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When the Unthinkable Happens: A clinician’s guide to coping with the suicide of a patient.


Thursday, February 7, 2019: 3:45 PM-5:15 PM
Desert Salon 5/6 (JW Marriott Desert Springs Resort and Spa)

Background: Suicide is considered an occupational hazard for mental health clinicians.  In training, practice guidelines, and CME there is a significant amount of attention paid to suicide assessments and potential interventions. Very little is taught about how to manage after the loss of a patient to suicide which can lead to personal and professional consequences. This workshop will bring to light common reactions to the loss of a patient to suicide using cases. In addition the presenters will discuss possible interventions at the personal, colleague, institution and field to help clinicians build resiliency following the loss of patient to suicide.

Objectives:

  1. Review data on rates of suicide for different types of mental health workers and the reactions and impact of a patient’s suicide on a clinician, including the impacts on personal and professional life
  2. Discuss ways to cope with a patient’s suicide on a personal, professional, collegial, medico legal, and institution level
  3. Advocate for professional training and guidance for coping with a patient’s suicide in training and in continued education settings

  1. Introduction
  2. Brief survey of who is in the audience, if their institution has a policy or plan for if a patient completes suicide
  3. Overview of epidemiological data on rates of suicides and the numbers of clinicians affected
  4. Through cases will discuss the following:
  5. Common personal reactions
  6. Potential professional reactions including difference based on stage in career (trainee vs seasoned clinician)
  7. Medicolegal concerns
  8. Recommendations for intuitional responses to suicide
  9. Discussing ways to open up this conversation in professional circles
  10. Discuss sample curriculum for trainees and possible CME
  11. Discuss resources that exist currently if a clinician experiences a patients suicide

It is estimated that there are 30,000 suicides a year with about half of those being under the care of a mental health treatment provider, therefore it is estimated that there are 15,000 clinicians yearly that survive the loss of a patient to suicide. Studies have shown that about 50% of psychiatrists, 25% of psychologists, and 25 % of counselors have lost at least one patient to suicide. In training, continuing education, supervision, and medico-legal advice the emphasis in on suicide assessment and treatment. Intellectually clinicians learn and know that despite this training; clinically it is almost impossible to predict with accuracy who will attempt suicide. For the most part the training ends at the assessment and treatment but fails to give any practice parameters, guidelines, or training on what to do when a patient completes suicide. This interactive presentation, using clinical cases, will discuss common reactions when a patient completes suicide including impacts in a clinicians professional, legal, and personal life. The workshop will explore recommendations for clinicians, supervisors, front line staff, and institutions on how to proceed after a patient completes suicide that is designed to help the team deal with the loss in appropriate way that helps minimize the negative impacts on the clinician, explores the lessons that may be learned, and maximizes chances for increased resiliency. There will be a review of proposed curriculums on postventions after a completed suicide for training programs in psychiatry. Attendees will learn of resources available to cope with the loss of a patient to suicide or to help a trainee or colleague cope. Attendees are encouraged to participate and bring examples from their own practice to discuss.
Primary Presenter:
Nicole Garber, MD

Nicole Garber graduated from Saint Louis University School of Medicine, she completed her general psychiatry residency training at Emory University School of Medicine, and completed a child and adolescent psychiatry fellowship at Baylor School of Medicine. She began to work with Baylor at the Menninger Clinic. She is currently the medical director at The Meadows Ranch. She is extensively trained in DBT, TF-CBT, mentalization based treatment, and is currently in child and adolescent psychoanalytic training.



Co-presenters:
Sindhu Idicula, MD

Sindhu Idicula graduated from the University of Texas Medical Branch School of Medicine and completed both her general psychiatry residency training and child and adolescent psychiatry fellowship training at Baylor College of Medicine. She continued as faculty there where she spent time caring for patients with eating disorders. She is actively involved in education, teaching at the medical school and for residents. She is also deeply interested in psychotherapy, and has pursued training in DBT, psychodynamic psychotherapy, and is currently a clinical candidate in adult psychoanalytic training.



and Edle Aasland, LPC

Edle Aasland Graduated with her Masters in Counseling at Northern Arizona University. Edle initially worked with Trauma survivors including those who have experienced loss from Suicide. Most recently Edle has worked at The Meadows Ranch as a therapist and as an administrator for women who are struggling with an Eating Disorder and comorbid diagnosis at a residential level. Edle has been trained in EMDR, DBT and TF-CBT.



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