O’leary and Gould researched on men who were sexually abused in childhood and subsequent suicidal ideation by doing community comparison, explanations and practice implications. Both researchers who based in Australia believe that it is important to undertake a research that helps explain the manifestation of suicidality in men due to the high suicidal rate in the western world.
Much of the previous research have been restricted to women therefore there was a lack of research in men presentation of suicidal ideation. The study draws on a clinical sample of 147 Australian men who were sexually abused in childhood and comparisons are made with a community sample of 1,231 men. It was found that the sexually abused men were up to ten times more likely to report suicidal ideation.
To understand risk factors for suicidal ideation, a regression model was constructed and researcher found that the most important variables in this model include self-blame, isolation and physical injuries sustained from the abuse. These variables are further explored qualitatively where more detailed responses were collected and analysed. This study emphasizes the need for screening and assessment of men in clinical populations as well as in other vulnerable populations.
It calls for high levels of skill in therapeutic engagement by the worker in order to create the climate within which disclosure and assessment can take place. Men have a greater tendency to not recognise or respond to their own negative emotions or distress, which may result in more chronic and severe emotional responses to adverse life events.
Men are less inclined to communicate feelings of despair or hopelessness, and are more likely to present a stoic attitude towards misfortune and have fewer social connections. Differences in help seeking between men and women are additional contributing factors. Men tend not to seek help for emotional difficulties, often feeling that help-seeking is a weakness or failure and preferring to solve problems on their own, without being a burden on others.
Compounding this is a frequent lack of awareness among men of available support services, or a sense that these services do not adequately cater for their needs and would not help in their situation. To begin to understand suicide in men we need to acknowledge the psychobiological and cultural realities and demands on men’s lives. Counsellor should routinely ask about suicidal thoughts and behaviour, whatever the reason a man is seeking help for.
Initial client history forms should include questions about previous suicidal behaviour and exposure to other’s suicidal behaviour and trauma, and these should be followed up through verbal inquiry. Many men may respond better to psychological treatments that encourage problem solving and enhance their ability to develop coping strategies and gain control over their emotions and circumstances. Strong social connectedness is a protective factor worth cultivating and supporting in men. Men in transition need to be supported to reach out and maintain social and family connections.
The importance of employment and financial security cannot be understated in the lives of men. Consideration and support of these protective factors will mitigate risk for suicide and enhance wellbeing. Continuity of care is of utmost importance for suicidal clients; if referring on, consider providing follow-up call or caring postcards to support a smooth transition and continued uptake of care. Suicide prevention programs for men should generally draw on men’s skills and strengths, rather than on perceived failings or shortcomings.
It is also valuable to introduce suicide prevention programs that target the family and friends of suicidal men who do not seek help themselves. The role of the counsellor is to assist a client in altering their constricted thinking, and in moving from a death-oriented position to a life-oriented position. Ultimately, we want to assist the suicidal client in untangling and addressing what is driving the suicidal feelings, and in helping them re-develop a sense of hope, as well as increase connections with family and community support systems, including peer support.
Grief takes place when people lost loved ones in their lives. It is an overpowering negative emotion due to the lost but can be decrease over time. Researcher found out there was about ten to fifteen percent of people who can be extended, extenuate and critically affect grief-stricken individuals. Authors revealed that as high as about 30% to 70% people have complicated grief. Complicated grief is defined by overwhelming sadness that can’t diminish even after six months of post-lost.
One continuously grief intensely, psychological and emotional is in distress that leads to impairment of occupational and social ability. It is different from adaptive grief and will attenuate with time, adversely complicated grief may lead to other problems like suicidal ideation and behaviour, sleep disturbance, disruption in daily activities, and increased substance use.
Some go to the extent of developing other mental disorders like heightened panic or bipolar disorder. This article provides clarification between adaptive grief and complicated grief, giving suggestion on how to diagnose and craft treatment plan for client with complicated grief.
Clinician needs to understand the difference between adaptive and complicated grief. Client with complicated grief will need more time to collaborate as one social and psychological function is impaired. Therefore, empathize with unconditional positive regard cum understanding will help in building therapeutic alliance with client.
Clinician needs to check in with client on suicide ideation. If the deceased is caused by other party, then clinician need to check in at homicide intention too. A contract of suicide and homicide need to be secure if both are denied at the time of counseling; with phone contacts given to the client in case they are in emergency and can’t share their suicide ideation or homicide intention.
Assess client whether have the following criteria such as prolong grief meet time length to qualify for complicated grief if persists for at least six months; powerful yearning to reconnect with the deceased; inability to accept the death of deceased, aimless about life and can’t move forward in creating own life. Client is confused, distrust others, apathy, shock, bitterness or anger surrounding the loss.
Counsellor can use assessment tools to ascertain client’s level of complicated grief. Besides this, a few treatment skills are suggested for counsellor to use. First skill that was mentioned is Imaginal Revisiting which is similar to prolonged exposure, where bereave client tell the story of deceased and face up with aspects of event that prevent one from accepting the lost, counselor process and reflect with client and working at accepting the present and make plans for future.
Second skill, Imaginal Conversation is a figurative dialogue between the griever and the deceased loved ones with intention to process issues that ignite guilt or inconclusive relationship with the deceased and followed by Emotional Memory Work where the bereave will attend to both positive and negative memories of the deceased loved ones and will also review future planning, life goals and ignite meaningful relationships.
Utilizing Cognitive Behavior Therapy to help client with complicated grief by using technique of exposure; such as talk and write down prevent thought, painful emotion and stop visiting places which will trigger memory. The other tool is cognitive reframing the events, thoughts and meaning so bereave client can move forward from complicated grief stages and eventually to adaptive grief.
Counselors should go through training so one can recognize between common grief and complicated grief and provide appropriate treatment for their bereaved clients. The paper further emphasizes that counselor educators should bring everybody attention to the symptoms of complicated grief and guide them to use appropriate screening and assessment instruments. This research paper enlightened and motivated me to learn and look for suitable assessment tools that can be used when working with bereaved client.