SIR GALAHAD AND SAVING THE NATION
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1 SIR GALAHAD AND SAVING THE NATION research as a personal journey Dr Andrew Reeves 5th Keele Counselling Conference, 27 March 2011 A PERSONAL JOURNEY It was like being pushed into a dark cave; but there must be some meaning to it I really needed to understand I wanted to do it differently Isobel s death had to impact beyond just my own process
2 Lots of research into suicide risk assessment But it generally all tries to do the same thing Who
3 Gender, i.e. males generally present with greater risk across different ages; Age, i.e. males age and over 75; Relationships single, widowed, divorced/separated; Social isolation; Psychopathology and Psychiatric Illness specific diagnoses: -Depression; -Schizophrenia; -Alcohol / drug misuse; -Hopelessness; -Paranoia; -mood disorders; -Psychosis; -affective disorders, i.e. lack of affective control, violence; -anxiety / panic disorders; -co-morbidity; -PTSD; Occupational Factors, i.e. unemployment / retired; Personality Disorders (sociopathy, aggression for example); History of child sexual abuse / child physical abuse / adult sexual assault Specific plan formulated Prior suicide attempts / family history of suicide or suicide attempts Issues related to sexuality Physical illness and other medical factors, i.e. biochemical / hormonal changes When How to predict Why
4 our best route to understanding suicide is not through the study of the structure of the brain, nor the study of social statistics, nor the study of mental diseases, but directly through the study of human emotions described in the words of the suicidal person. The most important question to a potentially suicidal person is not an inquiry about family history or laboratory tests of blood or spinal fluid, but where do you hurt? and how can I help you? Shneidman, 1998 Where do you hurt? How can I help you?
5 IN PURSUIT OF ANSWERS How are counsellors taught to work with suicide risk (questionnaire) How do we talk to our clients about suicide (discourse analysis) How can we learn, from a counselling perspective, about working with suicide (thematic analysis) How might we hoist ourselves by our own petards? (grounded theory) HOW ARE WE TAUGHT? 95.8% of respondents believed risk training to be an essential component of counsellor training 47.8% of respondents did not provide time for trainees to develop risk assessment skills 12.5% of courses did not consider their trainees competent to work with risk on qualification
6 SUICIDE ENDS EXISTENTIAL CRISIS what s the point what s the point in carrying on? I feel really alone with it all I just feel that I don t exist I don t belong in the life I live in SUICIDE REMOVES A SENSE OF BEING STUCK WITH THE NEGOTIATIONS AND MANOEUVRINGS OF LIFE I m thinking about stopping it. I don t see what s keeping me here, or why I carry on. I feel stuck and cannot see a way forward. I need to get out and go somewhere else. I need to get out of people s way and get out of this stuckness
7 SUICIDE ENDS APATHY AND FATIGUE GENERATED BY THE BURDENSOME NATURE OF LIFE I just feel too tired to carry on. It feels so heavy. I don t know if I can continue to manage it any further/longer. I feel so tired and exhausted in keeping it going. I don t want people to worry about me any more. I need to take the pain away; to erase the pain. TO HARD TO SPEAK Clients typically talked about suicide in metaphor Counsellors predominantly used reflective responses Both became defined by the shame of suicide The client was not given the space to explore their feelings Counsellors were left not knowing
8 HOW CAN WE LEARN Policy and legal influencing factors Prediction-prevention culture Personal perspectives on suicide Influence of organisations on practice Nature of the suicide discourse in counselling Case study material and role play Post-suicide support HOISTED BY OUR OWN PETARDS? Counsellor Risk assessment forms
9 FORMS-DRIVEN VS. DIALOGIC-LED Counselling services use forms to prioritise allocation They acknowledge scores not always accurate Difficult to disregard what the form says Even if it contradicts a counsellor assessment This situation relies on the efficacy of forms Where do you hurt? How can I help you? THANK YOU Dr Andrew Reeves To download this presentation, go to my website, click on the DOWNLOADS link, and then find the link for this conference (pdf format) A.Reeves@liverpool.ac.uk
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