EXPLORING STRENGTHSBASED APPROACHES TO SUICIDE AND THE MONTANA

EXPLORING STRENGTHS-BASED APPROACHES TO SUICIDE AND THE MONTANA HAPPINESS PROJECT Presented on Montana Conference on Suicide Prevention July 30, 2021 John Sommers-Flanagan, Ph. D. , University of Montana Department of Counseling John. sf@mso. umt. edu or https: //johnsommersflanagan. com/

PREPARATION Ø Welcome and Thank You Jen. . . and Ø Favorite and least favorite topic Ø 29+ years ago. . . Psychotherapy Networker article: https: //psychotherapynetworker. org/magazine/article/2565/themyth-of-infallibility/f 576 ab 48 -e 662 -46 f 0 -b 122 -06 ab 19 d 35 e 28/OIM

LEARNING PROCESS Ø We are distant, but we can still be engaged • I will talk about strengths-based suicide approaches and the MHP • You imagine yourself slightly modifying how you think about suicide, suicidality, and happiness

CAVEATS AND DISCLAIMERS Ø One of my daughters is an attorney Ø Information provided today is based on research and clinical experience. I hope it will help you in your work. Ø As professionals and independent actors, you’re responsible for applying this and other educational and training experiences into your work. Ø You agree to not hold the presenter (me) responsible for adverse outcomes that might be associated with this course material.

OUTSIDE THE BOX STRENGTHS AND SUICIDE

STRENGTHS-BASED PRINCIPLES – I Embrace Shneidman’s position that suicidal thoughts and behaviors are neither an illness* nor a sin*. Instead, de-pathologize and view suicide disclosures as a natural communication of pain and an unmatched opportunity to offer compassionate help.

STRENGTHS-BASED PRINCIPLES – 2 Recognize the limits of risk and protective factor assessment (because mostly it doesn’t work; 50 year meta-analysis; Columbia E. R. study). Instead, we collaborate with people/patients to develop an individualized safety plan and decrease personal distress.

STRENGTHS-BASED PRINCIPLES – 3 While focusing on suicide (which is essential), resist the temptation to over-focus on suicide. Remember that the person/patient is always a whole person with an array of strengths and resources: Show compassion for the suicide pain, but pay attention to and draw out the positives*.

STRENGTHS-BASED PRINCIPLES – 4 Collaborate and use therapeutic assessment: • Who’s the expert? • Start with empathy and compassion • Use a normalizing frame and ask nuanced suicide questions, like Jobes’s “That one thing. ” • Balance your questioning: Don’t just go through the PHQ-9. Question #9 is a mish-mash, hugger mugger, blend of passive suicidality and self-harm.

STRENGTHS-BASED PRINCIPLES – 5 Despite embracing a strengths-based model, remember that you may need to be directive, you may need to initiate protective action, and you may need to be the voice of authority and rational decision-making in the room.

SAMPLE SKILL 1: NORMALIZING FRAME • I’ve read that up to 50% of teenagers have thought about suicide. Is that true for you? • Most people who feel down think about suicide from time to time. Have you had thoughts about suicide? • Practice these or similar words right now

SKILL #2: EVALUATING IDEATION Ø Remember Disclosure is good news (it’s a sign of trust)! Ø Trigger Ø Frequency Ø Intensity Ø Duration Ø Termination of ideation* [Tommie] Ø Alternative [Positive] Triggers

SKILL 3: MOOD SCALING WITH A SUICIDE FLOOR • This is my favorite 5 minute online (or in person) interview strategy • May I ask some questions about your mood?

MOOD SCALING PRACTICE • [Read Along or just listen] Rate your mood, using a zero to 10 scale. Zero is the worst mood possible. Zero means you’re totally depressed and so you’re just going to kill yourself. A 10 is your best possible mood. A 10 would mean you’re as happy as you could be, maybe dancing or singing or doing whatever you do when you’re extremely happy. Using zero to 10, what rating would you give your mood right now? • What’s happening now that makes you give your mood that rating? • What’s the worst or lowest mood rating you’ve ever had? What was happening to make you feel so down? • For you, what would be a normal mood rating on a normal day? • What’s the best mood rating you’ve ever had? What was happening that helped you have such a high mood rating?

SEVEN ORGANIZING LIFE DIMENSIONS Sample Problem(s) Strengths (Examples) Sample Goal(s) Excruciating distress or Shneidman’s “Psychache” Can identify mood triggers; mood responsiveness Self-soothing and emotional coping skills are developed Mental/Cogniti Problem-solving impairment; ve Can brainstorm in session; hopefulness Problem-solving is routine; hope strengthened Interpersonal- Thwarted belongingness or Social universe is clear; supports identified perceived burden Presence of social support; employment/recreation Arousal/agitation; health distress; trauma Exercise; nutrition; Physical relaxation skills physical developed; trauma relaxation/calming skills treatment Emotional hopelessness Physical Cultural/Spirit Absence of or Frequent religious Reconnection with

WHAT IS THE MONTANA HAPPINESS PROJECT? Ø MISSION: We work with organizations and individuals to support mental health, promote happiness, and reduce suicide through professional education, consultation, and supervision

WHAT IS THE MONTANA HAPPINESS PROJECT? - 2 Ø We recognize that active pursuit of a happy and well-lived life is one method through which individuals can cope with and transform their suicidal thoughts

MHP – STRENGTHS-BASED UNPLUGGED Ø Strengths-based, but not shallow Ø Lead with empathy, pursue “psychache” Ø Begin problem-solving process for assessment and intervention Ø May need to build hope and do problem-solving from the bottom up Ø Work with people across 7 dimensions

TAKING CARE OF YOURSELF: WITNESS SOMETHING INSPIRING

SUMMARY AND CONCLUSIONS • We talked about strengths-based principles, drivers (and goals) in seven dimensions, and one positive psychology intervention. • And, there’s so much more! • What do you want to remember and practice?

STRENGTHS-BASED RESOURCES – 1 • Sign up to be an email follower of my blog at: https: //johnsommersflanagan. com/ • The MHP website will launch in August

STRENGTHS-BASED RESOURCES – 2 • Check out the 7. 5 hour training videos at Psychotherapy. net : https: //www. psychotherapy. net/videos/expert/john -sommers-flanagan

STRENGTHS-BASED RESOURCES – 3 • Our book on strengthsbased suicide assessment and treatment is available through ACA (print), Wiley (audio), and other booksellers: https: //imis. counseling. org/s tore/detail. aspx? id=78174.

STRENGTHS-BASED RESOURCES – 4 • You can read “The Myth of Infallibility” on Psychotherapy Networker: https: //www. psychotherapynetworker. org/ magazine/article/2565/the-myth-ofinfallibility/f 576 ab 48 -e 662 -46 f 0 -b 12206 ab 19 d 35 e 28/OIM