The case of Chico calls for comprehensive assessment to establish the implications of the mixed signals he presents. In the chapter on suicide foundations, the authors cite the US 2005 suicide statistics that shows suicide rates as statistically significant among Hispanics at 5.1% (Koslow, Ruiz, & Nemeroff, 2014). Chico, being a Latino male faces heightened risk of suicide as data also shows age and gender to be major antecedents. American males have higher rates of complete suicides compared to females. The rates of suicide among adolescents are also high. The socio-demographic factors increase Chico’s vulnerability, but the main concern is the presence of signs and symptoms a professional counselor interprets to suggest suicide ideation. The paper develops a framework for assessment and prevention of suicide based on data from Chico’s case study.
Developmentally Relevant Counseling Treatment or Intervention Plans
The most critical aspects needed to come up with developmentally relevant treatment and intervention plans are socio-demographic factors. Chico is an adolescent, and a Latino male, attributes with immense implications on strategies the counselor intends to use to manage their mental problems and reduce the risk of suicide. According to Shain (2007), the American Academy of Pediatrics established suicide as the third leading cause of mortality among adolescents aged 15 to 19 years. At this age, adolescents tend to be impulsive, have different perspectives of time, and focus on proximal outcomes during decision-making. risky behavior. Consequently, suicide among adolescents has strong links to behavioral factors (Daniel & Goldston, 2009). In the case, Chico shows perception of being a burden to his parents, expresses pessimism about his existing situation, and smokes marijuana and drinks alcohol four times in a week. Chico’s behavioral changes are synonymous to those in Joiner’s interpersonal theory of suicide (IPTS). The IPTS advances that suicide is an outcome of a combination of factors including perception of being burdensome to others, social alienation, and potential for self-harm. Barzilay et al. (2015) found out that thwarted belongingness, depression, and risk behavior mediated the above factors resulting to suicide ideation among adolescents. Chico expresses majority of these attributes. Therefore, developmentally appropriate management strategies need to focus on screening for depression, behavior, and suicide ideation. The implication of counselors and pediatrics is that they must possess appropriate knowledge, skills, comfort handling the topic, and access to community resources to ensure success in treatment or prevention (Shain, 2007).
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Adolescents attend schools and live with their families, increasing the complexity of their social environments and potential risk factors. Development and implementation of comprehensive strategies at home and in school is imperative to treat or prevent serious suicide cases. Therefore, counselors need to emphasize on interventions that recognize cognitive behavioral or problem-solving strategies. The objective is to teach the adolescent adaptive coping skills and dissociate them from negative thinking associated with suicidality. Overall, developmentally related interventions seek to institute behavior change and risk avoidance by teaching positive perception of the self.
Evidence-based Counseling Strategies and Techniques for Prevention and Intervention
Counselors dealing with suicidal adolescents automatically become responsible for their emotional wellbeing. In the case of there are red flags for suicide ideation such as increased use of marijuana and alcohol, initial expression of purposelessness, withdrawal from peers, mood changes, and feeling trapped and hopeless that his home situation will not get any better. Chico shows attributes consistent with Pompili and Tatarelli (2010) observation that emotional problems in adolescents have grave and persistent consequences that lead to poor academic performance, school failure, social isolation, health problems, hazardous and risky behaviors, and suicide ideation. Under the circumstances, the objective of the counselor dealing with Chico is to perform a number of functions to: advise, reassure, communicate, clarify thinking, reorient, and assist in release of emotional tension. There are a number of evidence-based strategies for achieving these goals with adolescents.
Directive counseling is one of the major strategies used by counselors in dealing with adolescents. In this strategy, the counselor plays an active role to assists the adolescent learn and solve individual problems. The key aspect is to replace the emotional behavior of the client with predetermined rationalized behavior. The success of directive counseling is dependent on identification of the problem and recommendation of a resolution for the client to follow. The strategy is sometimes referred to as counselor-centered because the counselor plays an active role from analysis and synthesis of the problem to prescription and follow up.
The second counseling strategy suitable for Chico’s case is non-directive counseling. In this approach, the counselee assumes the pivotal role in the counseling process contrary to the case in directive counseling. The counselor role is subdued to listening, supporting, and encouraging the client without any form of assertion. Non-directive counseling is progressive and represents a growth process that leads the client to self-discovery through independence and integration. The strategy does not focus on the proximal function of solving the problem. Employing the approach to the case implies Chico would visit the counselor and present his concerns, and the counselor will initiate the process of building mutual trust, understanding, and acceptance with the counselee to ensure success. The counselor provides comprehensive information and guides the client in the analysis synthesis, and diagnosis of the challenges. The client also performs predicts outcomes of the problem, decides on the solution, the strengths and weaknesses of the solutions prior to the final decision.
