[Episode 74] Today’s Social Work Podcast is an interview alongside Shawn Christopher Shea, M.D., developer of an approach to uncovering suicidal ideation in addition to intent called the Chronological Assessment of Suicide Events (CASE) approach. In today’s episode, Shawn takes us through the CASE approach. He explains the value of assessing for suicidal content at unlike fourth dimension points in addition to emphasizes that eliciting suicidal ideation in addition to intent is a hard in addition to sensitive topic. He talks nigh how moving through the CASE approach to assist flora a therapeutic alliance in addition to rapport alongside suicidal clients. He emphasizes the fine art of the interview, using validity techniques, in addition to how nosotros utilization words every bit fundamental to uncovering suicidal ideation in addition to intent. He talks nigh how the CASE approach is useful for whatever mental wellness provider. Shawn makes the declaration that the CASE approach is an ideal approach to for assessing for suicidal risk that doesn’t sound similar a pat suicide assessment. He emphasizes that the CASE approach is one-third of a thorough suicide assessment, the other 2 parts existence identifying risk in addition to protective factors, in addition to the lastly business office existence developing a clinical formulation.
Shawn has written that a thorough suicide assessment has 3 parts: 1) Gathering information related to risk factors, protective factors, in addition to alert signs of suicide; 2) Collecting information related to the patient’s suicidal ideation, planning, behaviors, desire, in addition to intent; in addition to 3) Making a clinical formulation of risk based on these 2 databases. He writes that inwards the “clinical in addition to enquiry literature, much attending has been given to the kickoff in addition to tertiary tasks (gathering risk/protective factors/warning signs in addition to clinical formulation). Significantly less attending has been given to the 2nd task—the detailed laid of interviewing skills needed to effectively elicit suicidal ideation, behaviors, in addition to intent. But inwards many respects, it is the validity of the information from the 2nd element that may yield the greatest hint of imminent suicide.” (Shea, 2009, p. 1).
My interview alongside Shawn is a unmarried episode inwards 2 continuous parts. In Part I Shawn in addition to I utter nigh the CASE approach, including some of the validity techniques he has developed or uses to elicit suicidal ideation in addition to intent. In the 2nd business office Shawn in addition to I do a purpose play where he uses the CASE approach.
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| This figure represents the 3 components of a thorough suicide assessment. The CASE approach provides a framework for assessing the information inwards the ruddy foursquare (ideation, plan, behaviors, desire, in addition to intent). |
My interview alongside Shawn is a unmarried episode inwards 2 continuous parts. In Part I Shawn in addition to I utter nigh the CASE approach, including some of the validity techniques he has developed or uses to elicit suicidal ideation in addition to intent. In the 2nd business office Shawn in addition to I do a purpose play where he uses the CASE approach.
Download MP3 [1:05:09]Bio (from his website):
Shawn Christopher Shea, M.D. is an internationally acclaimed workshop leader in addition to innovator inwards the fields of suicide prevention, edifice resiliency, clinical interviewing, in addition to improving medication adherence having given over 850 presentations worldwide. He is the creator of the highly acclaimed interviewing strategy for uncovering suicidal ideation in addition to intent - the Chronological Assessment of Suicide Events (the CASE Approach). His other clinical interviewing innovations, including facilic supervision, macrotraining, in addition to the Medication Interest Model (MIM) receive got been adopted around the globe alongside his writings existence translated into a diversity of languages every bit various every bit French, Greek, Japanese, in addition to Chinese.
TRANSCRIPT
Introduction
Jonathan Singer: Today’s Social Work Podcast explores the number of, “how do nosotros know if our customer wants to plough over away past times suicide?” Uncovering suicidal ideation in addition to intent is ane of the most challenging things that clinicians are expected to do. And if you lot can’t do that, therefore you lot can’t really do a thorough suicide assessment. And, every bit nosotros all know, doing a thorough suicide assessment is ane of the basic expectations of clinical social work. So, fifty-fifty though ane of my kickoff episodes of the Social Work Podcast addresses suicide assessment, I wanted to furnish to a greater extent than in-depth information on the topic. So, I was real glad to live able to utter alongside ane of the leading experts inwards the world, Shawn Christopher Shea.
I’ve known Shawn for a number of years. He in addition to I served on a commission together through the American Association of Suicidology, developing a workshop on Recognizing in addition to Responding to Suicide Risk. Shawn developed an approach to uncovering suicidal ideation in addition to intent called the Chronological Assessment of Suicide Events, or CASE, approach. He developed this over years, doing the work. This wasn’t developed inwards a enquiry lab conceptually. I’m a large fan of this approach. I beloved Shawn’s book, “The Practical Art of Suicide Assessment” in addition to I took his half-day workshop on the CASE approach a twain of years ago. I observe his techniques in addition to this approach to live ideal for clinicians.
Today’s episode is a petty chip unlike from most episodes that I publish, for a twain of reasons. One, this is the longest episode I’ve ever published. It clocks inwards at over an hour. And, I’m non going to do a large long intro because I want to acquire correct to the view of the interview. There are really 2 parts to the interview. The kickoff business office is a conversation alongside Shawn where nosotros utter nigh the CASE Approach, the importance of using specific techniques to uncover ideation in addition to intent, every bit good every bit the importance of bespeak nigh ideation in addition to intent both at the acquaint 2nd but also at points inwards the past. And the CASE approach sets out a squeamish slowly way of remembering in addition to figuring out how to do that.
What happens adjacent inwards this interview is that, I enquire Shawn if he could do a purpose play. I was sitting at that spot in addition to I was thinking “this stuff is really, really valuable. And it is great to utter nigh it conceptually. But, wouldn’t it live therefore much ameliorate if nosotros could do a demonstration?” And, Shawn was fantastic. He said, “sure, let’s move for it.”
So the 2nd business office of the interview, nosotros do a purpose play where I’m a suicidal teenager in addition to he’s a schoolhouse counselor using the CASE Approach. Now, a quick give-and-take nigh the purpose play. It is an intense purpose play. We utter nigh suicide. We utter nigh ways that a teenager powerfulness kill himself. We utter nigh bullying, nigh feelings of isolation, sadness, in addition to hopelessness. We utter similar I’m really at risk for killing myself. I am non an actor, therefore I doubtfulness if anyone is going to forget that it is a purpose play. But, inwards the spirit of total disclosure, in addition to recognition that this is ane of those topics that tin give the axe take away upward a diversity of reactions - some that you lot powerfulness non want to receive got piece running on the treadmill or sitting inwards your university’s reckoner lab, this is an intense episode. The goodness tidings is that Shawn models genuineness, empathy in addition to unconditional positive regard, every bit good every bit a deep agreement of how to figure out if someone is suicidal.
And so, without farther ado, on to Episode 74 of the Social Work Podcast: The Chronological Assessment of Suicide Events (CASE Approach): Interview in addition to Role Play alongside Shawn Christopher Shea, M.D.
Jonathan Singer: Shawn, give cheers you lot therefore much for existence hither today in addition to talking alongside us nigh assessing suicidal ideation, working alongside folks who are suicidal. I really appreciate you're taking the time.
Shawn Christopher Shea: It's a please in addition to an honour to live hither Jonathan. I'm excited.
Jonathan Singer: Could you lot utter nigh the CASE Approach?
Shawn Christopher Shea: Yeah. The CASE Approach is an interviewing strategy for helping all of us inwards the frontlines to assist our clients to experience to a greater extent than comfortable literally sharing their suicidal ideation, their behavior, their planning in addition to particularly their intent. And it's literally built alongside a serial of interviewing techniques that are flexible. Nobody, sure as shooting non I, am proverb this is the correct way to uncover suicidal thought or a measure of attention or anything similar that, but I think it's a reasonable way to uncover suicidal thought in addition to ideation in addition to intent. And the CASE Approach ultimately - in addition to stands past times the way, for the Chronological Assessment of Suicide Events (that’s what the acronym is) - but it's a framework that tin give the axe allow all of us to observe our way for uncovering suicidal ideation in addition to attempt. Because I'm absolutely convinced the way you lot in addition to I in addition to all of your listeners elicit suicidal ideation - the actual words nosotros utilization - changes the database. And the CASE Approach allows us to say “well, how do I do it compared to this in addition to do I similar this nigh it?” And past times the way, I invite anybody who’s interested inwards the CASE Approach, the things you lot similar nigh it, hopefully you'll adapt. Things you lot don’t like, you lot should throw out in addition to non do. No ane should do anything inwards an interview they're uncomfortable with. And also hopefully we'll generate an excitement nigh the ability of interviewing in addition to principles of how you lot tin give the axe written report what you're already doing in addition to observe those things in addition to brand them fifty-fifty better.
Jonathan Singer: So, the chronological aspect–
Shawn Christopher Shea: Yeah.
Jonathan Singer: Does that hateful that you lot start alongside sort of what's oldest in addition to therefore come upward to what's newest or what does it hateful for the chronological assessment?
Shawn Christopher Shea: Right. Once again, to emphasize ane aspect of it, it's non nigh risk in addition to protective factors which are real of import in addition to you're going to garner those inwards a unlike business office of your interview. This is really looking at precisely ane specific laid - pieces of information - which is the actual suicidal deportment in addition to intent of the person. So, it focuses on what types of behaviors in addition to thoughts receive got they demonstrated that powerfulness reverberate that they really do intend to kill themselves. And therefore nosotros do that past times going chronologically to brand sure we're non missing something.
So, it starts alongside you lot would hopefully sensitively heighten the topic using, for instance, a technique called Shame Attenuation, which focuses on the hurting of the person. You powerfulness say, you lot know, “Jonathan alongside all of your pain, receive got you lot been having whatever thoughts of killing yourself?” And therefore that brings that upward to the recent, the suicidal ideation a somebody has in addition to you lot explore that sensitively, but comprehensively therefore you lot really empathise the angst in addition to the amount of planning in addition to the intent behind it.
Then you lot shift - it's why it's called chronological is nosotros didn’t move over what nosotros telephone telephone recent suicidal thoughts in addition to behaviors, therefore that’s the previous 2 months before the interview. And that’s a aureate mine of information of the person’s actual pain, but also the score alongside which they're really thinking nigh killing themselves, planning it out, practicing it.
And therefore you lot shift to past times suicide attempts.
And therefore the lastly timeframe, which is ane that’s often I don’t think emphasized enough, is that nosotros really therefore shift the whole way dorsum to the acquaint 2nd in addition to explore what the somebody has been thinking nigh suicide piece we're really speaking. So, a somebody you lot know past times the way, inwards an emergency room for illustration could live sitting at that spot piece you're interviewing them going “I precisely want this guy would closed upward in addition to I'm going habitation in addition to shoot myself.” Or they tin give the axe live inwards an inpatient unit of measurement in addition to the somebody who powerfulness receive got died past times suicide say 2 days after discharge, lastly twain of people they powerfulness receive got seen they powerfulness receive got been sitting at that spot precisely proverb to themselves say what he wants, acquire home, acquire the gun. Say what wants – so, those are people having suicidal thoughts piece they're existence interviewed in addition to nosotros really think that’s of import to tap.
Jonathan Singer: So, you lot start out alongside what's going on inwards the moment, move dorsum 2 months, move back–
Shawn Christopher Shea: Yes.
Jonathan Singer: – a lifetime, the past times in addition to therefore you lot come upward correct back–
Shawn Christopher Shea: To correct now.
Jonathan Singer: – to correct now.
Shawn Christopher Shea: And ane of the things the argue nosotros do it inwards that club is that it is really hard for people to utter nigh suicide. I mean, perhaps somebody who’s coping alongside borderline procedure powerfulness utter nigh it a fair amount to acquire some relief in addition to a sense that people care. The typical somebody really doesn’t want to utter much nigh their suicidal thought. Many people who plough over away past times suicide powerfulness leak it to a position unit of measurement member. You know they powerfulness say something similar don’t worry nigh me or you lot won't receive got to worry nigh me inwards half-dozen months or inwards the summer, but it is the rare somebody who would sit down downwards in addition to say, “Oh in addition to past times the way, I'm thinking of shooting myself in addition to you lot know lastly black I had a gun out in addition to I had it loaded in addition to I had it inwards my oral cavity in addition to my oral cavity is inwards the…” They don’t say halt correct there.
Jonathan Singer: Right. They're non going to do your assessment for you.
Shawn Christopher Shea: No. No, they don’t.
Jonathan Singer: Yeah.
Shawn Christopher Shea: And they don’t say that to the position unit of measurement members is what I'm saying. So, they receive got to shoulder the shame in addition to the guilt in addition to the stigma. So, if the interviewer is really real thing of fact in addition to opened upward in addition to sensitive, but comprehensively nigh bespeak them nigh their suicidal planning in addition to they realized that “this guy is neither, you lot know, overreacting to boundary in addition to pose me inwards a straightjacket or underreacting similar he’s afraid of this. He doesn’t want to utter nigh it, but geez this guy is precisely talking to me nigh my suicidal thought. It's a prophylactic position to talk.”
And what nosotros observe is that real often every bit people move through these chronological aspects of the CASE Approach, the therapeutic alliance often strengthens, because you're belike the kickoff somebody inwards their life that they’ve ever been able to part this type of stuff with. And therefore so every bit it gets ameliorate in addition to ameliorate the therapeutic alliance, nosotros hold off until the lastly business office of the CASE Approach to enquire nigh correct now, do nosotros demand to live worried nigh what you're – because nosotros want the therapeutic alliance every bit powerful every bit possible before you lot enquire nigh something that critical.
Jonathan Singer: So, you're doing all of this move therefore that they tin give the axe believe inwards you.
Shawn Christopher Shea: Sure, yeah.
Jonathan Singer: Yeah. But you lot also said that there's a lot of shame in addition to stigma associated alongside suicide. So what are some of the ways that you lot address that respectfully or do it inwards such a way that you're non shaming in addition to stigmatizing them?
Shawn Christopher Shea: Right. Well, ane thing is is kickoff of all, the timing of this which is you lot know, the CASE Approach, this interview strategy which is real flexible. I mean, you lot pick in addition to select in addition to tally it to the uniqueness of the human being. You know, the kickoff thing is when you're going to do it. And plainly you lot don’t do it correct off the bat alongside somebody. You hold off until you’ve already done the goodness stuff nosotros all do which is engage well, communicate empathy, goodness oculus contact, therefore it's usually done deeper into the interview if it's a 60-minute interview or an intake of 15, you lot know, it's usually done inwards 20 minutes or xxx minutes, therefore you’ve already engaged the somebody -hopefully real well.
And therefore the techniques themselves are fifty-fifty themselves engaging. I'm a huge proponent that there's non an antagonism betwixt sound information gathering in addition to the communication of empathy when they are both done well. And therefore the CASE – people who similar to tell their story. And therefore what it does is it helps people to walk through what they're really experiencing. It borrows from several well-known interviewers, validity techniques in addition to some of the validity techniques that I myself receive got developed, in addition to it weaves them together sensitively.
For instance, I demonstrated the ane technique, shame attenuation, which is a squeamish way to heighten the topic. You cue off of their hurting to attenuate their shame. So, every bit I said, “you know, alongside all your pain, receive got you lot been having whatever thoughts of killing yourself?” Another way of getting at it to heighten the topic is a technique that I developed called Normalization. Normalization, I assist you lot to experience prophylactic to communicate something that is awkward similar suicidal ideation past times letting you lot know I've heard this from other people. So, I powerfulness say, “Jonathan sometimes people who receive got been dealing alongside therefore much hurting every bit you lot receive got been talking nigh inwards the past, you lot know, fifteen minutes, they observe themselves having thoughts of killing themselves in addition to I'm wondering if those thoughts receive got your mind.”
And boom, you're correct inwards there. But I want to emphasize ane thing that’s, you lot know, I think this is both hopefully real useful to people, but it's also real intellectually exciting because we're learning how to utilization linguistic communication well, is that all of the validity techniques, these specific techniques similar normalization, shame attenuation, there's a whole bunch of them, gentle assumption, they weren't developed for uncovering suicidal ideation. They were developed past times clinical interviewing experts to uncover whatever sensitive material. Incest, amount abuse, domestic violence, plainly something similar suicide, therefore for people who larn how to do the CASE Approach, they're really learning validity techniques that they tin give the axe utilization alongside absolutely every customer that you lot view every fourth dimension you're seeing them because you're uncovering sensitive cloth in addition to therefore that’s what nosotros do.
Jonathan Singer: So, how many validity techniques are there? I mean, do people receive got to larn similar 50 or–
Shawn Christopher Shea: Oh, no, no. There's nigh half-dozen or vii validity techniques that are used inwards the chronological assessment of suicide events. In the literature though, you lot know, I've precisely written inwards ane my ane textbook, on precisely clinical interviewing, I at nowadays receive got a whole chapter precisely on validity techniques in addition to there's many to a greater extent than of them, you lot know, seven. There are all sorts of validity techniques that are used on all sorts of unlike circumstances. The ones inwards the CASE Approach that are real pop or the 2 ways of raising a sense of topic, shame attenuation, normalization which I've already talked nigh therefore ane time you’ve raised the topic, it's how do you lot explore it inwards a sensitive way.
So, there's an interviewing technique called The Behavioral Incident past times Gerald Pascal. There's an interviewing technique called The Gentle Assumption which was developed, I believe it's past times Pomeroy. Then there's an interviewing technique called Denial of the Specific which nosotros developed. There's ane called Symptom Amplification which nosotros developed in addition to all of these are utilized to explore the suicidal ideation inwards to a greater extent than sensitive yet thorough way.
Jonathan Singer: And these are the things that you lot utter nigh inwards your mass on the CASE Approach.
Shawn Christopher Shea: Oh, absolutely.
Jonathan Singer: So, if people want to know to a greater extent than nigh how to larn how to do these, they tin give the axe acquire the–
Shawn Christopher Shea: Oh, they sure as shooting can. I mean, you lot know, ane thing precisely therefore people knows. You tin give the axe larn all nigh the CASE Approach without fifty-fifty buying the book. If you lot move to our website which nosotros tin give the axe utter nigh I suppose later, there's a costless PDF, a squeamish petty monograph, a published monograph, on the CASE Approach which is a costless download. Now, the mass itself The Practical Art of Suicide Assessment, that covers the CASE Approach, but that’s all nigh all sorts of aspects of suicide assessment, therefore that also talks nigh risk in addition to protective factors in addition to alert signs. It talks nigh the etiology. An entire chapter on formulation in addition to how you lot pose it altogether whether you're working alongside a somebody alongside borderline procedure or psychotic procedure fifty-fifty receive got a document effect, therefore the mass covers much much to a greater extent than than the CASE Approach.
Jonathan Singer: And therefore alongside the CASE Approach, this is something that a clinician could utilization that doesn’t move inwards an emergency subdivision or doesn’t view folks who are suicidal similar every bit their job. But you lot know maybe move inwards a domestic violence shelter or something similar that in addition to they start to think well, maybe this somebody powerfulness live suicidal. Is that how it starts for people who don’t know that they're going to live working alongside folks who are suicidal?
Shawn Christopher Shea: Yeah, I mean, you lot tin give the axe – I mean, the chronological assessment of suicide events, the CASE Approach is, you lot know, literally a flexible interview in addition to strategy, therefore it tin give the axe live used past times all mental wellness professionals inwards all disciplines inwards whatever situation, therefore whether it's your initial coming together alongside someone or whether you're seeing them on an inpatient unit, whether you're inwards private exercise in addition to you're doing psychotherapy in addition to counseling, it's quite pop alongside amount abuse counselors. In fact, at that spot was a Pb article on it inwards Counselor magazine. So yeah, anybody – past times the way, anybody that I think you're coming together for an initial assessment, you lot should ever do a suicide assessment, you lot know, no thing what they're presenting alongside because you lot receive got no – it's such a taboo topic. You receive got no idea.
