References
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Leading causes of death by age group, united states-2017. Web-based Injury Statistics Query and Reporting System (WISQARS). http://www.cdc.gov/violenceprevention/suicide/statistics/leading_causes.html Accessed 15 June 2020.
Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, et al. Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull. 2017;143(2):187–232.
Barzilay S, Schuck A, Bloch-Elkouby S, Yaseen ZS, Hawes M, Rosenfield P, et al. Associations between clinicians’ emotional responses, therapeutic alliance, and patient suicidal ideation. Depress Anxiety. 2020;37(3):214–23.
Scocco P, Toffol E, Pilotto E, Pertile R. Psychiatrists’ emotional reactions to patient suicidal behavior. J Psychiatr Pract. 2012;18:94–108.
Galynker I. The suicidal crisis: clinical guide to the assessment of imminent suicide risk. New York: Oxford University Press; 2017.
Practice Guidelines for the Psychiatric Evaluation of Adults, Third Edition. In: The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults. American Psychiatric Association; 2015. https://doi.org/10.1176/appi.books.9780890426760.pe02 Accessed 22 June 2020
Assessment and Management of Patients at Risk for Suicide. In: VA/DoD Clinical Practice Guidelines. U.S Department of Veterans Affairs. 2019. https://www.healthquality.va.gov/guidelines/MH/srb/VADoDSuicideRiskFullCPGFinal5088212019.pdf. Accessed 22 June 2020
Beck AT, Steer RA, Ranieri WF. Scale for suicide ideation: psychometric properties of a self-report version. J Clin Psychol. 1988;44(4):499–505.
Hasley JP, Ghosh B, Huggins J, Bell MR, Adler LE, Shroyer ALW. A review of “suicidal intent” within the existing suicide literature. Suicide Life Threat Behav. 2008;38(5):576–91.
O’Connor SS, Carney E, Jennings KW, Johnson LL, Gutierrez PM, Jobes DA. Relative impact of risk factors, thwarted belongingness, and perceived burdensomeness on suicidal ideation in veteran service members. J Clin Psychol. 2017;73(10):1360–9.
Deisenhammer EA, Ing C-M, Strauss R, Kemmler G, Hinterhuber H, Weiss EM. The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt? J Clin Psychiatry. 2009;70(1):19–24.
Stone D, Simon T, Fowler K, Kegler S, Yuan K, Holland K, et al. Vital signs: trends in state suicide rates — United States, 1999–2016 and circumstances contributing to suicide — 27 States, 2015. MMWR Morb Mortal Wkly Rep. 2018;67:617–24.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.
Richards JE, Whiteside U, Ludman EJ, Pabiniak C, Kirlin B, Hidalgo R, et al. Understanding why patients may not report suicidal ideation at a health care visit prior to a suicide attempt: a qualitative study. Psychiatr Serv. 2019;70(1):40–5.
Dunster-Page C, Haddock G, Wainwright L, Berry K. The relationship between therapeutic alliance and patient’s suicidal thoughts, self-harming behaviours and suicide attempts: a systematic review. J Affect Disord. 2017;223:165–74.
Flückiger C, Del Re AC, Wampold BE, Horvath AO. The alliance in adult psychotherapy: a meta-analytic synthesis. Psychotherapy. 2018;55(4):316–40.
Flückiger C, Del Re AC, Wlodasch D, Horvath AO, Solomonov N, Wampold BE. Assessing the alliance-outcome association adjusted for patient characteristics and treatment processes: a meta-analytic summary of direct comparisons. J Couns Psychol. 2020;67:706–11.
Probst GH, Berger T, Flückiger C. The alliance-outcome relation in internet-based interventions for psychological disorders: a correlational meta-analysis. Verhaltenstherapie. 2019. https://www.karger.com/DOI/10.1159/000503432 Accessed 22 June 2020
Horvath AO. Research on the alliance: knowledge in search of a theory. Psychother Res. 2018;28(4):499–516.
Maltsberger JT, Buie DH. Countertransference hate in the treatment of suicidal patients. Arch Gen Psychiatry. 1974;30(5):625–33.