Another effective counseling strategy applicable to the case study is eclectic counseling. The approach combines directive and non-directive strategies depending on prevailing situational factors. Under the eclectic strategy, the counselor is accorded the freedom to use whatever procedures or techniques they find suitable to the content of the client. The emphasis under this technique is on utilization of the solutions that hold the most promise. The implication for the counselor and the client is that the approach may change from time to time, hence, the need for flexibility. The counselor and the client have freedom of expression, which further ensures a strong working relationship between them.
Principles, Models, and Documentation Formats of Biopsychosocial Case Conceptualization and Treatment Planning
Techniques and Interventions for Prevention and Treatment of a Broad Range of Mental Health Issues
Mental health problems can be debilitating to adolescents. Suicide ranks as the fifteenth cause of death globally. Bolton, Gunnell, and Turecki (2015) noted that research has shown suicide rate to be relatively low in the general population, but people with mental problems have much higher rates. Chico’s condition, if left to progress to adverse state, increases the risk of suicide ideation and capacity to realize the same. Therefore, interventions for mental health problems form the primary defense in the treatment and prevention of suicide. A number of techniques are used in the management of diverse mental issues. According to Mental Health America, many individuals with mental problems can achieve strength and wellness through participation in individual or group therapy. People can choose from the broad categories of interventions or a combination of them including:
Psychotherapy – Psychotherapy is the most common technique use in the treatment and prevention of mental illnesses. It is administered by a trained professional with the objective to explore cognitive attributes and behaviors and develop an improvement plan. Performed using a number of techniques including cognitive behavioral therapy, dialectical behavior therapy, and exposure therapy.
Medication – Medication is not an outright cure for mental illness. The intervention is applied to alleviate the severity of symptoms and is usually effective when paired with psychotherapy.
Case management – An individual is assigned a case manager who partakes in planning and implementing strategies to fast track the recovery process. Directive counseling falls under this category.
Hospitalization – The intervention is applied under special circumstances that require close monitoring, accurate diagnosis, or change of medication due to a deteriorating mental condition.
Support group – Here members of the group offer guidance to one another towards a shared recovery goal. Members are often non-professional peers with shred experiences of mental or emotional problems.
Self-help plan – This is a type of non-directive counseling approach where an individual assumes responsibility to address their condition with the guidance of a professional.
Complementary and alternative medicine – These are therapies that are related to standard care and may be used as replacements to or to complement standard methods.
Peer support – the technique uses individuals who suffered from similar problems to offer support to their peers. Chico can benefit through peer support on drug and substance use.
Procedures for Assessing Risk of Aggression, Danger to Others, Self-inflicted Harm, or Suicide
Chico’s case has most of the hallmarks of suicidality, but the assertion lacks certainty without deployment of approved assessment and diagnostic frameworks. The attributes assessed among suicide attempters include aggression and inflicted self-harm. A study by Sahlin, Moberg, Hirvikoski, and Jokinen (2015) found out suicide attempters with history of non-suicidal self-inflicted injury to have more interpersonal violence and exacerbated suicidal behavior. The conclusion that can be drawn from these findings is that individuals with suicidal behavior have the tendency to be aggressive, and can be a danger to others and themselves. The observation justifies the need for effective and correct diagnosis to facilitate implementation of appropriate treatment and preventive measures. Oquendo and Baca-Garcia (2015) argued for the diagnosis of suicide behavior as a separate mental issue because a significant proportion of people who succumb to suicide (10% in the US) have no history of mental disorders. A similar cue was employed in the development of the DSM-5 classification of suicide as a mental problem. The DSM-5 bases its classification and diagnosis of suicide on the definition of key indicators of suicidality. They include completed suicide, suicide attempt, preparatory act toward suicidal behavior, suicide ideation, non-suicidal events Self-injurious behavior, no suicidal intent, other, no deliberate self-harm, Indeterminate or potentially suicidal events Self-injurious behavior, suicidal intent unknown, and lack of sufficient information to facilitate a conclusive diagnosis (Posner et al. , 2007).
Suicide Prevention Models and Strategies
Existing suicide prevention strategies assume interdisciplinary approaches involving school, families, and emergency departments. Years of data collection led to prevention strategies intended to reduce incidence and prevalence of suicide in the general population. Prevention science in the field has adopted the use of the universal, selective, and indicated (USI) model (Goldsmith, Pellmar, Kleinman, & Bunney, 2002). The model USI model places emphasis on define population, which means attending to the general population, specific at risk groups, and specific individuals at high risk. The three population groups are perceived optimal for the realization of the unique objectives of the prevention types.
Goldsmith et al. (2002) observed that universal strategies address the whole population and are implemented at country, state, local community, school, and neighborhood levels. Universal prevention programs seek to touch everyone by reducing associated barriers to care, knowledge building, increasing access to assistance, and improving protective processes. Programs that fall under the universal interventions are public education campaigns, school-based suicide awareness programs, restriction of suicide means, education programs in mainstream media, and school-based crisis response. Selective interventions target specific groups perceived to be at greater risk of becoming suicidal. Selective strategies are employed to prevent suicide related behaviors among the target subpopulations. Programs used under selective intervention include screening, training of gatekeepers, caregivers, and peers, support and skill building for at risk groups, and improving access to treatment and referral services. Indicated interventions are targeted at specific individuals experiencing early signs of suicide. Programs under this category of intervention are implement for groups or individuals and may involve skill building and support, training of parents, case management for high-risk individuals, and provision of referral resources and services.
