Children and Adolescent Suicide Behavior Essay

Introduction

Suicide entails taking one’s life. On the other hand, suicidal behavior involves the contemplation of plans and thoughts to take one’s life. Suicidal behavior precedes suicide. Therefore, controlling suicidal behavior is a success factor for mitigating incidents of suicide. Among the many groups of people who are susceptible to showing suicidal behavior, adolescents take the front line (Berman et al., 2006, p.1116).

This result forms the rationale for the focus of this assessment paper. Nevertheless, since incidences of suicide are recorded across people of different ages, suicidal behavior amounts to a serious and significant public health problem across the globe. Surprisingly, incidences of suicide are preventable through various social work and psychiatric interventions.

According to the American Association of Suicidology, such interventions include “effective assessment and treatment of people with mental disorders, promotion of help-seeking, early detection and support for youth in crisis, training in life skills, and reduction of access to lethal means” (2011, p.1).

However, the extent to which these approaches have been effective in the achievement of the noble goal of reducing incidences of suicides in America remains questionable. This argument is relevant since the Center for Disease Control and Prevention (2012) informs that incidences of adolescent suicides have been on the rise over the last one decade (p.1).

The focus of this paper is to scrutinize the prevalence of youth suicidal behavior. It proposes a methodology for assessing and diagnosing the problem besides providing an extensive explanation of the relevance of the proposed methodology within the sphere of social work.

The paper also endeavors to evaluate the weakness of the proposed method of assessing adolescent suicidal behavior coupled with presentation of mechanisms of modifying the methodology to lessen its problems.

Prevalence of Adolescent ideation Suicidal Behavior

Known/Unknown Facts about Adolescent Suicidal Behavior

Several facts are known about adolescent suicidal problem. In fact, among the many causes of youth’s deaths, suicide is incredibly significant. World Health Organization (2001) puts it among “the top 3 causes of death in the population aged 15 to 34 years” (Para.1).

The Center for Disease Control and Prevention (2012) confirms this rating by emphasizing that suicide is in the third position in the list of the causes of deaths of people aged between 10 to 24 years (p.2). It results in the loss of an approximated 4600 lives of the US’ adolescents annually.

In addition, with regard to the Center for Disease Control and Prevention (2012) statistics, among the top three means used to accomplish adolescent suicides, the use of firearms stands at 45 percent with self induced poisoning and suffocation being at 8 percent and 40 percent respectively (Para 7).

Risks for contemplation of plans to commit suicide increase substantially during adolescence. In this regard, according to Liu (2004), “prevalence rates for suicidal ideation among adolescents were estimated to be 11% for severe suicidal ideation to 75% for any degree of suicidal ideation with an average rate of 20% for suicidal ideation and 8% for suicide attempts” (p.1352) in 2003.

These prevalence rates for suicide ideation are shocking since they are indications of the threshold of the dangers of successful cases of suicides completion in the future. Many scholars find many of the suicides that are completed as having been instigated by multiple factors including “psychological, family, biological, social, and cognitive factors” (CDC, 2012, Para.11).

The prevalence of adolescent suicides also appears as largely unbalanced on gender and age demographic factors in the U.S. For instance, according to the Centre for Disease Control and Prevention (2012), “of the reported suicides in the 10 to 24 age group, 81% of the deaths are males and 19% are females” (Para. 10).

However, the same source argues that girls are more likely to attempt suicides in relation to boys. Suicide associated fatalities are also more prevalent among the Native American youths (CDC, 2012, Para.11: Berman et al, 2006, p.1116).

However, how to eradicate suicidal behavior completely among the adolescents remains unknown because, amid the various interventions, health organizations in the US continue to register fatalities associated with the problem.

Diagnosing and Assessing the Problem

Method

CBT (cognitive-behavioral therapy) is the proposed method for diagnosis and assessing suicidal behavior of adolescents. However, it is crucial to note that, in diagnosing and or assessing adolescents’ suicidal problem, a consideration of risk factors for instigation of the plans and thoughts for committing suicide is paramount.

Therefore, identification of individual circumstances that may lead to expressions of such a suicidal problem among adolescents amounts to a successful assessment procedure.

In helping to treat the problem, patients are put on psychotherapy to relax potential inhibitors for a free expression of certain aspects such as stress and stereotyping that are experienced in the life of the patient that may contribute to the suicidal behavior. Objectives

The objective of relaxing the mind of the patient through psychotherapy is to:

• Make it possible to acquire information on the patient’s history of suicidal attempts.
• Get information on the history of suicidal behavior in the a patient’s family.
• Acquire information on the encountered stressful events in the life of the patient.
• Get information on the patient’s incarceration.
• Dig out the existence of cases of mental illness and or history of depression in the patient’s life.
• Know whether the patient has easy access to lethal methods for suicide such as firearms.
• Extract information on the history of patient’s engagement in drug abuse and or excessive alcohol consumption.