And how do you lot weave it into that conversation? And ane of the things that nosotros really emphasize in addition to that I think anyone of listeners who larn nigh the CASE Approach in addition to flex nosotros larn how to utilize it is it's really designed to experience extraordinarily conversational, you lot know, to the client. You receive got absolutely no thought that you're really using specific interviewing techniques to assist them to part these materials. So, it's precisely merely feels, when it's done well, similar I'm really precisely alongside somebody who’s a great listener, who cares. And of course, hopefully they are. But that great listener who cares is also a skilled clinician in addition to they are really using techniques that a best friend could non use. And that’s why people come upward to us because nosotros receive got an expertise that fifty-fifty an emphatic listener who’s a friend does non have. So, hopefully, we’re every bit emphatic every bit a best friend, but nosotros also – at that spot are interviewing techniques that have, you lot know, goodness evidence-based that they assist people to part hard cloth in addition to that’s what it's all about. We are real guardedly optimistic that the CASE Approach tin give the axe really salve a lot of lives. I've been doing a lot of move alongside our armed forces in addition to a lot of move inwards high schools, colleges in addition to nosotros think that it tin give the axe assist inwards a lot of unlike places.
Jonathan Singer: So, at the destination of doing a suicide assessment using the CASE Approach, what is it that a clinician should live able to do or should know?
Shawn Christopher Shea: It raises an interesting dot that’s non I think talked plenty nigh inwards the literature, that a suicide assessment is really non a unmarried thing. It's an ongoing procedure in addition to it really is composed of 3 unlike processes or tasks. There are 2 information gathering tasks. 1) You uncover risk in addition to protective factors in addition to alert signs. And therefore there's some other whole laid of information that you lot demand to assemble which is 2) the unique suicidal ideation, deportment planning in addition to intent. That’s the phonological, that’s the human business office of it. So, it's similar you're putting a jigsaw puzzle together. Those are the 2 bags of puzzle pieces that you lot receive got to uncover.
Jonathan Singer: And therefore when say similar gathering the risk factors in addition to alert signs, therefore you're talking nigh similar risk factors powerfulness live you're similar a 65-year-old white manful somebody who is living alone, owns a gun–
Shawn Christopher Shea: Right, right.
Jonathan Singer: Right. Sort of the things that are statistically–
Shawn Christopher Shea: Yeah, the classic risk factors of family, history, a sense of loss or ongoing pain, medical illnesses, presence of a specific diagnosis in addition to therefore those are the 2 information areas: 1) is the classic risk factors in addition to protective factors in addition to therefore 2) the unique suicidal ideation, deportment planning. So, those are 2 components of a suicide assessment. The tertiary element has cypher to do alongside the interviewing or information gathering. It's after you lot assemble those things, how do you lot formulate it in addition to that’s a pure, cognitive in addition to intuitive process. And sometimes nosotros don’t emphasize intuition in addition to intuition really does play a purpose inwards how nosotros pose this all together, but what's of import to realize is a truthful suicide assessment has all 3 of those components.
The CASE Approach precisely to be, you lot know, really clear because it really has a real small-scale goal to it. It isn't a suicide assessment protocol. It doesn’t comprehend all 3 of those things. It is really merely an interviewing strategy to uncover ane of the bags of the puzzle pieces - the suicidal ideation, behavior, planning in addition to intent. It says cypher nigh how to assemble risk in addition to protective factors in addition to alert signs. You receive got to do that inwards a unlike business office of the interview either before you lot do the CASE Approach or after you lot did the CASE Approach. in addition to it says absolutely cypher nigh how you lot pose it all together, you lot know, the clinical formulation.
What it does is it precisely makes sure that that ane purse of puzzle pieces, which past times the way, I think is extraordinarily hard to garner the truth on, the actual intent of the patient, that that purse of puzzles pieces, the interviewer has the best possible pieces that they tin give the axe acquire therefore they tin give the axe plug that into their ain formulation of risk. So, it has a real small-scale task. What I would combat is arguably ane of the most of import if non the of import project of a suicide assessment or at to the lowest degree it's a foundation. I ever utilization the analogy it's similar a computer: garbage in, garbage out. You could live the best clinical formulator inwards the globe if the customer has non shared alongside you lot their existent intent, you lot can't perhaps come upward up alongside a goodness suicide assessment.
Jonathan Singer: Right. It could live – sound beautiful when you're stuffing it, you lot know, alongside your supervisor, the psychiatrist or whomever in addition to you're really telling them crap–
Shawn Christopher Shea: Right.
Jonathan Singer: – because you’ve gotten above.
Shawn Christopher Shea: Because you lot don’t receive got the truth.
Jonathan Singer: Yeah, because you lot don’t receive got the truth.
Shawn Christopher Shea: You don’t receive got the truth, in addition to every bit you lot know, this is precisely ane surface area of what I'm interested inwards clinical interviewing in addition to therefore I've been studying clinical interviewing for almost 3 decades in addition to I'm real convinced that nosotros tin give the axe prepare ourselves in addition to prepare our staffs in addition to the people that nosotros ourselves are supervising to really do surprisingly sophisticated interviewing in addition to it is an art, but it's non precisely an art. It's also a arts and crafts in addition to it's a science set. And ane of the things is it really needs to live practiced in addition to crafted in addition to you lot know, I think particularly for illustration inwards schools of social move in addition to counseling, it has been emphasized that you lot receive got to larn interviewing skills past times people actually, you lot know, coaching you.
I'm a huge fan past times the way of the counselor Allen Ivey in addition to his concepts of microtraining. One of the things that I think is sort of the adjacent flat is recognizing that beyond precisely emphatic statements in addition to maybe open-ended questions, at that spot are whole literally belike hundreds of interviewing techniques that are real sophisticated in addition to those tin give the axe live practiced in addition to taught in addition to nosotros are real involved inwards developing the educational applied scientific discipline in addition to I don’t hateful electronic. I mean, precisely the thought of how do you lot teach.
There are styles of purpose playing in addition to grooming that tin give the axe allow us for illustration quite literally I tin give the axe receive got 28 graduate students inwards social move in addition to therefore ane twenty-four hr menstruation of grooming volition utilization an ultra-sophisticated trend of purpose playing that I tin give the axe tell you lot a petty chip nigh if you lot want, but inwards ane twenty-four hr menstruation training, nosotros tin give the axe prepare them in addition to do most of the CASE Approach alongside surprising sophistication in addition to alongside the thought that it volition stick. They volition do it therefore alongside a customer afterward that black or half-dozen months from then. And it's really exciting to view in addition to ane time you lot larn the CASE Approach, you'll view it's a sophisticated interview strategy.
It has many many sequences of these techniques, but you lot tin give the axe prepare somebody to do it in addition to it gives them a sense of competence, an excitement nigh the interviewing procedure in addition to people recognize that nosotros really are professionals, you lot know, that people they're banking on us to receive got a science laid that their best friend doesn’t receive got in addition to that science laid is what nosotros take away to the unique dynamic nosotros create alongside the somebody inwards pain.
Jonathan Singer: So, I am interested inwards how you lot do that, but I also was wondering – could I pose you lot on the spot?
Shawn Christopher Shea: [laughing] You receive got many times before before nosotros receive got this mike on, yeah.
Jonathan Singer: Okay. So, I was wondering, could nosotros do a quickie purpose play?
Shawn Christopher Shea: We can, sure. [laughing] Who are nosotros going to do it with? Oh, you lot hateful alongside me. Oh, yes, yes.
Jonathan Singer: Yeah. So, I would similar to live let's say a teenager–
Shawn Christopher Shea: Okay.
Jonathan Singer: – who is coming to you lot in addition to I precisely want you lot to demonstrate a petty chip of what you're talking about.
Shawn Christopher Shea: Okay.
Jonathan Singer: Okay. So, let's precisely say that we've been talking for 15, 20, 25 minutes, correct in addition to you lot know that I've been having some problems inwards school, you lot know–
Shawn Christopher Shea: Right.
Jonathan Singer: – some bullying maybe–
Shawn Christopher Shea: Right.
Jonathan Singer: – problems alongside friends, you lot know. I don’t acquire along good alongside my parents–
Shawn Christopher Shea: Right.
Jonathan Singer: – in addition to you lot know, I've had a history of suicide attempts inwards the past times in addition to I've been referred past times my instructor to you, the schoolhouse counselor–
Shawn Christopher Shea: Yeah, yeah.
Jonathan Singer: – because I precisely receive got been basically lethargic inwards course of instruction all day.
Shawn Christopher Shea: Yeah. Now, it's really of import to brand this really – to hold inwards mind, I've been interviewing you lot for 20 minutes, therefore all the cloth you lot precisely described we're going to assume I receive got already sensitively uncovered, okay.
Jonathan Singer: Exactly.
Shawn Christopher Shea: So, we're at nowadays deep into the – to brand this really useful though, I want you lot if you lot can, I want you lot to painting demo what your method of selection is to kill yourself.
Jonathan Singer: Okay.
Shawn Christopher Shea: I want you lot to receive got – well, because I want this to live realistic, I want you lot to receive got at to the lowest degree several other ways that you lot thought of in addition to we're also going to laid the scene in addition to a real of import dot that many people miss which is how people respond to these questions in addition to how opened upward they're going to live are going to vary on how much they want to plough over away in addition to that is often missed inwards the field.
