Factors contributing to therapists' distress after the suicide of a patient.
OBJECTIVE
Factors contributing to therapists' severe distress after the suicide of a patient were investigated.


METHODS
Therapists for 34 patients who died by suicide completed a semistructured questionnaire about their reactions, wrote case narratives, and participated in a workshop.


RESULTS
Thirteen of the 34 therapists were severely distressed. Four factors were identified as sources of severe distress: failure to hospitalize an imminently suicidal patient who then died, a treatment decision the therapist felt contributed to the suicide, negative reactions from the therapist's institution, and fear of a lawsuit by the patient's relatives. Although one emotion was sometimes dominant in the therapist's response to the suicide, severely distressed therapists, compared to others, reported a significantly larger number of intense emotional states.


CONCLUSIONS
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.
American Foundation for Suicide Prevention, 22nd Floor, 120 Wall St., New York, NY 10005, USA. hhendin@afsp.org
Herbert
H
Hendin
Ann Pollinger
AP
Haas
John T
JT
Maltsberger
Katalin
K
Szanto
Heather
H
Rabinowicz
D000328:Adult; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001294:Attitude to Health; D002423:Cause of Death; D003657:Decision Making; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D005239:Fear / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016365:Liability, Legal; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000193:education / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D040921:Stress Disorders, Traumatic / Q000175:diagnosis* / Q000453:epidemiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires