Objective: Research shows elevated rates of trauma exposure and traumatic stress among youth with suicidal thoughts and behaviors, underscoring the need for a trauma-informed approach to suicide prevention and intervention. The purpose of this study was to identify, from the perspective of caregivers, clinical practices that are sensitive to the needs of youth with co-occurring traumatic stress and suicidal thoughts and behaviors, as well as common barriers to receiving care. Method: Qualitative interviews were conducted with 13 caregivers of youth with trauma histories and comorbid suicidal thoughts and/ or behaviors. Interviews were analyzed using a grounded theory approach. Results: Qualitative analysis of interviews revealed themes related to the need for caregiver involvement in treatment, the impact of therapist and relationship characteristics such as authenticity and genuineness, and the importance of provider education about trauma. Common barriers included difficulties navigating the mental health system and cost. Conclusions: Findings provide guidance on how mental health providers can effectively recognize and respond to traumatic stress among youth presenting with suicidal thoughts and behaviors. System-level issues related to accessibility also are discussed.
Clinical Impact StatementWhen asked about suicide prevention practices that are sensitive to the needs of youth and families who have experienced trauma, caregivers of youth with co-occurring traumatic stress and suicidal thoughts/behaviors emphasized the importance of (a) caregiver involvement and acknowledging caregiver distress; (b) clinician authenticity, genuineness, and warmth; and (c) clinician knowledge about trauma and the impact of traumatic stress on suicide risk. Caregivers also emphasized the need for more direct support around mental health care navigation.
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