So, I want you lot to pick somebody who really really wants to plough over away - that if I don’t uncover this inwards the adjacent 3 days, this would unfortunately live a teenager who died past times suicide. And that they are inwards tremendous angst in addition to they're also quite worried that if they part their method of choice, I'll halt them in addition to non that they won't, but I receive got to enquire the correct inquiry to acquire at it in addition to that when nosotros kickoff enquire a typical somebody similar that, if they really really want to die, they real frequently, when asked nigh suicide, volition part non the method of selection first.
They’ll part something else that they thought nigh in addition to maybe they’ve fifty-fifty had some actions on it in addition to they’ll part those actions, but they're keeping this closed to their hip, the method of selection in addition to what we're trying to prepare people is it's non plenty to precisely ask. It's non plenty to precisely start to explore a method fifty-fifty if there's actual activity taken on it. It's if you're inwards the room alongside that somebody who really wants to die. Can you lot utilization techniques that volition assist them to ultimately part the method of selection alongside you? And that’s really where nosotros salve people’s lives.
And the other thing that’s of import for people to realize is that that’s a relatively a rarity for us to live alongside such an individual. Most of the people we're doing suicide assessments alongside are non imminently unsafe in addition to therefore it's of import to realize that nosotros want to exercise the techniques that we're going to utilization alongside the somebody who is imminently – alongside everybody that we're working alongside inwards a sense that we've acquire comfortable, it's graceful, it's 2nd nature because that ane inwards a hundred somebody or that ane inwards a thou somebody who really is at imminent risk alongside you, you lot got it. You’ve got the techniques. You're used to them. You're comfortable alongside them in addition to you'll hopefully salve their lives in addition to I ever similar to think that, you lot know, that’s what they're coming to us for, that somebody who’s really closed to killing themselves, that they are inwards the room alongside somebody who has the science laid to salve their life in addition to it's non precisely bespeak them nigh suicide. It's much to a greater extent than complicated.
I ever similar to emphasize to people that recollect suicide, nosotros all know this, that suicide is highly stigmatized, you lot know. Not perhaps every bit stigmatized every bit say incest, but it's close. You would never think that if you lot met a position unit of measurement where at that spot was some incest for an initial intake in addition to you’ve got a hint of incest, you lot could precisely plough to this position unit of measurement in addition to go, “tell me all nigh your incest” in addition to they're going to tell you lot all nigh it. No. That’s laughable because nosotros know that people are going to live hesitant to part nigh stigmatizing. Yet clinicians volition sometimes think “well, if I enquire someone nigh suicide directly, they're going to tell me.” Well, non necessarily truthful at all. And if it's precisely every bit stigmatizing every bit or closed every bit incest, it could live real hesitant. And non only that, if they really REALLY want to kill themselves in addition to they are worried you're going to halt them, good therefore they powerfulness live real hesitant to part a method of choice, therefore yeah.
Jonathan Singer: Okay.
Shawn Christopher Shea: So, let's pick that upward and–
Jonathan Singer: Okay.
Shawn Christopher Shea: So, nosotros assume we've been talking. You want to live called Jonathan?
Jonathan Singer: Yeah, sure, sure, you lot telephone telephone me Jonathan, yeah.
Shawn Christopher Shea: And why don’t you lot give me – tell me precisely a petty chip – let's pretend that you lot described all of the stresses that you lot had precisely described in addition to we've talked hopefully inwards depth nigh the violence that some of the other students are showing you lot in addition to the verbal abuse. And maybe you’ve fifty-fifty shared alongside me a lot of your depressive symptoms.
Jonathan Singer: Mm-hmm.
Shawn Christopher Shea: So, let's assume that every bit a clinician I experience I've got goodness engagement. I got a reasonable painting demo of the stresses. I fifty-fifty empathise that inwards a differential diagnosis, you lot human face similar you lot receive got a major depression. So, I'm sitting hither inwards my clinician’s chair – “wow, I wonder if Jonathan is suicidal?” So that’s where we're at. Why don’t you lot say some stuff about, you lot know, some of your depressive feeling wrap upward on say you lot can't slumber or whatever, therefore so I'll heighten the topic in addition to we'll view what happened.
-- 29:17: Beginning of Role Play --
Jonathan Singer: Well, I mean, I approximate I precisely haven’t been sleeping well. I don’t similar to – I mean, I don’t similar to move to bed at I approximate what most people would consider similar normal bedtime.
Shawn Christopher Shea: Yeah.
Jonathan Singer: Like, you lot know, I would much rather move to bed at 4:00 inwards the morning–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – in addition to therefore slumber until, I don’t know, 4:00 inwards the after- I think if I did that, maybe I'll acquire some sleep, but I don’t know I wake upward in addition to I'm notwithstanding tired and… um…
Shawn Christopher Shea: Yeah. Well, you lot know, Jonathan you’ve been describing a lot of depression, a lot of hurting from you lot know, non existence able to slumber in addition to I know you’ve been crying a lot in addition to the globe looks real bleak to you. I'm wondering alongside all of your pain, receive got you lot been having whatever thoughts of killing yourself?
Jonathan Singer: No… um… I mean, non – similar a piece ago, a petty bit.
Shawn Christopher Shea: Well, it looks similar it's hard to utter nigh it. It's tough to utter nigh suicide. What kinds of ways receive got you lot thought of, fifty-fifty if they're fleeting?
Jonathan Singer: Well, I've thought nigh there's this bar inwards my room in addition to I've got some rope–
Shawn Christopher Shea: Okay.
Jonathan Singer: – and–
Shawn Christopher Shea: Have you lot ever gotten a rope out piece you're really having thoughts of killing yourself?
Jonathan Singer: Yeah, yeah. Uh-huh. Yeah.
Shawn Christopher Shea: When was that?
Jonathan Singer: So, today is – therefore Tuesday.
Shawn Christopher Shea: Okay.
Jonathan Singer: Tuesday.
Shawn Christopher Shea: That’s pretty recent. And where were you? You say you're inwards your room when you lot receive got thought alongside the rope out, or…?
Jonathan Singer: Yeah, yeah. My mom doesn’t know that it's there.
Shawn Christopher Shea: Oh, yeah, yeah.
Jonathan Singer: But yeah, it was inwards the garage in addition to I moved it into my chamber because she found me really a twain of years ago. I precisely tied it around my neck.
Shawn Christopher Shea: Wow, that was a twain of years ago.
Jonathan Singer: A twain of years ago.
Shawn Christopher Shea: So at nowadays I want to move dorsum to what happened precisely late though–
Jonathan Singer: Yeah.
Shawn Christopher Shea: – because that’s where your hurting is.
Jonathan Singer: Yeah.
Shawn Christopher Shea: When you lot got that rope out, did you lot really move far into a noose?
Jonathan Singer: Yeah.
Shawn Christopher Shea: Mm-hmm.
Jonathan Singer: Yeah.
Shawn Christopher Shea: And did you lot really necktie it around that bar and…
Jonathan Singer: A twain of days ago?
Shawn Christopher Shea: Yeah.
Jonathan Singer: Yeah.
Shawn Christopher Shea: Okay.
Jonathan Singer: Yeah.
Shawn Christopher Shea: So, you lot know, you're really at some flat thinking nigh it inwards a fairly serious way. Did you lot really pose the noose around your cervix piece you lot were thinking nigh it?
Jonathan Singer: Yeah.
Shawn Christopher Shea: Wow, okay.
Jonathan Singer: Yeah.
Shawn Christopher Shea: And when you lot over – what were you lot standing on when you lot did that?
Jonathan Singer: So, there's a chair that I receive got for my desk–
Shawn Christopher Shea: Oh, okay.
Jonathan Singer: I precisely moved it over there.
Shawn Christopher Shea: Okay.
Jonathan Singer: But–
Shawn Christopher Shea: So, when you lot were standing on the chair in addition to you lot had the rope around your cervix similar that in addition to what kinds of thoughts were going through your mind?
Jonathan Singer: That everybody would live ameliorate off if I was dead.
Shawn Christopher Shea: Okay. And every bit you lot were thinking that, you're plainly weighing the pros in addition to the cons in addition to that’s a real hard thought in addition to what other thoughts did you lot have?
Jonathan Singer: That my – I was really feeling guilty that my mom was going to receive got to explicate this to my younger sis in addition to that I didn’t want anybody to think that this was their fault.
Shawn Christopher Shea: Okay. And what ultimately do you lot think stopped you?
Jonathan Singer: So, I started to pace off the chair–
Shawn Christopher Shea: Mm-hmm.
Jonathan Singer: – in addition to I, I don’t know, I precisely – I precisely didn’t – I couldn’t do it.
Shawn Christopher Shea: Okay.
Jonathan Singer: I don’t know why.
Shawn Christopher Shea: Oh, you lot said business office of it though is that you lot didn’t want your mom to observe you lot in addition to didn’t want her receive got to explicate that your sister, therefore I mean–
Jonathan Singer: Yeah.
Shawn Christopher Shea: – these were powerful things in addition to also showing that fifty-fifty amidst of all your pain, which plainly is real severe, you lot know, what's striking to me is you're notwithstanding thinking nigh other people, which is a wonderful thing. You know, you lot struck me every bit somebody who’s real caring in addition to I'm sure you lot do a lot of goodness things for a lot of people in addition to that’s, you lot know, ane of the reasons I suppose that it stopped you.
Jonathan Singer: I promise so.
Shawn Christopher Shea: Yeah. Well, you lot know, precisely to acquire a ameliorate thought of what was going on alongside you lot during that night, how long were you lot really upward on that chair alongside the noose around your cervix and…
Jonathan Singer: I hateful I think it was belike similar fifteen minutes maybe.
Shawn Christopher Shea: Oh yeah.
Jonathan Singer: Just variety of thinking nigh it.
Shawn Christopher Shea: Yeah. What did you lot do alongside the noose?
Jonathan Singer: I precisely pose it dorsum nether my bed.
Shawn Christopher Shea: Is it notwithstanding there?
Jonathan Singer: Mm-hmm. Yeah.
Shawn Christopher Shea: Is it notwithstanding made every bit a noose?
