The purpose of this study was to explore adolescent beliefs concerning the causes of adolescent suicide and to examine the influence that suicidal others have on adolescents' behavior. The researcher asked the following questions: Do students reporting suicidal behavior and those reporting no suicidal behavior give different causes for suicide? Do males and females give different causes for suicide? Does knowing someone who attempted or committed suicide affect an adolescent's suicidal behavior? The population sample was 473 eleventh- and twelfth-grade students from a suburban public school district near a large metropolitan area in the northeastern United States who completed self-report measures including an open-ended question measuring suicidal causality and a background questionnaire. Data were analyzed using cross-tabulations to compare suicidal and nonsuicidal adolescents. Specific tests included the Fisher's Exact Test (two-tailed) and chi-square. The findings showed that, of the high school students studied, 23% reported self-hurt behavior and 6.7% reported suicide attempts. A theme of "too much pressure" was reported by 40% of the adolescents as a cause of suicide. Males and females reported statistically significant divergent views regarding the causes of adolescent suicide. Other findings showed highly significant differences between the suicidal and nonsuicidal adolescents when they knew someone who attempted or committed suicide. This information suggests that approximately one in three adolescents who report self-hurt behavior may attempt suicide and that counseling needs to address the findings that males and females perceive the causes of suicide differently and therefore may respond to treatment programs differently. The importance of peer identification with others who attempt or commit suicidal acts cannot be underestimated.

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The authors describe the process by which the nursing staff of an eating disorder program was able to identify an ineffective treatment model and to implement some needed changes. They describe the Therapeutic/Administrative Split Model, a method to improve communication and treatment planning between the nurse and psychiatrist. How family control issues are mirrored in the treatment process, and played out within the transference, are also explored.