Preferred Assessment Procedure

Steps

To achieve the above objectives of psychotherapy as the approach for helping to diagnose and assess the adolescents’ suicidal behavior through CBT, a number of steps (preferred assessment procedure) will be deployed. They include:

1. Conducting preliminary examination of the likely causes of suicidal behavior in the patient (This may involves establishing the historical background of the patients such as how they relate with their parents, economic conditions, or whether the patient abused alcohol)
2. Creating artificial stimuli to force the patient to express his or her feelings as established in (i) above (An example of artificial stimuli is giving patient alcohol if it is thought by the assessor to be the cause of the problems)
3. Managing and creating necessary additional artificial stimuli that prompt a full expression of behaviors observed in (ii)
4. Observation of the likely contributing risks to the suicidal behavior not established in the preliminary examination step to develop the requisite stimulation approaches for their portrayal (The doctor can monitor the reactions or behavior of the patient to see whether he or she has any signs of stress)

When the patient has fully expressed his or her life experience concerns that may result in suicidal ideation behavior, corrective mechanisms for such behaviors are considered. The point at which the patient has fully expressed his/her risk factors to the contemplation of plans to commit suicide is known when the patient attempts to develop a tolerant mechanism of the risk factors expressed upon execution of steps (i), (ii), and (iv).

Usefulness of the Mode of Assessment for Social Work

Many social work scholars contend that the majority of adolescents who are put under their care have psychological challenges associated with depression. In fact, with regard to Donaldson, Spirito, and Esposito-Smythers (2005), “…depression is among the most common reasons cited by adolescents when seeking treatment” (p.113).

Depression is also a risk factor for making adolescents resort to drug abuse and excessive consumption of alcohol as perceived mechanisms for enabling them to manage stress that is associated with experiences such as family conflicts. Therefore, by managing well depression among adolescents, it is also possible to manage the associated risk factors that may lead to contemplation of plans and thoughts to commit suicide.

The question is how to achieve a successful depression management strategy among adolescents. The solution to this query rests on CBT in which Spirito, Wolf, and Uhl (2011) argue, “Cognitive-Behavioral Therapy (CBT) has been the most widely researched psychotherapy approach to treating depression in adolescents” (p.191).

A common argument among clinical scholars is that completed suicides coupled with suicidal ideation would disappear when the depressive disorders among adolescents are treated.

However, the above argument faces challenges because of the evidence that treatment of depressive disorder does not necessarily imply that suicidal ideation will disappear because depressive disorders, which may lead to suicide ideation have their causes. Consequently, the most effective way to deal with depressive disorders is to address the causes of the suicide ideation to be dealt with completely.

For instance, among the adults, Linehan (2007) posits, “suicidal thoughts and behavior need to be directly addressed if problems associated with depressive disorder are to improve” (p.305).

Therefore, CBT as a methodology of helping in diagnosis, assessment, and treatment of suicidal behavior problems among adolescents is useful in social work to the extent that it can lead to the elimination of the depressive disorders and suicidal ideation. Arguably, the methodology is helpful in social work particularly when applied consistent with the success of the suicidality model for adults.

The model evidences how “suicide attempts emerge from reciprocity among maladaptive cognition, behavior, and affective responses to stressors” (Brent & Melhem, 2008, p.158).

In particular, the model argues out that suicidal behaviors among adolescents emanate from “genetic predisposition toward psychopathology, and/or exposure to significant negative life events such as history of abuse or neglect, adverse parenting resulting from parental psychopathology, and peer victimization, and bullying” (Kim & Leventhal, 2008, p.133).

This argument concurs with the objectives of the proposed method of diagnosing and assessing suicidal behaviors among adolescents in this paper. Therefore, based on the success of adult approaches to diagnosis and assessing suicidal behaviors and on upon considering that the proposed method borrows from the models, one would expect the proposed model to be important in the achievement of the laid out objectives.

Weakness and Deficiencies of the Mode of Assessment

Even though it is held that the proposed mode of assessment will be successful in assessing suicidal ideation behavior among adolescents, it is not immune from deficiencies and weaknesses. A major deficiency is its reliability in only cognitive and behavioral therapeutic interventions.

Therefore, the advantage of diagnosis intervention in contributing to quick relief of patients from depressive situations so that they can easily adapt and respond quickly to psychotherapy is forgone. Secondly, the authentication of the proposed model largely depends on the success of adult-focused models of management of suicidal ideation behaviors.

Modifications to Overcome the Weakness: Improving Efficacy of the Mode of Assessment

Use of medicine such as anti-depressants can incredibly aid in quick relaxation of the minds of patients. While this may not be a permanent solution to the depressive disorders leading to the development of suicidal behaviors among adolescents, it is a necessary element for incorporation in the proposed methodology of CBT as a mode of diagnosing and assessing suicidal behavior problems in adolescents.

Hence, in the steps for assessing suicidal behavior problem among adolescents, prescription of medication coupled with checks for medication adherence precedes (i) above. Assessment of suicidal thoughts, suicidal ideation behaviors, and various risk factors for portrayal of suicidal ideation behaviors follow later.