Jonathan Singer: Mm-hmm.
Shawn Christopher Shea: Well, that volition live something it’ll kill you, therefore you’ve got to acquire that out of at that spot in addition to we'll utter to a greater extent than nigh that at the destination of the talk. One of the things I'm wondering is is that over say roughly the past times 2 months, what other ways receive got you lot thought perhaps of killing yourself.
Jonathan Singer: I hateful just, you lot know, precisely the rope really, precisely the rope.
Shawn Christopher Shea: Is at that spot some other fourth dimension that you lot really got the rope out over the past times 2 months?
Jonathan Singer: Yeah, but precisely similar a twain of times–
Shawn Christopher Shea: Okay.
Jonathan Singer: – I think.
Shawn Christopher Shea: And therefore you lot said that a twain of times you’ve gotten the rope out. Now, I'm wondering there's lots of unlike thoughts that tin give the axe move through somebody’s hear in addition to at this dot inwards time, if you lot tin give the axe think sort of dorsum over it, had you lot thought of whatever other ways that you lot powerfulness really kill yourself such every bit you lot know, a mutual way that cross people’s minds today every bit they think of overdosing unless that’s something powerfulness receive got crossed your mind.
Jonathan Singer: Yeah, yeah.
Shawn Christopher Shea: Okay.
Jonathan Singer: Yeah, yeah, yeah.
Shawn Christopher Shea: And inwards what ways did you lot think of overdosing? What types of pills or?
Jonathan Singer: So, I'm on some medication similar – I forget what it's like, Prozac or something in addition to I was–
Shawn Christopher Shea: Oh, for depression or–
Jonathan Singer: Yeah.
Shawn Christopher Shea: Oh.
Jonathan Singer: And, you lot know, I haven’t been taking it really regularly, therefore I receive got a bunch of them, therefore I was thinking maybe that.
Shawn Christopher Shea: Yeah, sure. Do you lot know the names of those pills are?
Jonathan Singer: Oh, what it's called? Serata.
Shawn Christopher Shea: Sertraline?
Jonathan Singer: Sertraline, yeah. That’s it. That’s it. Yeah, yeah, yeah, yeah, yeah.
Shawn Christopher Shea: Now, did you lot ever acquire the Sertraline out piece you're having thoughts of killing yourself?
Jonathan Singer: Yeah, yeah.
Shawn Christopher Shea: Okay. Now, when was that?
Jonathan Singer: That was nigh – view today’s Thursday, therefore okay, I approximate it was nigh maybe a twain of Thursdays, a twain – it was on a Friday.
Shawn Christopher Shea: Okay.
Jonathan Singer: I didn’t move to schoolhouse that day, therefore a twain – yeah.
Shawn Christopher Shea: And where were you lot when did that?
Jonathan Singer: In my room.
Shawn Christopher Shea: Oh, therefore the same room where you lot acquire the rope out.
Jonathan Singer: Yeah, yeah, yeah. I pass a lot of fourth dimension inwards my room.
Shawn Christopher Shea: Not bad, you lot know.
Jonathan Singer: Because I got – I receive got my TV in addition to reckoner in addition to my new–
Shawn Christopher Shea: That’s also a sort of a prophylactic refuge from what you lot said before inwards the interview. It's a position where you're safe. You don’t receive got to interact alongside your position unit of measurement and–
Jonathan Singer: Yeah, yeah.
Shawn Christopher Shea: So, I want to move dorsum though because it looks similar you lot receive got these pills, you're thinking nigh them.
Jonathan Singer: Uh-huh.
Shawn Christopher Shea: Now, did you lot really receive got the pills out piece you lot were thinking of overdosing, right?
Jonathan Singer: Yeah, I did. I precisely variety of poured them out on the table.
Shawn Christopher Shea: Did you lot receive got any?
Jonathan Singer: I took precisely a twain because I didn’t receive got whatever water–
Shawn Christopher Shea: Mm-hmm.
Jonathan Singer: – inwards my room in addition to I didn’t want to receive got to–
Shawn Christopher Shea: It's therefore hard to swallow.
Jonathan Singer: Yeah. I didn’t want to acquire out because my mom sometimes she’s worried nigh me in addition to therefore she’ll really enquire me what's going on.
Shawn Christopher Shea: So, how many pills do you lot think you lot really took?
Jonathan Singer: Probably similar I don’t know, a twain maybe.
Shawn Christopher Shea: 5, 10, 15?
Jonathan Singer: Probably similar viii I think.
Shawn Christopher Shea: Okay. Did you lot whatever receive got whatever other pills also Sertraline?
Jonathan Singer: No. Well, I had precisely – at that spot were a twain of Advil–
Shawn Christopher Shea: Okay.
Jonathan Singer: – that I took.
Shawn Christopher Shea: Now, what stopped you lot from taking to a greater extent than of that? Now, ane thing you lot couldn’t drinkable you lot said, but was at that spot also something else that really stopped you lot that you lot said this, I don’t want to do this. Why? And here's why I don’t want to do this.
Jonathan Singer: I heard that somebody ane time said that you lot couldn’t really kill yourself alongside those things.
Shawn Christopher Shea: Okay.
Jonathan Singer: And therefore I thought well, therefore if I don’t receive got – similar if I'm out in addition to my mom asks where did they go,–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – similar I would receive got to explicate it to her in addition to therefore I was similar this is non going to move anyway maybe–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – in addition to therefore I just, it didn’t seem similar it was going to work.
Shawn Christopher Shea: Yeah.
Jonathan Singer: So, I precisely didn’t want to do that.
Shawn Christopher Shea: You know when you're – whatever amount of hurting you’ve been inwards which is plainly extreme hurting in addition to you lot thought nigh the hanging in addition to really had some pretty serious thoughts nigh that in addition to had a small, relatively little overdose of the pills it's were similar mutual for people to live thinking nigh other ways of thinking themselves. I mean, I observe that’s a real mutual thing for people in addition to they sort unlike ways, therefore I'm interested at that spot powerfulness receive got been fifty-fifty some other way that you’ve been thinking nigh similar some other mutual way inwards our civilisation volition live to shoot oneself in addition to I'm wondering if you’ve thought of using a gun or anything similar that.
Jonathan Singer: Yeah. No, I really – I don’t believe inwards guns actually.
Shawn Christopher Shea: Okay, good.
Jonathan Singer: I think that at that spot are – yeah. I don’t think people should live allowed to receive got guns.
Shawn Christopher Shea: Okay.
Jonathan Singer: It's too dangerous.
Shawn Christopher Shea: Okay. What nigh things – some other thing that’s sometimes fairly mutual is people volition either say drive their motorcar real speedily off into a 3 or off the road. Any thoughts similar that?
Jonathan Singer: No. I mean, I receive got a learner’s permit, but I can't – no. But I did think – therefore I thought nigh jumping.
Shawn Christopher Shea: Yeah. I was precisely going to enquire you lot nigh that–
Jonathan Singer: Yeah.
Shawn Christopher Shea: – because that is some other mutual way, yeah.
Jonathan Singer: But I don’t know where I would do it so…
Shawn Christopher Shea: Did you lot ever move anywhere hunting for a span or…
Jonathan Singer: Well, there's – I hateful at that spot is bridge, but it's I don’t know, the thought of getting inwards that H2O precisely is awful. I don’t think I tin give the axe do that.
Shawn Christopher Shea: Okay.
Jonathan Singer: I mean, I – yeah, I mean, I've thought nigh it, but I don’t really think I tin give the axe do that.
Shawn Christopher Shea: Yeah.
Jonathan Singer: Like…
Shawn Christopher Shea: Yeah.
Jonathan Singer: Yeah.
Shawn Christopher Shea: And nosotros talked nigh the motorcar in addition to you're non really driving that much at this dot inwards time–
Jonathan Singer: Right.
Shawn Christopher Shea: – in addition to some other thing that sometimes people think nigh is carbon monoxide poisoning similar at other parents’ garage or something similar that alongside a car, receive got thought of that?
Jonathan Singer: Yeah. Actually, nosotros – our motorcar doesn’t fit inwards our garage.
Shawn Christopher Shea: Okay.
Jonathan Singer: Now somebody online said that if you lot run a lawnmower–
Shawn Christopher Shea: Okay.
Jonathan Singer: – you lot fill upward it upward alongside gas, but nosotros receive got an electrical lawnmower so–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – that, therefore no, non really that either.
Shawn Christopher Shea: Yeah. Sounds similar you lot puzzled through some stuff. I'm curious roughly how much fourth dimension receive got you lot pass online, on the spider web trying to observe unlike ways because you lot know, before doing that now–
Jonathan Singer: Yeah, yeah.
Shawn Christopher Shea: – a fair amount actually.
Jonathan Singer: You know non – I mean, non much I guess.
Shawn Christopher Shea: Okay. Well, are nosotros talking an hr a day, ane time a week…
Jonathan Singer: I mean, belike an hour, maybe a twain of hours a day.
Shawn Christopher Shea: Searching on the spider web for something nigh suicide...
Jonathan Singer: I hateful non precisely similar how to do it, but I mean, you lot know, precisely you lot know the spider web is goodness because at that spot are a lot of other people that are upset and–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – you lot know it's – I observe that I tin give the axe utter to people there.
Shawn Christopher Shea: Oh sure.
Jonathan Singer: Yeah.
Shawn Christopher Shea: They tin give the axe live really goodness supports in addition to past times the way–
Jonathan Singer: Yeah.
Shawn Christopher Shea: – often tin give the axe assist preclude a suicide past times finding other people who tin give the axe furnish some back upward and–
Jonathan Singer: Yeah. People receive got been similar don’t do it man.
Shawn Christopher Shea: Oh good. That’s good.
Jonathan Singer: You know, yeah so…
Shawn Christopher Shea: That’s what we're hoping volition plough over off on the web.
Jonathan Singer: Yeah.
