In the Room

Book Review: Suicide Risk Management A Manual for Health Professionals

Suicide Risk Management: A Manual for Health Professionals, by Stan Kutcher and Sonia Chehil is a good introduction to the subject of suicide assessment. This book in my view is geared to the beginning mental health professional. It is only 109 pages of well spaced text some of which is repeated in different layouts. Overall it is an extremely practical book which is written in easy to read language.

The book divides up into roughly four sections. The first section backgrounds and provides an  understanding of suicide. It has helpful little sections such as common myths about suicide. It covers a spectrum of disorders and situations where suicidal behaviour may be more prevalent and does a good job of covering and discussing a range of risk factors.

The second section looks directly at suicide risk assessment. They provide a practical four step process with a structured Suicide Risk Assessment Guide (SRAG) complete with flow diagrams to help you visualise each stage of this assessment process. I found this section quite useful even as an experienced clinician. Because I don’t deal with suicide on a daily basis in my practice it is easy to forget things and Kutcher and Chechil use of simple acronyms is very helpful. They emphasise the need to ask “the question” and provide a number of good ways to do this. Bottom line is you need to call a spade a spade but in a gentle and empathic way. Their suggestions include"

• Have you ever thought about harming yourself?
• Have you ever tried to do anything to yourself that could have seriously harmed you or killed you?
• Have you been thinking about killing yourself lately?

The third section deals with commonly encountered problems. This is one of the weaker sections in the book. It is only a few pages long and deals with complex issues such as countertransference and self harm or repeated low lethality clients in a brief and glib manner. Advice such as, avoid common traps such as manipulation and exploitation with no suggestion on how do this, is not helpful in my view.

The last section of the book focuses on what they call “Bringing it all together” and introduces a summary assessment tool on which to rate potential risk. Again they provide a nice structured way of doing this with their Tool for the Assessment of Suicide Risk (TASR). This is essentially a rating from for collating the information gathered with the Suicide Risk Assessment Guide (SRAG). Some practice using this with a range of vignettes is provided.

Overall a practical easy written book geared to the beginning professional. It is certainly a book I could recommend to my interns. Personally I would have liked more meat on the bones but then I don’t think I am necessarily this book's target market.

Received from the publisher 18^th December 2006.

The Short and the Long of it: What’s on my Bedside Table.

I have just picked up the recently published paperback version of R. Horacio Etchegoyen’s book: Fundamentals of Psychoanalytic Technique. This book was first published in 1991 and has been on my must read for some time. At some 800 pages it needs quite some time to be read and digested. However Etchegoyen has a delightfully easy to read style and makes many of the complex concepts of psychoanalysis readily understandable, at least to me who always struggled to some degree with Freud in the original. The focus of the book is on technique and not theory and it goes well beyond the last book of this type which in my view was Greenson’s book: The Technique and Practice of Psychoanalysis which sadly only every got to Part I.

For those of you who cook I liken this book to Madeleine Kamman’s book: The Making of a Cook. Everything is covered in fine detail but this is no dry technical tome, the personal character and passion of the author comes through on page after page. It is book you can read solidly or dip into repeatedly and always come up with something new. I have a soft spot for Argentineans. A favourite poet of mine is Gorges Luis Borges. His poem: Another Poem of Gifts hangs on my wall, a reminder to keep life in perspective. Racker’s book on countertransference I return to with some regularity.

If Etchegoyen’s book is a Kamman then Coren’s book Short Term Psychotherapy is a Jamie Oliver cookbook. Short, slightly frothy with a few great recipes. Coren whips through the shorter dynamic psychotherapies in fifty or sixty pages with a competent brief few pages on each. It is the middle of this book which is the more satisfying for me with a number of chapters devoted to technique in shorter term therapy integrating a number of ideas but particularly Malan’s. There is a nice discussion for example on the when, how and the need to make transference based interpretation in shorter term dynamic therapy. These chapters are extremely practical and easy to understand. I would recommend this as an introductory text for anyone thinking about taking up short term psychodynamic therapy.

 

 

New Book: Clinical Psychology for Trainees

A plug for a new book, Clinical Psychology for Trainees: Foundations of Science-Informed Practice,by a local colleague,  Professor Andrew Page.  Looks good, particularly for those starting their training in clinical psychology.

This book describes the practice of clinical psychology with special emphasis on providing trainee therapists with the skills and strategies to achieve the core competencies required for a science-informed clinical practice. It will support the reader in making the transition from the lecture theatre to the consulting room. The approach incorporates a contemporary perspective on the multiple roles of clinical psychologists within a competitive health care market, where professional psychologists not only need to be accountable for their outcomes and efficient in achieving them, but also need to be conscious of the social and political context in which psychology is practised. Chapters are organised around the acquisition of key competencies and linked within an evidence-based, science-informed framework. Case studies, handouts, graphics and worksheets are employed to encourage the implementation of the skills described. This book should be read by all those enrolled in, or contemplating, postgraduate studies in clinical psychology.