To overcome the second weakness, it is necessary that evidence-based analysis for suicidal ideation behaviors intervention for adolescents proposed here be conducted before it is implemented. This helps in reducing problems associated with generalizations.

One of the generalizations is assuming that it will also be successful in handling similar problems among the adolescents since similar methods are successful in handling suicidal ideation behavioral problems among the adults.

Why the Proposed Modifications are Helpful: How to do their Evaluation for Effectiveness

CBT intervention for the suicidal behaviors among adolescents emphasizes two approaches: behavioral and cognitive facets of care. With regard to Spirito, Wolf, and Uhl, “the behavioral component of treatments for depression emphasizes various skill deficits in the domains of coping skills, interpersonal relationships, social problem solving, and participation in pleasant activities” (2011, p.194).

On the other hand, the cognitive facet embraces focusing on the process of identification coupled with challenging the adolescents’ processes of automatic thoughts.

Consistent with these concerns of behavioral and cognitive facets of CBT, Spirito, Wolf, and Uhl posit, “CBT for depressed adolescents addresses lagging cognitive and behavioral skills that are needed to create and maintain supportive relationships to regulate emotion” (2011, p.197).

Arguably, adolescents seeking psychological interventions to suicidal ideation behavior problems will be admitted with less ability to make appropriate choices to enhance the cognitions of the repercussions of engaging in suicidal ideations. Therefore, before the administration of CBT, it is critical to ensure that a patient does not have lagging behavioral and cognitive skills.

To achieve this, administration of medication such as depressants is vital. Therefore, the capacity of the proposed method for managing suicidal behavior of adolescents to produce reliable results is dependent on the modification of the desired procedures to integrate the roles of anti-depressant interventions in the management of risk factors that may lead to expression of suicidal behaviors among the adolescents.

The next thing that stands out is the challenge of evaluation of the efficacy of the modified procedures in the realization of the goals and objectives of the proposed method. The modified method is evaluated by conducting reviews on the efficacy of CBT in the management of depressive disorders among the adolescents.

The rationale for emphasis on the capacity of the adopted CBT approaches in the management of the suicidal behaviors among adolescents rests on the pillars of the argument that depressive disorders are significant risk factors to suicidal ideation behaviors (Klein, Jacobs, & Reinecke, 2007, p.1405).

Conclusion

Therefore, based on the expositions made in the paper, it is clear that adolescents are at a higher risk of committing or rather attempting suicides. The stage is associated with the exploration of many things such as ones ability to approach another of the opposite sex and the creation of peer groups amongst others.

These explorations are risky to many young people since many join them without knowing the repercussions that they can face if they are not watchful of their behaviors. Therefore, upon disappointments, adolescents resort to life endangering attempts such as suicidal ideation as a way of relieving the pain. The prevalence rates for cases of adolescents’ suicides are still evident amid the enormous efforts to curtail them.

Consequently, it is paramount to design and implement various methods for continued fight against such incidences. The paper has proposed one of such methods. The method entails the use of CBT approach, which is modified to integrate medicinal intervention in the management of suicidal behavior among adolescents.

Reference List

American Association of Suicidology. (2011). Youth Suicidal Behavior-Facts Sheet. Web.

Berman, A., Jobes, D., Morton, M., & Silverman, D. (2006). Adolescents’ Suicide: Assessment and Intervention. American Journal of Psychiatry, 163(6), 1116-1117.

Brent, D., & Melhem, N. (2008). Familial transmission of suicidal behavior. Psychiatr Clin North Am, 31(2), 157–177.

Centre for Disease Control and Prevention (2012). Youth Suicide Prevention. Web.

Donaldson, D, Spirito, A, Esposito-Smythers, C. (2005). Treatment for Adolescents Following a Suicide Attempt: Results of a Pilot Trial. Journal of American Academic Child Adolescent Psychiatry, 44(2), 113–120.

Kim, Y., & Leventhal, B. (2008). Bullying and Suicide. International Journal of Adolescent Medical Health, 20(2), 133–154.

Klein, J., Jacobs, R., & Reinecke, M. (2007). Cognitive-Behavioral Therapy for Adolescent Depression: A meta-analytic Investigation of Changes in Effect-size Estimates. Journal of American Academy for Child Adolescent Psychiatry, 46(11), 1403–1413.

Linehan, M. (2007). Behavioral Treatments of Suicidal Behaviors: Definitional Obfuscation and Treatment Outcomes. Academic Science, 836(13), 302–328.

Liu, X. (2004). Sleep and adolescent suicidal behavior. SLEEP, 27(7), 1351-1358.

Spirito, A., Wolf J., & Uhl, C. (2011). Cognitive-Behavioral Therapy for Adolescent Depression and Suicidality. Journal of American Academic Child Adolescent Psychiatry, 20(2), 191-204.

World Health Organization. (2001). The World Health Report 2001: Mental Health, New Understanding and New Hope. Geneva: World Health Organization.