Shawn Christopher Shea: Well, you lot know, you lot in addition to I receive got talked nigh an awful lot of unlike ways you’ve been thinking nigh in addition to I'm curious, is at that spot whatever way that you’ve thought nigh that nosotros haven’t talked about?
Jonathan Singer: I don’t think so. No, those are the – I mean, that’s really the – those are it.
Shawn Christopher Shea: On your real worst days Jonathan, you lot know, when you're thinking the most nigh killing yourself, you lot know, roughly how much fourth dimension do you lot pass thinking nigh killing yourself? 70% of your waking hours, you lot know 80%, 90% of your waking hours, precisely roughly how much?
Jonathan Singer: Probably similar one-half the time.
Shawn Christopher Shea: Half the fourth dimension that you're awake.
Jonathan Singer: Yeah.
Shawn Christopher Shea: That’s a lot of pain.
Jonathan Singer: Yeah.
Shawn Christopher Shea: You know, I receive got inwards talking alongside you lot in addition to you lot know your hurting is real very existent in addition to we’d similar to live able to assist you lot alongside that in addition to – but I'm really struck alongside the significance of the hurting in addition to its intensity in addition to I think we're going to live able to help, but I want to larn a petty chip to a greater extent than nigh suicidal thought for you, therefore nosotros brand sure that you're prophylactic in addition to nosotros tin give the axe assist you lot to deal alongside those thoughts in addition to observe other reasons to live because I think you lot receive got lots of great reasons to live that we've been talking about, but what nigh inwards the past. Have you lot really ever tried to kill yourself inwards the past?
Jonathan Singer: Yeah. There were a twain of months where I tried belike every twain of weeks–
Shawn Christopher Shea: Okay.
Jonathan Singer: – or similar 2 months.
Shawn Christopher Shea: And when was that roughly?
Jonathan Singer: About 2 years ago.
Shawn Christopher Shea: Okay. And what ways did you lot really endeavor suicide similar that?
Jonathan Singer: Hanging. Yeah. There were a twain of times where I was precisely hanging.
Shawn Christopher Shea: Wow.
Jonathan Singer: Like precisely for similar 3 or iv seconds in addition to therefore I similar variety of got my feet dorsum on the chair and…
Shawn Christopher Shea: Okay.
Jonathan Singer: Yeah.
Shawn Christopher Shea: And other ways that you lot really attempted suicide inwards the past?
Jonathan Singer: I hateful I was doing some cutting, but non to really to die.
Shawn Christopher Shea: Yeah.
Jonathan Singer: Because you lot know that’s non – I mean, I precisely don’t – I think it hurts, but I don’t think I tin give the axe do that so.
Shawn Christopher Shea: Yeah, okay.
Jonathan Singer: This is mostly is the hanging.
Shawn Christopher Shea: Yeah, you lot know, the argue I'm bespeak is is that you lot know I want to acquire a goodness experience for what's going on inwards the past times alongside you lot alongside suicide, therefore nosotros tin give the axe assist to brand sure, you lot know, that doesn’t plough over off for you lot or something you lot experience the demand to do at nowadays in addition to alongside the hanging, that sounds, you lot know, fairly serious to me. Actually, if you lot said that a twain of seconds of maybe precisely hanging there. That’s a scary thing.
Jonathan Singer: Yeah.
Shawn Christopher Shea: What was going on dorsum therefore that was – therefore was the stress the same? Were you lot existence bullied dorsum therefore or were they similar stresses to what was happening now? What was going on?
Jonathan Singer: Yeah. There were some kids at schoolhouse that were, that I thought were my friends in addition to it turns out that they were existence really hateful online in addition to therefore I would come upward to schoolhouse in addition to similar this – I play keyboards–
Shawn Christopher Shea: Yeah, okay.
Jonathan Singer: – in addition to these kids that I've known for a long fourth dimension they invited me over to play–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – some music alongside them in addition to I got over at that spot in addition to they precisely spent the whole fourth dimension similar mocking me–
Shawn Christopher Shea: Bragging on you.
Jonathan Singer: Yeah, bragging therefore similar “Oh, I thought you lot said you lot could play in addition to you lot suck” in addition to you lot know–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – similar you lot know, similar you lot know, “Why don’t you lot play chopsticks again,” in addition to similar it was–
Shawn Christopher Shea: Yeah, yeah.
Jonathan Singer: It was precisely humiliating in addition to I–
Shawn Christopher Shea: And it was, yeah.
Jonathan Singer: Yeah, in addition to these were similar my friends or I thought in addition to therefore I, I mentioned it to somebody in addition to they were similar “They utter nigh you lot all the fourth dimension man.”
Shawn Christopher Shea: What a sense of betrayal.
Jonathan Singer: It was awful.
Shawn Christopher Shea: Yeah.
Jonathan Singer: And so–
Shawn Christopher Shea: So, it's a petty chip similar to what nosotros were talking nigh before inwards the interview when nosotros – nigh some of the things that kids had been proverb and–
Jonathan Singer: Yeah.
Shawn Christopher Shea: – late a friend really seemed to betray you lot and–
Jonathan Singer: Yeah, yeah, yeah. Yeah, it's big.
Shawn Christopher Shea: And whatever other attempts, serious attempts?
Jonathan Singer: Just – well, I mean, similar nigh – I approximate nigh half-dozen months agone also past times hanging, but that’s when my mom came in–
Shawn Christopher Shea: Okay.
Jonathan Singer: – in addition to she totally freaked out.
Shawn Christopher Shea: Oh yeah. Well, who wouldn’t?
Jonathan Singer: Yeah.
Shawn Christopher Shea: Yeah.
Jonathan Singer: And therefore – but that was it.
Shawn Christopher Shea: Okay.
Jonathan Singer: Yeah.
Shawn Christopher Shea: Now, getting back, you lot know, to the acquaint 2nd correct at nowadays where we're talking, every bit we've been talking, receive got you lot been having whatever thoughts of killing yourself?
Jonathan Singer: Not really.
Shawn Christopher Shea: Well, you lot human face at some flat precisely because of your hesitancy in addition to because you lot powerfulness receive got some thoughts or…
Jonathan Singer: I approximate I'm precisely like, you lot know, similar what is the dot of all this, you lot know?
Shawn Christopher Shea: Sure.
Jonathan Singer: Like yeah, therefore yeah I guess.
Shawn Christopher Shea: Okay.
Jonathan Singer: Yeah.
Shawn Christopher Shea: And, you lot know, every bit you lot were thinking, piece we're hither talking, you lot know, this is surprising (indiscernible 0:42:06.1) because you lot know a lot of pain. Were you lot really thinking of a specific method?
Jonathan Singer: I was thinking nigh the rope.
Shawn Christopher Shea: Oh okay. It's notwithstanding dorsum there, correct you lot told me, nether the bed?
Jonathan Singer: Yeah, nether the bed, yeah.
Shawn Christopher Shea: So, nosotros definitely receive got to acquire that rope out of there, okay?
Jonathan Singer: Yeah.
Shawn Christopher Shea: That’s ane thing that’s for sure.
Jonathan Singer: Yeah.
Shawn Christopher Shea: Well, you lot know, in addition to sure as shooting that you're wondering to whether it's worth going on in addition to if nosotros had looked at the amount of hurting you're feeling from the betrayal in addition to what's going on alongside the bullying in addition to that type of thing, if null was your feelings in addition to say geez, you lot know, I'm inwards a lot of hurting from this, but I think I tin give the axe deal alongside it in addition to a 10 was, you lot know, the hurting is therefore great that I don’t know if I tin give the axe really proceed in addition to I really think that I powerfulness receive got to kill myself soon.
Jonathan Singer: Mm-hmm.
Shawn Christopher Shea: Where would you lot pose yourself on that scale from a 0 to 10?
Jonathan Singer: Right now?
Shawn Christopher Shea: Right now.
Jonathan Singer: Probably nigh 8.
Shawn Christopher Shea: Wow, that’s a lot. Are you lot feeling hopeless?
Jonathan Singer: Yeah. I mean, it's – when I kickoff came inwards I think I was belike to a greater extent than similar a 10.
Shawn Christopher Shea: Okay.
Jonathan Singer: But, yeah, again, I hateful I just, you lot know, this position sucks similar my parents don’t receive got – I mean, they're squeamish in addition to everything.
Shawn Christopher Shea: Yeah.
Jonathan Singer: But like, I don’t know, it's precisely been going on therefore long.
Shawn Christopher Shea: Yeah.
Jonathan Singer: Like, you lot know, nosotros got those stupid videos online similar it gets ameliorate in addition to it's similar really?
Shawn Christopher Shea: Yeah.
Jonathan Singer: When?
Shawn Christopher Shea: Yeah.
Jonathan Singer: When does it acquire better, you lot know?
Shawn Christopher Shea: Yeah. You sort of view stuff that’s similar the rose-colored glasses, you lot know, if you lot precisely think positive in addition to you lot know frankly it's tougher than that, but the ane thing I really am glad that you lot came inwards because I do think that there's clearly some things that nosotros tin give the axe do that I'd similar to pass a petty fourth dimension at nowadays talking to a greater extent than about, but kickoff of all, I think it is great that you lot really came in. You know that something prompted that. I don’t what it is. You know, I would think perhaps it's a business office of you lot that really wants to live in addition to a business office of you lot that wants to assist your siblings in addition to friends in addition to your parents or whatever. But nosotros do know ane thing something prompted you lot to come upward in. That nosotros know for a fact in addition to therefore whatever that ambivalence was, that’s a goodness thing. That’s why you're here.
Jonathan Singer: Yeah. Well, I mean, it was you lot know, it was Mrs. Stevens who was similar you lot demand to go.
Shawn Christopher Shea: Yeah, yeah.
