Factors Contributing to Therapists’ Distress After the Suicide of a Patient

Hendin, Herbert; Haas, Ann Pollinger; Maltsberger, John T.; Szántó, Katalin; H, Rabinowicz

doi:10.1176/appi.ajp.161.8.1442

Cited by 103 publications

(94 citation statements)

References 12 publications

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“…This contrasts with Hendin's study, which cites fear of litigation as one of four factors contributing to severe distress in professionals in the aftermath of a suicide. 8 A number went on to suggest that there should be an independent and confidential support available such as a telephone helpline or debriefing from a psychologist. However, many felt that although such support should be available, it should be left to an individual consultant's discretion whether to avail oneself of it and one should not be pressured into doing so.…”

Section: Discussionmentioning

confidence: 99%

Impact of patient suicide on consultant psychiatrists in Ireland

2010

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Suicide of a patient is a very distressing event for a consultant psychiatrist and can adversely affect both their personal and professional life. Consultant psychiatrists have been shown to have higher levels of work-related exhaustion than their medical and surgical colleagues and patient suicide potentially contributes to this.1 A review of studies from the USA, Canada and the UK suggests that 50-70% of consultant psychiatrists will experience the suicide of a patient at some point in their career.2 Despite it potentially being one of the most distressing events in a psychiatrist's career, the number of studies in the literature is relatively small and there has been only one Irish study to date.3 The studies conducted thus far have all identified patient suicide as a cause of considerable distress, yet it is an event for which training leaves psychiatrists underprepared. We conducted a nationwide study of all consultant adult psychiatrists in Ireland to establish the impact on their personal and professional life. MethodWe sent a confidential postal questionnaire to 292 consultant psychiatrists in Ireland (not including child and adolescent psychiatrists), identified through records held by the Irish Medical Council and the Irish Medical Directory (www.imd.ie) that were cross-checked with each individual hospital. To maintain confidentiality and thus optimise our response rate, the questionnaires were not coded or numbered in any way and were sent with a noncoded, stamped, addressed return envelope. However, each participant was assigned a number and was sent a corresponding numbered envelope and asked to post this simultaneously with their questionnaire, to aid identification of non-responders. Non-responders were contacted again by post after 10 weeks and after a further 8 weeks they were contacted by email if available.We examined each consultant's most recent experience of patient suicide as well as the suicide they perceived to be most distressing. We did not specify that the deaths had to have been recorded as suicides in the coroner's court, instead leaving the choice of case to each individual's judgement.The questionnaire (available from the author on request) was divided into three sections: the first gathered basic demographic data; this was followed by a section relating to the consultant's most recent experience of patient suicide, the individual patient's characteristics, the effect the suicide had on the consultant, both personally and professionally, and what coping strategies they used in its aftermath. The final section of the questionnaire asked the psychiatrists to provide that same information regarding the suicide they had found to be most distressing during their consultant career. Consultants had the opportunity to provide additional information in free-text boxes. Results Study sampleA total of 292 questionnaires were sent. We received 182 responses, of which 4 were excluded owing to incomplete information; this gave us a response rate of 61%. The Aims and method To study the effects...

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Section: Discussionmentioning

confidence: 99%

Impact of patient suicide on consultant psychiatrists in Ireland

2010

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“…Les réactions fluctuent en fonction de plusieurs facteurs, dont l'expérience clinique du thérapeute, sa personnalité et ses zones de conflits internes, la nature du lien thérapeutique établi avec le patient et le degré d'ambivalence dans cette relation, les éléments contextuels au décès incluant les réactions négatives de l'institution, les poursuites légales, les réactions hostiles de la famille du patient décédé, les événe-ments de vie stressants vécus par le professionnel au moment du suicide, ainsi que le soutien social obtenu Chemtob et al, 1988a ;Cotton et al, 1983 ;Cryan et al, 1995 ;Dewar et al, 2000 ;Goodman, 1995 ;Hendin L'impact du suicide d'un patient chez des professionnels en santé mentale Différences entre les femmes et les hommes Henry et al, 2003 ;Horn, 1995 ;Howard, 2000 ;Kleespies et al, 1990 ;1993 ;Lapp, 1986 ;M. A.ams et Foster, 2000 ;Tillman, 2006 ;Trimble et al, 2000).…”

