Copyright 2014, Midnight Demon p 10-11. All rights reserved. Collerone, G
David Jobes is my idol. I really love his works and he is a great suicidologist. He really gets what it means to be suicidal and better than that, he wants to help suicidal people. Most clinicians do not want to deal with suicidality with a ten foot pole. They are afraid of the risks involved, from liability to malpractice to ethical concerns. Dr. Jobes has written about all of this and with a passion created a clinical framework to deal with this population. The framework is called CAMS (Collaborating Assessment, and Managing of Suicide). It is a philosophical yet empirical theory that has helped thousands of suicidal people get out of their suicidal thinking and on with their lives. CAMS was developed specifically to modify clinician behaviors in how they initially identify, engage, assess, conceptualize, treatment plan, and manage suicidal outpatients. It is a brilliant concept that is much needed in outpatient therapy as inpatient treatments have gone by the way side and insurance companies have dictated more on treatment than clinical matters. The heart of CAMS is the emphasis on a strong therapeutic alliance where counselor and client work closely together to develop a shared understanding of what brings the client to think about suicide. CAMS is similar to the Aeschi model, where the clinician is open to hearing the clients story of why they are suicidal. It is a patient oriented model rather than a physician oriented model.
These CAMS model has an assessment tool called the Suicide Status Form (SSF) and it is used to assess, treatment plan, and track suicidal patients. The cool thing about this assessment is that it multi-faceted and is not restricted to one mode of therapy or type of clinician. It can be used across all disciplines and types of therapists (DBT, CBT, psychodynamic, etc.) As long as there is a willingness to adhere to the principles of putting the client first, that is the first step in the right direction.
The SSF is a seven page assessment tool that is used to initiate, track and follow the outcome of suicidality. It was created so people who are suicidal are not lost to follow up. More can be said about this in Jobes’s book, Managing Suicide Risk.
I have used the SSF in my therapy. But I have to confess that my therapist and I never followed through completely with it. We would use the initial and the tracking forms but never quite got to the outcome phase of the assessment. Because I felt like it was my idea, and she wasn’t into changing her style of treatment, it was difficult to follow through. But that is okay because I am still here regardless. We mostly use the SSF to assess my psychological pain, reasons for living/dying, and the level of my suicidality.
I will repeatedly talk about the works of Jobes, Shneidman, and the Aeschi model throughout this book. It is because I think there is not enough awareness of this in the world of psychiatry, psychotherapy and psychology. And there is even less in the training of therapists and future psychiatrists. It really is a shame that not enough awareness of suicide is mentioned in the course of graduate college training and it is often left up to the students to figure it all out on their own, if at all. Usually it isn’t until a suicide or attempted suicide happens that people have hindsight and that isn’t always 20/20.
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