Therapeutic risk management of the suicidal patient: safety planning.
This column is the fourth in a series describing a model for therapeutic risk management of the suicidal patient. Previous columns presented an overview of the therapeutic risk management model, provided recommendations for how to augment risk assessment using structured assessments, and discussed the importance of risk stratification in terms of both severity and temporality. This final column in the series discusses the safety planning intervention as a critical component of therapeutic risk management of suicide risk. We first present concerns related to the relatively common practice of using no-suicide contracts to manage risk. We then present the safety planning intervention as an alternative approach and provide recommendations for how to use this innovative strategy to therapeutically mitigate risk in the suicidal patient.
Dr. Matarazzo is Co-Director of the VISN 19 MIRECC Suicide Consultation Service and a Clinical Research Psychologist, VISN 19 MIRECC, Denver VA, and Assistant Professor of Psychiatry, University of Colorado. Dr. Homaifar is the Training Director for the Post-Doctoral Fellowship and Co-director of the VA Suicide Risk Management Consultation Program, VISN 19 MIRECC, Denver VA, and Assistant Professor of Psychiatry, University of Colorado. Dr. Wortzel is the Michael K. Cooper Professor of Neurocognitive Disease, Director of Neuropsychiatry, an Assistant Professor in Psychiatry, Neurology and Physical Medicine & Rehabilitation, and Faculty for the Forensic Psychiatry Fellowship at the University of Colorado. He is Director of Neuropsychiatric Services for the VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC) at the Denver VA. Address inquires to: hal.wortzel@ucdenver.edu.
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D003419:Crisis Intervention / Q000379:methods / Q000458:organization & administration; D005555:Forensic Psychiatry; D006801:Humans; D010347:Patient Care Planning / Q000458:organization & administration*; D011569:Psychiatric Status Rating Scales; D011580:Psychological Techniques; D018570:Risk Assessment / Q000379:methods; D012449:Safety; D059020:Suicidal Ideation; D013405:Suicide / Q000331:legislation & jurisprudence / Q000523:psychology; D000092864:Suicide Prevention