Jonathan Singer: And–
Shawn Christopher Shea: Thanks for Mrs. Stevens–
Jonathan Singer: Yeah, and–
Shawn Christopher Shea: But you lot know what, you’ve sure as shooting seemed to opened upward up nigh this stuff, therefore given the jeopardy to utter nigh it unless I'm misreading you. Okay. You’ve shared a lot of nigh it, therefore there's a business office of you lot that wants to part or you lot wouldn’t live sharing.
Jonathan Singer: That’s true. I mean, I – you lot know, I similar people.
Shawn Christopher Shea: Yeah. (crosstalk 0:45:10.6).
Jonathan Singer: I precisely don’t know why don’t similar me.
Shawn Christopher Shea: Yeah, yeah. Well, that’s for some of the stuff that we're going to receive got a human face at is what is going on in addition to what is happening alongside relationships in addition to also, you lot know, you lot sure as shooting take away a lot of goodness things too. And you’ve described some interactions before inwards our interview where, you lot know, at that spot sure as shooting were people who are enjoying you. You were talking nigh that ane black for illustration alongside the music in addition to how much the crowd was into that. You're grin fifty-fifty every bit nosotros were talking nigh that in addition to I want to larn to a greater extent than about, those aspects of your life that are positive and, but I receive got no doubts nigh the hurting in addition to therefore that’s something that hopefully we're going to live able to assist you lot alongside today.
So, you lot know, I'd similar to move dorsum in addition to utter a petty chip nigh something you lot said before inwards the interview. You had commented that you lot were really drinking a petty chip to a greater extent than than you lot commonly would similar to live drinking in addition to that you're a petty chip concerned nigh your drinking. So, precisely tell me precisely a petty chip to a greater extent than nigh what the drinking has been similar for you lot in addition to what your concerns are nigh it. [fade out]
-- 50:40: End of Role Play --
Shawn Christopher Shea: Anyway, how is that? How is that? I thought it was going to live a petty bit, you lot know, so. [lauging]
Jonathan Singer: Okay.
Shawn Christopher Shea: What was that similar for you?
Jonathan Singer: First of all, it was real warm in addition to connecting–
Shawn Christopher Shea: Oh good.
Jonathan Singer: – in addition to emphatic in addition to it was gentle in addition to you lot were picking upward on all sorts of things that I wasn’t going to utter about.
Shawn Christopher Shea: Yeah.
Jonathan Singer: But that I wanted to utter about.
Shawn Christopher Shea: Yeah.
Jonathan Singer: So, that was amazing.
Shawn Christopher Shea: Yeah. Oh good. Well, you lot know, you lot were a tough cookie there. I mean, you lot plainly were inwards a lot of hurting in addition to you lot were clearly playing a purpose when you lot utter nigh playing a purpose where someone who is inwards a lot of hurting in addition to really wanted to plough over away in addition to you lot know, ane of the things that for your listeners to dot out, that I'd similar to dot out – really something is a petty chip atypical at that spot which is is that I think someone alongside that amount of hurting when kickoff asked nigh suicidal thought, wouldn’t part the hanging.
The kickoff thing he belike would receive got shared was say the overdose or thinking nigh that because I observe that many people who are inwards intense hurting in addition to want to kill themselves – so, we’d similar to give a number or per centum that the kickoff per centum is how much a somebody wants to die. The 2nd per centum is how much nosotros think they want to live. So, a 10/90 or 10% who wants to die, 90% of them wants to live and, you lot know, 40/60 or 40% who wants to die, 60% – you lot know, inwards those arrive at are some stuff when nosotros asked the questions.
I don’t think it's at all odd for a somebody to tell us a fair amount nigh the truth in addition to they volition often share, you lot know, maybe fifty-fifty if they’ve had a method of choice. They often don’t receive got a method, but they receive got when they part that. But where we're really concerned are the 95/5-ers or the 90/10 or someone who 95% of them wants to die, precisely a little 5% prompted them to telephone telephone us on a crisis delineate or to move to the schoolhouse counseling middle or whatever. Those people who really want that, those are the ones who belike live (cagier) in addition to therefore I think generally, you lot know, I would predict that the educatee are most probable would receive got kickoff shared the thoughts of overdosing because they're to a greater extent than comfortable doing that addition also they don’t want you lot taking a role.
And therefore they're going to lookout adult man how clinician responds to talking nigh the overdose in addition to if the clinician looks ill-at-ease, which is meta-communicating that “I don’t want to hear this or I'm uncomfortable alongside this or you're a bad somebody for having this,” they may farther clam up. Whereas if they experience hopefully similar you lot were, good this guy tin give the axe hear to me in addition to this is non unfamiliar turf for this clinician. He sees precisely apartment out bespeak me inwards a sensitive thing of fact way. And therefore they're to a greater extent than probable to part every bit you lot probe farther in addition to you lot tin give the axe see, you lot know, alongside that particular educatee that nosotros precisely interviewed that you lot played.
You know at kickoff you lot wouldn’t receive got thought that he had such extensive thoughts of hanging himself or that at that spot were serious attempts inwards the past. You noticed that I was checking to view what I uncovered where that sounded similar a fairly pregnant deportment inwards the past times where it's really suspended. I mean, that’s every bit closed every bit you lot tin give the axe acquire in addition to often past times the way, for many people you lot know if you’ve kicked away the chair therefore that’s why the people plough over away fifty-fifty if they alter their minds because it's real hard to halt a suffocation alongside a rope, a hanging.
So, fortunately, you lot must receive got non displace far off of the chair, had it available, but fifty-fifty alongside that situation, you lot know, you lot really saw that past times probing a petty chip ameliorate you lot could observe out, you lot want to observe out if that serious past times attempt, the triggers are similar to what is going on at nowadays in addition to is the method the same. You know, Thomas Joiner has really helped us to empathise that people may exercise suicide methods in addition to that exercise powerfulness dot their closer in addition to therefore if you lot observe a past times suicide attempt, that serious ane in addition to you lot realized in addition to you lot therefore enquire specifically – I recommend bespeak what were the triggers in addition to what is the method because if the triggers in addition to the method are at nowadays identical – so, if I'm interviewing a 27-year-old human being who’s contemplating, you lot know, taking a large overdose of aspirin because he’s going through a divorce, if when I uncover the past times suicidal ideation he tells me he had a serious endeavor inwards college, I would therefore enquire what did you lot do in addition to if he told me an overdose, I'd say what kinds of pills to view if they were aspirin again.
And therefore ane time again, precisely every bit I did hither I'd enquire him what was the province of affairs in addition to if he said, “Well, my lady friend had broken upward alongside me.” These are ruddy lights. Does this person, you lot know, exercise this inwards the past? This is a stress that nosotros know resulted inwards a major overdose inwards the past times in addition to that’s how nosotros start to assemble information that gives us ameliorate predictive abilities alongside this person.
Jonathan Singer: This is therefore incredibly powerful, everything that you’ve been talking about.
Shawn Christopher Shea: Oh good.
Jonathan Singer: Yeah, absolutely. The techniques that you lot were using–
Shawn Christopher Shea: Yeah.
Jonathan Singer: I mean, plainly you lot know, the illustration that sort of–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – what's going on in addition to therefore 2 months in addition to therefore the past times in addition to therefore correct now, how are you lot feeling. Influenza A virus subtype H5N1 twain of times it seemed similar you lot were bespeak me nigh how often I was thinking of things or–
Shawn Christopher Shea: Right. We used actually, what hopefully, you lot know, could come upward across to listeners in addition to sometimes it's harder to do when you lot can't view the interview you lot get, you lot know, you’d lack those non-verbals, but really if you lot read the articles or you lot written report the mass on The Practical Art of Suicide Assessment, you'll view that really that interview, I was flexibly structuring in addition to determining how I want to do it, but I was really intentionally bespeak in addition to using real specific techniques. You really – you lot saw me utilization a technique called Gentle Assumption where instead of proverb receive got you lot thought of other ways.
Influenza A virus subtype H5N1 gender activity researcher Pomeroy in addition to Company found that it's to a greater extent than powerful to say what other ways receive got you lot thought of killing yourself in addition to of course, you lot know, when they learned past times doing, receive got gender activity histories, that you lot know, if you lot asked a person, you lot know, do you lot masturbate? Influenza A virus subtype H5N1 lot of people say “no.” If you lot say what do you lot experience when you lot masturbate? People often volition tell you.
Jonathan Singer: Which answers the kickoff question, too. Yeah.
Shawn Christopher Shea: Yeah. They telephone telephone that a Gentle Assumption.
Jonathan Singer: Okay.
Shawn Christopher Shea: And therefore nosotros used gentle supposition instead of proverb receive got you lot thought of other ways after they’ve described, you lot know, a way. We’d say “Oh, what are the ways receive got you lot thought of Jonathan.” And therefore you lot saw the creation of what nosotros telephone telephone Verbal Videotape. In a traditional sense, that’s called similar a chain analysis inwards Cognitive Behavioral Therapy or DBT [Dialectical Behavior Therapy], but we’d similar to telephone telephone it the Verbal Videotape which is you lot utilization a technique called the Behavioral Incident that was developed past times Gerald Pascal, a psychologist, in addition to you're asked fact finding questions or sequencing questions, you lot know, “what happened next, what did you lot do next” in addition to you lot literally walk the somebody through the event, sort of pace past times pace therefore they brand upward - In your hear you're using this behavioral incidents, therefore the customer tin give the axe create a verbal videotape where you lot tin give the axe view it unfolding. And if you lot acquire a gap, you lot precisely read what nosotros telephone telephone those Nixon gaps. If there's a Nixon gap that take–
Jonathan Singer: There's similar eighteen minutes that -
Shawn Christopher Shea: [Laughs] Yeah, yeah.
Jonathan Singer: – that nobody can–
Shawn Christopher Shea: There are eighteen minutes. That’s really scary.
Jonathan Singer: Even eighteen seconds is scary, yeah.