Modestin J. Counter-transference reactions contributing to completed suicide. Br J Med Psychol. 1987;60(Pt 4):379–85.
Barzilay S, Yaseen ZS, Hawes M, Gorman B, Altman R, Foster A, et al. Emotional responses to suicidal patients: factor structure, construct, and predictive validity of the Therapist Response Questionnaire-Suicide Form. Front Psychiatry. 2018;9:104.
Prabhakar D, Balon R, Anzia JM, Gabbard GO, Lomax JW, Bandstra BS, et al. Helping psychiatry residents cope with patient suicide. Acad Psychiatry. 2014;38(5):593–7.
Jobes DA. The Collaborative Assessment and Management of Suicidality (CAMS): an evolving evidence-based clinical approach to suicidal risk. Suicide Life Threat Behav. 2012;42(6):640–53.
Dimeff L, Linehan M. Dialectical behavior therapy in a nutshell. California Psychol. 2001;34.
Hayes JA. The inner world of the psychotherapist: a program of research on countertransference. Psychother Res. 2004;14(1):21–36.
Tuckett D. Does anything go? Towards a framework for the more transparent assessment of psychoanalytic competence. Int J Psychoanal. 2005;86(1):31–49.
Perry JC, Bond M, Presniak MD. Alliance, reactions to treatment, and counter-transference in the process of recovery from suicidal phenomena in long-term dynamic psychotherapy. Psychother Res. 2013;23(5):592–605.
Moukaddam N, Andry T, Cao J, Moon Y, Tucci V, Shah A, et al. Instant countertransference affects assessment and treatment recommendations for depression in patients openly professing religious faith. Spiritual Clin Pract. 2018;6(2):100–9.
Michaud L, Ligier F, Bourquin C, Corbeil S, Saraga M, Stiefel F, et al. Differences and similarities in instant countertransference towards patients with suicidal ideation and personality disorders. J Affect Disord. 2020;265:669–78.
Burwell-Pender L, Halinski KH. Enhanced awareness of countertransference. J Profess Counsel: Pract Theory Res. 2008;36(2):38–51.
Yaseen ZS, Foster AE. What Is Empathy? In: Foster AE, Yaseen ZS, editors. Teaching empathy in healthcare: building a new core competency. Cham: Springer Nature; 2019. p. 3–16.
Lomax JW, Foster AE. The empathy seminar: Building a strong foundation for caregiving competency. In: Foster AE, Yaseen ZS, editors. Teaching Empathy in Healthcare: Building a New Core Competency. Cham: Springer; 2019. p. 127–42.
Bylund CL, Makoul G. Examining empathy in medical encounters: an observational study using the empathic communication coding system. Health Commun. 2005;18(2):123–40.
Mercer SW, Maxwell M, Heaney D, Watt GC. The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure. Fam Pract. 2004;21(6):699–705.
Munder T, Wilmers F, Leonhart R, Linster HW, Barth J. Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients. Clin Psychol Psychother. 2010;17(3):231–9.
Funding
This work was supported by the R34 MH119294-01 grant from the National Institute of Mental Health (NIMH) and AFSP # LSRG-1-050-18 from the American Foundation for Suicide Prevention.
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Adriana Foster, MD, is funded by National Institutes for Mental Health and American Foundation for Suicide Prevention for clinical research.
Karina McCoy, PsyD, is funded by National Institutes for Mental Health and American Foundation for Suicide Prevention for clinical research.
Igor Galynker, MD, PhD, is funded by National Institutes for Mental Health and American Foundation for Suicide Prevention for clinical research.
Matison Alderman, Daniel Safin, Xenia Aponte, and Meghan Caughey have no disclosures.
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Foster, A., Alderman, M., Safin, D. et al. Teaching Suicide Risk Assessment: Spotlight on the Therapeutic Relationship. Acad Psychiatry 45, 257–261 (2021). https://doi.org/10.1007/s40596-021-01421-2
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DOI: https://doi.org/10.1007/s40596-021-01421-2