Cultural Factors Relevant to Clinical Mental Health Counseling
The consensus among professionals in the field of psychology is that cultural influences play an important role in shaping individual perceptions and incidence of suicidality. Specific ethnic and religious beliefs and culture can determine how people manifest signs and symptoms of emotional distress. Therefore, clinical counselors must be apprehensive of the fact and device strategies of countering or addressing cultural differences and their effects on outcomes of treatment and recovery process. The American Psychological Association recognizes the need for exploration of risks and protective factors to inform the development of culturally sensitive suicide prevention and treatment strategies.
For counselors dealing with suicidal individuals and populations, a multicultural model that is sensitive and respectful to their clients is necessary. The implication for counselors is that they must demonstrate competency in the use of multicultural models. A counselor must show awareness of their personal cultural values and associated biases, awareness of the cline worldview, and understanding of culturally suitable interventions. The requirement is important in the case based on the understanding that Chico, a Latino by ethnicity, may demonstrate differential perception of phenomena and factors used in the standard diagnosis techniques. The model of counseling proves to be effective because it factors in eight critical factors namely: religious, economic, sexual, psychological, chronological, ethnic, trauma, family, physical characteristics, and residential location.
Ethical Standards and Application of Ethical and Legal Considerations
Counselors and clients in relation to ethical and legal considerations in the management of suicidal cases have expressed significant concerns. The role of counselors in the successful implementation of suicide prevention programs cannot be understated. However, counselors continue to face hurdles in their practice owing to ethical and legal challenges. According to Capuzzi (2002), students in the US expressed concerns about the reluctance by counselors to identify at risk individuals because of perception of the process as intrusive, laborious, and encouraging suicidal behavior.
Nevertheless, counselors are better placed to provide the most professional service, hence, must conform to the ethical and legal frameworks governing the process. They must show respect for autonomy, an important aspect when implementing directive counseling strategies where they are the active party. Counselors also need to show understanding of the principles of non-maleficence, beneficence, justice, and fidelity. Fair treatment of the patient without discrimination is critical in the realization of the intended goals. It also builds the fiduciary relationship between the counselor and the client for a positive commitment relationship based on trust and faith.
In relation to the legal aspects, a counselor needs to understand the provisions that govern the operationalization of the definitions of suicide. For instance, suicide or attempted suicide is no illegal, hence the counselee must not be treated with ridicule or suspicions that breed stigmatization. The counselor must demonstrate knowledge of the prohibitions around the phenomenon. For instance, assisted suicide is illegal and liable to prosecution for murder. The law gives mentally competent adults the autonomy to refuse treatment even in cases where their decision is fatal. They need to recognize the lack of comprehensive policies on the suicide, and devise ways of drawing from their personal experiences including existing local health legislation on the same.
References
Barzilay, S., Feldman, D., Snir, A., Apter, A., Carli, V., Hoven, C. W., ... & Wasserman, D. (2015). The interpersonal theory of suicide and adolescent suicidal behavior. Journal of affective disorders , 183 , 68-74.
Bolton, J. M., Gunnell, D., & Turecki, G. (2015). Suicide risk assessment and intervention in people with mental illness. Bmj , 351 , h4978.
Capuzzi, D. (2002). Legal and ethical challenges in counseling suicidal students. Professional School Counseling , 6 , 36-45.
Goldsmith, S. K., Pellmar, T. C., Kleinman, A. M., & Bunney, W. E. (2002). Reducing suicide: A national imperative . National Academies Press.
Koslow, S. H., Ruiz, P., & Nemeroff, C. B. (Eds.). (2014). A concise guide to understanding suicide: epidemiology, pathophysiology and prevention . Cambridge University Press.
Oquendo, M. A., & Baca-Garcia, E. (2014). Suicidal behavior disorder as a diagnostic entity in the DSM-5 classification system: advantages outweigh limitations. World Psychiatry , 13 (2), 128.
Pompili, M., & Tatarelli, R. (Eds.). (2010). Evidence-based practice in suicidology: a source book . Hogrefe Publishing.
Posner, K., Oquendo, M. A., Gould, M., Stanley, B., & Davies, M. (2007). Columbia Classification Algorithm of Suicide Assessment (C-CASA): classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants. American Journal of Psychiatry , 164 (7), 1035-1043.
Sahlin, H., Moberg, T., Hirvikoski, T., & Jokinen, J. (2015). Non-suicidal self-injury and interpersonal violence in suicide attempters. Archives of suicide research , 19 (4), 500-509.
Shain, B. N. (2007). Suicide and suicide attempts in adolescents. Pediatrics , 120 (3), 669-676.
