To Treat or Not to Treat: The Effect of Hypothetical Patients' Suicidal Severity on Therapists' Willingness to Treat.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 9504451 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1543-6136 (Electronic) Linking ISSN: 13811118 NLM ISO Abbreviation: Arch Suicide Res Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: Dordrecht ; Boston : Kluwer Academic Publishers, c1995-

Behavior Control*/methods ; Behavior Control*/psychology ; Depression*/diagnosis ; Depression*/psychology ; Depression*/therapy ; Suicide*/psychology ; Suicide Prevention*; Adult ; Attitude of Health Personnel ; Countertransference ; Female ; Humans ; Male ; Preventive Psychiatry/education ; Preventive Psychiatry/methods ; Professional Competence ; Psychiatric Status Rating Scales ; Psychiatry/methods ; Psychosocial Intervention/methods ; Psychotherapeutic Processes ; Risk Assessment/methods ; Suicidal Ideation

Therapists' intense negative emotional responses regarding suicidal patients raise questions about therapists' willingness to treat them; however, this issue has yet to be investigated. The aim of the current study is to examine to what extent the severity of suicidality of a hypothetical patient will influence therapists' willingness to treat and the likelihood of their referring out. Mental health professionals (N = 249) completed a questionnaire that presented a vignette of a hypothetical patient referred for psychological treatment. The vignette contained a manipulation of the severity of suicidality levels of the referred patient, with two randomly assigned conditions: suicidal or depressive symptoms. Participants were then asked about their willingness to treat the hypothetical patient. Our results showed that willingness to treat was significantly lower and the likelihood of referring out was significantly higher among therapists in the suicidal patient condition, relative to the depressive patient condition. Longer professional seniority and previous training in suicide prevention moderated these effects. Our findings highlighted therapists' reluctance, especially among young practitioners, to treat suicidal patients, an inclination that may have a critical impact on patient suicidal outcomes. Findings reinforced the need for specific training on suicide prevention in the mental health curriculum.

Keywords: countertransference; risk assessment; suicide; suicide prevention; therapist reactions

Date Created: 20190620 Date Completed: 20211008 Latest Revision: 20221207

20240628

10.1080/13811118.2019.1632233

31213144