Suicide and Suicidal Attempts in the United States: Costs and Policy Implications

The national cost of suicides and suicide attempts in the United States in 2013 was $58.4 billion based on reported numbers alone. Lost productivity (termed indirect costs) represents most (97.1%) of this cost. Adjustment for under‐reporting increased the total cost to $93.5 billion or $298 per capita, 2.1–2.8 times that of previous studies. Previous research suggests that improved continuity of care would likely reduce the number of subsequent suicidal attempts following a previous nonfatal attempt. We estimate a highly favorable benefit–cost ratio of 6 to 1 for investments in additional medical, counseling, and linkage services for such patients.     

Narratives of escape: A hermeneutic study of resiliency

This study examines the structure of narratives told by well-functioning adults who were at-risk as children. Participants told stories of their childhood based on pictures they selected from the TAT test (Thematic Apperception Test). Analysis of their narratives resulted in a set of hermeneutic rules which may be useful in interpreting the structure of narratives and in understanding the relationship between internalized images, reality construction, and resiliency. Two types of images were identified: negative images of stress and darkness and more positive images of escape and hope. Implications for helping clients develop images of strength and competence are discussed.The authors wish to thank an anonymous reviewer for his or her very helpful suggestions.     

Clarifying subsystem boundaries in grandfamilies

This article explores the benefits of clarifying subsystem boundaries in grandfamilies, families in which grandparents are primary caregivers to their grandchildren. The author reviews what is known about grandfamilies, presents the theory and research behind the importance of clear subsystem boundaries, and argues that grandfamilies are particularly vulnerable to problematic subsystem boundaries. Case examples are used to demonstrate how clarifying subsystem boundaries with grandfamilies in family therapy can open up resources for improved family functioning.     

Family therapy in israel: A review of therapy done under unusual circumstances

Major issues affecting family therapy practice in Israel are discussed. Issues making family therapy in Israel unique include historical topics such as the legacy of the Holocaust, the emergence of the family therapy movement from the cradle of the kibbutz; and more recent events such as constant wars, the specter of terrorist threat, and coping with the everyday pressures of life in Israel—stress, loss, and bereavement. Future trends in family therapy in the Israeli context include the peace process and the adjustment it requires from families living in the West Bank and the Golan Heights. The advent of peace and normalization will force family therapists to grapple with issues until now not given the attention they require by a country always on the brink of war, including family violence, feminist issues and patriarchal family orientations, single-parent families, and cultural diversity.The authors would like to acknowledge the help of Israel Charny, Yael Geron, Tzipi Glick, Ruth Malkinson, Judith Wertheimer, and Susan Zeidel.     

Gender identity and family relationships: Perspectives from incestuous fathers

The purpose of this study was to understand how incestuous fathers constructed their gender identities and family relationships and to determine how these perceptions were linked to incest. Analysis of intensive interviews with 20 incest offenders suggested that incest occurred in context of entitlement stemming from masculine gender constructions and family experiences which lead to conflicts regarding control and intimacy and a build up of failure. Case illustrations and implications for clinical practice are addressed.     

Paradoxes of qualitative research

In qualitative research paradoxes abound in research design, sampling, generalisation, ethics and the behaviour of the researcher. The ultimate paradox is that qualitative inquiry is impossible — both conceptually and practically — yet it still goes on. It must do so if the professions of counselling and psychotherapy are to advance.     

Technology and morality: Influences on public attitudes toward biotechnology

This study uses national survey data to test effects on individuals’ objections to biotechnology applied to plants and animals. We find that females and individuals who believe in the biblical story of creation have greater intrinsic moral objections to biotechnology than males and those who do not believe the creation story. We also find that the perception of personal benefit from biotechnology significantly decreases the likelihood of moral objection to both plant and animal biotechnology, and that perception of environmental risk from biotechnology significantly increases the likelihood of moral objection to both types of biotechnology. Policy issues are discussed. He has studied biotechnology, development, social change, work and industry. He currently works in the Survey Research Division at Research Triangle Institute in Research Triangle Park, North Carolina. He engages is applied studies of new technologies and public policies affecting consumers, industry, natural resources and society. He has researched moral attitude and religious affects in biotechnology acceptance, environmentalism, and in relation to numerous controversial social concerns and issues.     

Clients’ perceptions of personal psychotherapy or counselling for therapists

The purpose of this study was to examine clients’ opinions of therapists’ personal use of psychotherapy or counselling. Participants in this study, a nationwide sample of clients recruited through Amazon’s MTurk system, were asked to complete an online survey assessing their attitudes towards treatment use by therapists as well as their general attitudes towards psychological help-seeking and perceptions of stigma (social and self) with psychological treatments. In this study, we found that clients generally had positive views about therapists’ personal use of psychotherapy or counselling. Although overall positive attitudes were found, the results from repeated measures ANOVAs indicated that attitudes depended somewhat on whether the therapist had sought out treatment as part of a training requirement for self-enrichment, or for the treatment of a psychological problem. In addition, participating clients were less supportive of therapists disclosing a treatment use history with their clients. Regression analyses also indicated that attitudes towards treatment use by therapists were significantly predicted by general help-seeking attitudes and perceptions of stigma (social and self), but attitudes towards disclosure were not. The findings from this study have important implications regarding therapist treatment use and disclosure in practice.     

Suicide and Its Association with Individual,Family, Peer,and School Factors in an Adolescent Population in Southern Taiwan

A representative sample of 10,233 adolescent students was recruited to examine the rate of suicidal attempt and its correlates in the adolescents living in southern Taiwan. Five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia (Kiddie‐SADS‐E) were used to inquire about the participants' suicidality. The associations between suicidal attempt and multidimensional factors were examined by using logistic regression analysis: 9.1% of the participants reported a suicidal attempt in the preceding year. Female gender, low self‐esteem, weekly alcohol use, illicit drugs use, depression, high family conflict, low maternal education level, poor family function, low connectedness to school, low rank, poor feeling in peer group, and drop out from school were associated with adolescent suicidal attempt. The rate of suicidal attempt was found to be high in Taiwanese adolescents, and multidimensional factors were correlated to adolescent suicidal attempt.