Intervention Strategies in a Suicidal Case
Intervention Strategies in a Suicidal Case
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自杀案件的干预策略
DOI：
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发表时间：
1985
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通讯作者：
M. C. Mills
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作者：
M. C. Mills
治疗师必须迅速干预，保持自信，并为有自杀倾向的客户提供力量和支持的来源（2）。一个自杀的人通常是过度紧张的生活中的一个插曲，控制了他，使他无助于正常反应的环境（1）。在本案中，主要症状是嗜睡、失眠、食欲不振、对死亡的吸引力以及为死亡做好准备。本短期治疗干预包括16个疗程，每周2次，共8周。实施了以下战略。最初的几次访谈鼓励详细描述这个问题。重点是确定他认为是什么导致了他目前的不适状态。考虑的一个重要因素是他处理问题的惯用手段。在每次面试中实施的一个重要策略是检查他的积极品质。讨论集中在他的个人资源，内在力量和克服障碍的能力。在任何时候，他都没有被道德化，判断，或明确告诉他不应该自杀。一个对抗性的，非移情的或描绘与自杀客户有关的焦虑的治疗师，可能会在不知不觉中引发事件。大约在治疗期间的中途，治疗师减少了对来访者观点的强调。治疗师的观点和反映客户的感受得到了实施。还探讨了与他有联系和可以提供帮助的顾问。治疗的结束集中在客户和治疗师的观点的整合。两人都对他的危机反应做出了可能的解释。治疗的目的是澄清困惑，恢复客户的自我理解和信心。虽然他科普问题的能力得到了改善，但治疗师的可用性是显而易见的，他可以在任何需要的时候被看到。心理治疗侧重于客户的积极特征。在整个报告所述期间和成果会议期间，制定并澄清了访谈内容。来访者变得自信，理解他的反应，并感到如果突发事件再次发生，他可以控制自己的情绪。
A therapist must intervene quickly, be self-confident, and provide a suicidal client with a source of strength and support ( 2 ) . A suicidal individual is usually overly stressed with an episode in life which controls him and renders him helpless to respond to the environment normally (1). In the present case the primary symptoms were lethargy, insomnia, loss of appetite, attraction toward death, and preparation for the act. The present short-term therapeutic intervention consisted of 16 sessions, twice per week for 8 wk. The following strategies were implemented. The first few interviews encouraged detailed verbalization of the problem. Emphasis was on identifying what he believed was responsible for his present state of discomfort. An important factor considered was his usual means of regulating problems. A significant strategy implemented during each interview was an examination of his positive qualities. Discussion focussed on his personal resources, inner strength, and ability to surmount obstacles. At no point was he moralized, judged, or told explicitly that he should not commit suicide. A therapist who is confrontative, nonempathic or portrays anxiety in relating to suicidal clients, may unknowingly provoke the event. About mid-way through the therapeutic period, emphasis on the client's perspective was reduced by the therapist. The therapist's perspective and mirroring of the client's feelings was implemented. Also explored were resource persons with whom he had contact and who could be of assistance. The end of therapy focused on an integration of the client's and therapist's perspectives. A possible explanation for his crisis reaction was reached by both. Therapy was oriented towards clarifying confusion and restoring the client's self-understanding and confidence. Although his abiliry to cope with the problem was improved, the therapist's availability was evident and he could be seen whenever needed. Psychotherapy focused on the client's positive characteristics. The content of the interviews was developed and clarified throughout the period and outcome sessions. The client became self-confident, understood his reaction, and felt he was in control of his emotions should the precipitating event reoccur.