Stallman Helen M
Senior Lecturer, Psychology, Centre for Social Change, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia.
Australas Psychiatry. 2018 Apr;26(2):141-144. doi: 10.1177/1039856217732471. Epub 2017 Oct 2.
Suicide is a leading cause of premature death and, despite significant investment, the prevalence rate has remained relatively stable for more than a decade. Theoretically, the use of 'safety planning' as a response to suicidality likely maintains suicide as a potential solution for vulnerable people. This paper describes a theoretically-supported paradigm shift from safety planning to 'coping planning' to improve patient outcomes and improve the confidence and competence of clinicians working with people with suicidality.
Coping planning is a strategy used to support people with acute distress. Its components of 'caring', 'collaborating' and 'connecting' reinforce existing strengths, promote self-efficacy and link people with more intensive supports, as needed. Coping planning overcomes the limitations of existing approaches. It reframes suicide prevention from managing patients disclosing suicidality to ensuring patients have minimally sufficient temporary support to help them cope. This approach has the potential to promote coping self-efficacy and prevent deterioration that leads to suicide.
自杀是过早死亡的主要原因,尽管投入了大量资金,但十多年来患病率一直相对稳定。从理论上讲,使用“安全计划”来应对自杀倾向可能会使自杀成为弱势群体的一种潜在解决方案。本文描述了一种从安全计划到“应对计划”的理论支持的范式转变,以改善患者预后,并提高与有自杀倾向者打交道的临床医生的信心和能力。
应对计划是一种用于支持处于急性痛苦中的人的策略。其“关怀”“协作”和“联系”的组成部分强化了现有优势,提高了自我效能感,并根据需要将人们与更深入的支持联系起来。应对计划克服了现有方法的局限性。它将自杀预防从管理披露自杀倾向的患者转变为确保患者获得足够的临时支持以帮助他们应对。这种方法有可能促进应对自我效能感,并防止导致自杀的病情恶化。