rationale is presente d tha t th e state d recommendation s nee d a n empirica l base , i n contrast t o th e existing litigation-determined standard of care that has emerged over the last several decades. The authors review empirical literature, acknowledge identifiable limitations, and emphasize implications for day-to-day clinical practice and the continuing evolution of standards of care. Two interdependent forces have emerged in the last decade that have significantly altered the nature of care for suicidal patients— managed care and practice guidelines. Regardles s o f one's theoreticaJ orientation, psychotherapy as provided in today's mental health arena will be time limited in some form or fashion. Time limitations are most frequently imposed externally; that is, by the managed care company or insurance provider involved and, most often, by restricting the frequency, duration, or actual type of care provided. The dilemma many practitioners confront today is how to provide effective psychotherapeutic services for high-risk individuals within such rigid constraints, particularly for those patients who are suicidal, all the while balancing escalating liabilities.

Cite this work

No public copy is stored for this record, so only the metadata is cited.

Stored only when both papers are in the corpus — 69 citations exist upstream.

Papers that cite the same references — the relational fallback while embeddings are still backfilling.