Shawn Christopher Shea: I promise your listeners know what we’re referring to here. But anyway, if you lot receive got ane of these nix in addition to gaps, you lot precisely rewind the record in addition to restart it. That'll demo you lot how powerful that is. You're exploring alongside a verbal videotape using Pascal’s behavioral illustration in addition to you lot observe out the somebody overdosed. You observe out what the pills where they overdosed. Also, past times the way, often you're able to observe out how many pills were left inwards the bottle. That gives you lot an thought of the reflection of the intent. And therefore I say alongside this–
Jonathan Singer: And past times that, do you lot hateful similar if they say oh, at that spot were 35 left inwards the bottle then–
Shawn Christopher Shea: Yeah. If someone – if 2 unlike individuals, each took 20 aspirin in addition to ane of them I said, “You know I'm precisely curious, how many pills were left?” And the kickoff guy says, “Oh my God, at that spot are you lot know other pills all over the place. You know I know where you're going alongside this in addition to my married adult woman is a junkie. Trust me, there's drugs – I'm going to live dead, I'd live dead.” Okay. That gives me ane flat of intent. Now, if somebody took the exact same number of aspirin, 20 aspirins in addition to at the same dot I say, “You know I'm curious, how many pills were left?” And he turns to me in addition to goes to me “You know what, at that spot weren't whatever damn pills left inwards that bottle in addition to I’d ransacked the damn solid until goddamn it I passed out.” Okay. That is an only unlike intent level, but they both, what’s curious is that they both took the same pills in addition to the same number of pills, but it was past times bespeak how many pills were left, you lot got a reflection of the intent. It was, you lot know, sure as shooting different.
Jonathan Singer: And the intention is therefore central.
Shawn Christopher Shea: Oh, that’s where we're nigh is people kill themselves non because statistics say they should, they kill themselves because they intend to kill themselves. You know alongside rare exceptions for somebody past times accident ends upward killing or taking to a greater extent than than they thought, but you lot know, it's a choice. You’ve decided you lot want to kill yourself which is a tough position to be, but I want to move dorsum that, therefore if I therefore plough to that person, in addition to I said, “What happened after you lot took the pills?” They said, “I ended upward inwards the emergency room.” Well, there's your Nixon gap, you lot know, it's – I could view them inwards my caput taking the pills in addition to I tin give the axe view them existence you lot know snaked alongside a subway inwards the emergency room, but I receive got absolutely no thought how they got from the bath to the emergency room in addition to therefore what inwards the CASE Approach, the regulation is if you're making a verbal videotape, walk through what happened. If you lot can't view it, rewind the record in addition to restart alongside the deportment in addition to – therefore I'd move dorsum in addition to I'd say, “Well, correct after you lot took the pills Jim, what happened next?” And he goes, “Well, I called my brother.” I said, “You know, what did you lot say to your brother?” “I precisely told him I did something lightheaded I shouldn’t do. I took some pills I shouldn’t. Would you lot hear taking me to the emergency room?”
What a huge puzzle slice was precisely uncovered past times that interviewer. And I similar to dot out that, you lot know, that’s a puzzle slice that when you lot do start to do your clinical formulation which is non the illustration first. That’s what you lot do alongside the material, but when you lot do the clinical formulation, that’s a puzzle slice that powerfulness preclude an unnecessary hospitalization. Because that ane does non reverberate much intent at all. That reflects, actually, a powerful sense of I notwithstanding want to live alive. That puzzle piece, unless you lot utilization something similar the CASE Approach precisely comprehensively walking through this material, you lot powerfulness non receive got when you're doing your clinical formulation. If you lot didn’t do that, the adjacent thing you lot know this guy’s inwards a infirmary in addition to he doesn’t demand to live inwards a hospital.
So, it's all built to acquire the puzzle pieces nigh suicidal ideation, behavior, planning in addition to intent. And therefore that nosotros tin give the axe therefore make, nosotros plug those therefore into our clinical formulation in addition to at nowadays nosotros know we've got the best possible information nosotros receive got in addition to therefore nosotros tin give the axe do a goodness clinical formulation.
Jonathan Singer: So, are at that spot whatever other things nigh that that you lot wanted to highlight for our listeners?
Shawn Christopher Shea: Just only inwards a sense that, you lot know, I genuinely believe that nosotros tin give the axe salve lives past times using things in addition to learning to utilization something similar the CASE Approach in addition to it would live wonderful. Imagine if every graduate educatee of social move and/or social move student, every medical student, every nursing student, every psychiatry residency, if really nosotros prepare them inwards this in addition to tested them out. You know, ane of the things that we're doing is nosotros really receive got learned a way that nosotros utilization inwards our middle to really purpose play people therefore they really do know how to do this.
I hateful you lot tin give the axe think you lot know how to do it even, you lot know, from precisely hearing this podcast, but the truth of the thing is, it's really practicing it in addition to having a coach there, but imagine if every unmarried social worker or every unmarried medical educatee would receive got to do this in addition to do it to a reasonable fidelity alongside ane of their faculty before they could graduate, kickoff of all, the sense of confidence that all of these students would receive got in addition to therefore their science levels would receive got skyrocketed compared to what is typically existence done at nowadays in addition to I precisely – let's leave of absence social workers in addition to psychiatrists out of the painting demo for a minute, psychologists in addition to instead focus on main attention physicians, nurses in addition to PAs.
Fifty percent of all people who plough over away via suicide receive got seen ane of the main attention people inside a calendar month observe that real hope-producing. You know, the 10th leading movement of expiry inwards America, 50% of the fourth dimension they're inwards a room alongside a professional person who could assist to plough this around. If nosotros had each of those professionals every bit students pass precisely ane twenty-four hr menstruation practicing the CASE Approach the way we're describing it from our middle in addition to therefore exam out on it, the likelihood that those students when they acquire residents inwards position unit of measurement exercise or endocrinology or nursing or whatever, that they volition enquire I think has skyrocketed because people similar to do what they experience competent inwards in addition to boy, if you lot do a twenty-four hr menstruation of grooming of this you're non really – in addition to therefore receive got practiced it in addition to non only that, they non only know how to heighten the topic, they're going to know how to explore it in addition to they're going to know how to hunt for the method of selection in addition to they're going to know that precisely because you lot asked directly, you lot don’t acquire a direct reply at first.
I genuinely believe it is ane of the best chances nosotros receive got inwards the province to driblet the suicide rate. If nosotros know for a fact, our show base of operations is 50% of all suicides that occur the somebody has seen ane of these professionals in addition to main attention inwards ane calendar month therefore if nosotros tin give the axe instruct them how to do this, I genuinely believe it's ane of our greatest chances to driblet the suicide rate.
Jonathan Singer: Well, I promise that we're able to figure that out ane day, how to brand that happen.
Shawn Christopher Shea: Oh, that volition live wonderful.
Jonathan Singer: Yeah. I think it volition live great. Shawn, I want to give cheers you lot therefore much for taking your fourth dimension in addition to for sharing all these insights that you lot receive got gleaned over your 30+ years of–
Shawn Christopher Shea: Oh thanks.
Jonathan Singer: – of doing this work.
Shawn Christopher Shea: Thirty plus, it agency I'm really old, really.
Jonathan Singer: I'm sorry. The lastly iv years of – sorry.
Shawn Christopher Shea: I'm only 27. You know this, I dye my pilus white.
Jonathan Singer: [laughing] Yeah, it's an amazing look.
Shawn Christopher Shea: Yeah. These are imitation chins. That’s a imitation triple belly.
Jonathan Singer: But no, but seriously give cheers you lot for taking the fourth dimension to talking alongside us today–
Shawn Christopher Shea: Oh, it's my pleasure. It's an honor.
Jonathan Singer: – you lot know, nigh suicide assessment, the CASE Approach–
Shawn Christopher Shea: Yeah.
Jonathan Singer: – in addition to for doing the purpose play in addition to pose you lot on the hot spot in addition to you–
Shawn Christopher Shea: Oh yeah.
Jonathan Singer: – you lot exceeded all expectations.
Shawn Christopher Shea: Oh good. Thanks a lot Jonathan.
-- END --
References in addition to Resources
Reed, M. H. & Shea, S. C. (2011). Suicide Assessment inwards College Students: Innovations inwards Uncovering Suicidal Ideation in addition to Intent. In Understanding in addition to Preventing College Student Suicide, Dorian A. Lamis in addition to David Lester (Eds). Springfield, Illinois: Charles C. Thomas, Publisher.
Shea, S. C. (2012) The interpersonal fine art of suicide assessment: interviewing techniques for uncovering suicidal intent, ideation, in addition to actions. In The American Psychiatric Publishing Textbook of Suicide Assessment in addition to Management, Robert I. Simon in addition to Robert E. Hales (Eds). Washington DC: American Psychiatric Publishing.
Shea, S. C. (2011). The Practical Art of Suicide Assessment: Influenza A virus subtype H5N1 Guide for Mental Health Professionals in addition to Substance Abuse Counselors. Stoddard, N.H.: Mental Health Presses.
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| Some of Shawn's books on sale at the 2012 American Association of Suicidology conference |
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| Shawn in addition to I talking at the mass tabular array at the 2012 American Association of Suicidology Conference |
- This website has great resources for graduate students (and professors) in addition to to a greater extent than experienced clinicians including the Interviewing Tip of the Month, an up-to-date article on the CASE Approach, several other costless articles on interviewing in addition to teaching interviewing, every bit good every bit information on didactic workshops on suicide prevention in addition to on clinical interviewing. It also includes information on grouping experiential certification inwards the CASE Approach
APA (6th ed) citation for this podcast:
Singer, J. B. (Producer). (2012, September 11). #74 - The Chronological Assessment of Suicide Events (CASE) Approach: Interview in addition to purpose play alongside Shawn Christopher Shea, M.D. [Audio podcast]. Social Work Podcast. Retrieved from /search?q=the-chronological-assessment-of-suicide
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