Section: Résuméunclassified

“…Des études descriptives soulignent aussi que les professionnelles réagissent plus fortement au suicide d'un patient que leurs collègues de sexe masculin (Grad et Michel, 2005 ;Hendin et al, 2004 ;Lapp, 1986), les femmes manifestant davantage de culpabilité et de honte que les hommes (87 % et 31 % contre 50 % et 0 % respectivement). De plus, les femmes remettent en doute plus facilement leurs compétences et ont besoin davantage de consolation et de réconfort, alors que plus d'hommes réagissent en vaquant à leurs activités professionnelles habituelles (50 % des femmes comparativement à 75 % des hommes) (Grad et al, 1997).…”

Section: R E C H E R C H Eunclassified

L’impact du suicide d’un patient chez des professionnels en santé mentale

Henry

Séguin

Drouin

2009

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Résumé Cet article rapporte les résultats d’une recherche réalisée auprès de 141 professionnels en santé mentale pratiquant au Québec et ayant vécu le suicide d’un patient. Les professionnels ont réagi à cet événement différemment en fonction de leur sexe. Les femmes y ont répondu par un niveau de stress élevé au cours du premier mois, alors que les hommes ont dévoilé un niveau de stress faible. Le niveau élevé de stress relevé chez les femmes était accompagné de répercussions initialement plus intenses sur leur pratique professionnelle : tendance accrue à hospitaliser des patients suicidaires ou précautions accrues dans leur traitement, évaluation d’un plus grand nombre de patients comme présentant un risque de suicide, sentiment accru d’impuissance lors de l’évaluation ou du traitement de patients suicidaires, consultation plus fréquente de collègues et de superviseurs, attention accrue aux aspects légaux dans la pratique. L’article tente de mieux comprendre les différences entre les réactions des professionnels observées selon leur sexe, à la lumière des théories de la socialisation et du développement professionnel.

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“…In relation to the theme of therapist courage, it can be noted that working with suicidal clients is generally considered by therapists to be highly demanding and stressful (Hendin, Haas, Maltsberger, Szanto, & Rabinowicz, 2004). It is possible, therefore, that the salience of therapist courage in the analysis of the present case may have been heightened in this particular case, and that therapeutic work with other clients who have extreme difficulty in forming emotional bonds, but are not suicidal, may follow a different trajectory.…”

Section: Couragementioning

confidence: 88%

A Life-Saving Therapy: The Theory-Building Case of "Cora"

Halvorsen

Benum²,

Haavind³

et al. 2016

PCSP

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The present paper presents a case study of long-term (121 sessions over three years), integrative therapy with "Cora," a client with a history of severe relational trauma that had led to difficulty in forming close relationships, and a history of hospitalization resulting from a series of suicide attempts. Despite these challenges, Cora reported a highly satisfactory outcome at the end of therapy. Using the format of a theory-building case study (McLeod, 2010;Stiles, 2007), qualitative analysis of session evaluations, session transcripts, and post therapy interviews were used to investigate how both the client and therapist understood the process of therapy and why it had been successful. Data from quantitative process and outcome measures were analyzed to provide contextual information. In spite of repeated challenges and difficult therapeutic situations, Cora and the therapist were able to establish a recurring pattern of interaction that they found relevant and productive and that was characterized by persistence. Other helpful aspects of the therapy process included acting with courage, and the use of symbolic representations of their accomplishments. The results contribute to our understanding of the process of therapy with clients who have been exposed to severe relational trauma. The discussion includes reflection on methodological issues associated with mixed-methods case study research in psychotherapy.

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Factors Contributing to Therapists’ Distress After the Suicide of a Patient

Abstract: Over one-third of therapists who experienced a patient's suicide were found to suffer severe distress, pointing to the need for further study of the long-term effects of patient suicide on professional practice.

Cited by 103 publications

References 12 publications

Impact of patient suicide on consultant psychiatrists in Ireland

Impact of patient suicide on consultant psychiatrists in Ireland

L’impact du suicide d’un patient chez des professionnels en santé mentale

A Life-Saving Therapy: The Theory-Building Case of "Cora"

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