School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
New South Wales Health, Australia.
Psychother Res. 2024 Sep;34(7):972-990. doi: 10.1080/10503307.2023.2253360. Epub 2023 Sep 25.
The experience of frontline clinicians is an underutilized source of knowledge about improving youth suicide intervention. This qualitative study explored the perspectives of highly experienced, specialized mental health clinicians on the practical application of risk assessment, stabilization, and treatment and their experience of working in this practice area. Data were collected from seven focus groups with 28 clinicians and analyzed using consensual qualitative research methods. Four domains emerged, describing 1) youth suicide intervention as relationally focused and attachment-informed, 2) the need for flexible and tailored care balancing individual and family intervention in the context of family complexity and fractured relationships, 3) a nuanced, therapeutic approach to managing the complexity and uncertainty of adolescent suicide risk, and 4) working in youth suicide intervention as emotionally demanding and facilitated or hampered by the organizational and systems context. The importance of harnessing family systems and attachment-informed approaches to alliance, risk assessment, and treatment was emphasized, along with the parallel need for systemic clinician support and consideration of the potential negative consequences of administrative and risk management protocols.
一线临床医生的经验是改善青少年自杀干预的一个未被充分利用的知识来源。本定性研究探讨了经验丰富的专业精神健康临床医生对风险评估、稳定和治疗的实际应用的看法，以及他们在这一实践领域的工作经验。研究从七个焦点小组收集了 28 名临床医生的数据，使用共识定性研究方法进行了分析。四个领域出现了，描述了 1）青少年自杀干预注重关系和依恋信息，2）需要灵活和量身定制的护理，平衡个人和家庭干预，考虑到家庭复杂性和破裂关系的情况，3）对青少年自杀风险的复杂性和不确定性进行细微的、治疗性的处理，4）在青少年自杀干预工作中情感上的要求，以及组织和系统环境的促进或阻碍。强调了利用家庭系统和依恋知情方法来建立联盟、进行风险评估和治疗的重要性，同时也需要系统的临床医生支持，并考虑行政和风险管理协议的潜在负面影响。
