Client-reported impact of the Attempted Suicide Short Intervention Program

Figures & data

Table I. Contents of the Attempted Suicide Short Intervention Program.

Session 1	Clients are asked to narrate, in their own words, how it came about that they attempted suicide. This narrative interview is videotaped with the client's consent. The first session ends with a collaborative suicide risk assessment using the Suicide Status Form (Jobes, 2006).
Session 2	Client and therapist watch the videotaped narrative together, pausing to jointly reflect on important episodes. At the end of the second session, clients are given a psychoeducative handout (“Suicide Is Not a Rational Act”) and asked to return it with personal comments in the third session, after which the therapist prepares a draft summary of the client's narrative for the case conceptualization.
Session 3	The client's comments on the psychoeducative handout are discussed. The case conceptualization is completed collaboratively. This includes reviewing and revising the summary of the client's narrative; addressing key vulnerabilities and triggers associated with the suicidal episode; and identifying warning signs, safety strategies and long-term goals. These are documented in writing and given to the client.
(Session 4)	In the ASSIP manual, clients are offered an optional fourth session to complete tasks or practice safety measures. In our sample, clients were encouraged to invite their loved ones along for this fourth session.
Continued contact	After the sessions are completed, semi-standardized letters reminding the client of the work done and the possibility of contacting the therapist are sent for the next two years at 3, 6, 9, 12, 18 and 24 months after the last session. Clients are invited to reply to the letters with updates if they so wish.

Table II. Categories in participants’ accounts of ASSIP’s subjective impact.

Core Category	Life-affirming change				Collateral effects		Incompleteness of change
Subcategory	Feeling better	Thinking differently	Acting differently	Having new resources	Difficult feelings	Cognitive overload	Lack of desired change	Gains as incomplete	Need for sustenance	Unrealized potential
Examples of open codings	feeling relief; feeling valued; finding self-compassion; finding hope	realizing what happened to me; knowing what needs to change; gaining clarity	functioning better; not bottling it all up anymore	credible safety plan; having a safety net	exhaustion; feeling anxious; worrying about my therapist	dissociating due to stress; confusion; forgetfulness	achieving no enlightenment; no change in the underlying desire to die	need to verify insights; not all the way back to my normal functioning; need for further work	gains vulnerable to set-backs; need for sustaining resources	insufficient support for involving loved ones; hurried safety plan; no peer resources

Jobes, D. A. (2006). Managing suicidal risk: a collaborative approach. Guilford Press.

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