Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: The Importance of Active Engagement,Active Rescue,and Collaboration Between Crisis and Emergency Services

In 2012, the SAMHSA‐funded National Suicide Prevention Lifeline (Lifeline) completed implementation of the first national Policy for Helping Callers at Imminent Risk of Suicide across its network of crisis centers. The policy sought to: (1) provide a clear definition of imminent risk; (2) reflect the state of evidence, field experience, and promising practices related to reducing imminent risk through hotline interventions; and (3) provide a uniform policy and approach that could be applied across crisis center settings. The resulting policy established three essential principles: active engagement, active rescue, and collaboration between crisis and emergency services. A sample of the research and rationale that underpinned the development of this policy is provided here. In addition, policy implementation, challenges and successes, and implications for interventions to help Lifeline callers at imminent risk of suicide are detailed.     

Gegenübertragung im stationären Therapie-Setting

Background

Countertransference is seen as an instrument of research into a patient’s unconscious and is therapeutically useful in furthering psychodynamic work. For inpatient psychodynamic psychotherapy, where patients are treated by a team of psychotherapists, countertransference is much more complex and makes consideration and integration of different countertransference feelings necessary. Using the first German translation of the countertransference questionnaire (CTQ, Zittel Conclin and Westen, the countertransference questionnaire, 2005) an attempt was made to identify differences in countertransference phenomena in a team of psychotherapists and to show the impact countertransference has on therapy outcome.

Materials and methods

A total of t multiprofessional teams of psychotherapists (15 physicians, 5 psychologists and 9 body and art therapy psychotherapists) took part in the study and completed the CTQ for 137 patients (100 female, 37 male) at the beginning and at the end of inpatient psychotherapy. In addition, the patients completed two questionnaires, the Symptom Check List Revised 90-R (SCL-90) for the severity of symptoms and the Assessment of DSM-IV Personality Disorders Questionnaire (ADP-IV) for personality disorders.

Results

Body and art therapy psychotherapists expressed more positive, protective and involved countertransference feelings whereas psychotherapists for single and group therapy expressed more aggressive and hopeless feelings. Countertransference has an impact on therapy outcome and feelings of a lack of interest, aggression and resignation at the beginning of therapy can point to a poor outcome. Patients with personality disorders activate more negative countertransference reactions than patients without personality disorders but at the same time they may also evoke parent-like feelings of protection.

Conclusions

Using the CTQ it is possible to differentiate countertransference phenomena in a team of psychotherapists treating inpatients with psychodynamic psychotherapy. The timely perception and integration of countertransference feelings has a positive influence on the therapeutic process and therapy outcome.     

Test Review: Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV)

Objective: Evaluate neuropsychological functioning in children with non-syndromic cleft of the lip and/or palate (NSCL/P) through profile variance within type of cleft and comparisons to controls.

Methods: Children ages 7 to 17 years participated; 66 had a diagnosis of NSCL/P and 87 were healthy controls. Neuropsychological tests of language, visual-perceptual, executive functioning, and memory skills were administered. Between- and within-group differences were assessed.

Results: Within cleft types, children with NSCLP had an even profile with equal Verbal and Performance IQ (VIQ and PIQ, respectively). Children with non-syndromic cleft palate only (NSCP) had significantly lower VIQ than PIQ, while children with non-syndromic cleft lip only (NSCL) showed a nonsignificant trend for higher VIQ than PIQ. Overall, subjects with NSCL/P performed lower on measures of expressive language and verbal memory than controls.

Conclusions: While deficits in verbal and memory skills for children with NSCL/P remain apparent, there is still uncertainty around the possible influence of cleft type on the pattern of deficits.     

Effects of repeated collaborative retrieval on individual memory vary as a function of recall versus recognition tasks

Our research examines how prior group collaboration modulates later individual memory. We recently showed that repeated collaborative recall sessions benefit later individual recall more than a single collaborative recall session (Blumen & Rajaram, 2008). Current research compared the effects of repeated collaborative recall and repeated collaborative recognition on later individual recall and later individual recognition. A total of 192 participants studied a list of nouns and then completed three successive retrieval sessions in one of four conditions. While two collaborative recall sessions and two collaborative recognition sessions generated comparable levels of individual recall (CRecall-CRecall-I Recall ～ CRecognition-CRecognition-I Recall , Experiment 1a), two collaborative recognition sessions generated greater levels of individual recognition than two collaborative recall sessions (CRecognition-CRecognition- IRecognition > CRecall-CRecall- I Recognition , Experiment 1b). These findings are discussed in terms of two opposing mechanisms that operate during collaborative retrieval—re-exposure and retrieval disruption—and in terms of transfer-appropriate processing across collaborative and individual retrieval sessions.     

Perceived control and long-term changes in disability in late middle-aged and older persons: An eight-year follow-up study

This article examined the predictive role of perceived control in long-term changes in disability among 1541 independently living older persons. Disability referred to self-reported difficulties with (instrumental) activities of daily living. Perceived control referred to the extent to which one assumes oneself as having control over one's life chances, unlike the fatalistic assumption that one's life is ruled by external factors. Data on disability and perceived control were collected in 1993 and recollected in 2001. Covariates included age, gender, living arrangement, level of education, and the number of chronic medical conditions. Regression equations were estimated with disability in 2001 as outcome and the selected variables as predictors. The level of perceived control decreased and the level of disability increased significantly over an 8-year period. The predictive role of perceived control for subsequent change in disability was statistically significant but not very strong. The association between perceived control in 1993 and disability in 2001 was stronger for older persons (>65 years) compared to younger persons (≤65 years).