Psychological Self-Help

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The many prevention programs, mostly for teens and schools,
mentioned in these major papers need to be carefully studied,
replicated everywhere, and improved. About 4% of high school
students have made a suicide attempt in just the last year and 8%
have made at least one attempt in their short lifetimes (American
Academy of Pediatrics, 1996). A new book by Spirito and Overholster
(2002) should be mentioned because it deals in depth with this topic,
namely, assessing and treating teenage suicide attempters. Suicide is
a burgeoning psychological crisis that needs our utmost attention.
Some good work has been done but much more is needed. I’ll describe
a few specific programs already carried out that could provide the
basis for much more effective programs to decrease suicide. 
The United States Air Force had an unusually high rate of suicide in
the middle 1990’s and developed a program to reduce the number of
deaths. They arranged for both military and civilian agencies to
concentrate on supporting AF personnel having mental health or
psychosocial problems by urging them to see a counselor. In effect,
they hoped to remove the stigma associated with “seeing a shrink.”
The result after the program was put into practice in 1997 was a 33%
reduction in suicides. The evaluators also found that homicide, spouse
abuse, and accidental death also went down (Knox, K. L. et al., 2003).
Thus, relatively gentle encouragement to seek help when one is down
seems to yield benefits. 
An extraordinary group of Oregon psychologists have produced
impressive programmatic research about assessing and treating
depression, suicide, and many other problems. Their test for assessing
the risk of suicide was cited in the last section (Lewinsohn,
Langhinrichsen-Rohling, Rohde, & Langford, 1995). Recently, they
(Lewinsohn, Rohde, Seeley, & Hops, The coping with depression
course: A psychosocial treatment of adolescent depression) have made
adolescent depression, freely available online to therapists, counselors,
and teachers. They make it clear that their teaching manuals and aids
are for trained group leaders, not for self-helpers (Lewinsohn, Clarke,
Rohde, Hops, & Seeley, 1996). But the educational approach they
advocate and the how-to-cope topics they cover are rather similar to
skills training methods presented in self-help books, including this
book. Young people need the guidance schools can give. I strongly
recommend that counselors working with depressed and suicidal
students make use of the work from Oregon. 
There are especially designed treatment programs for suicidal
adolescents. Examples: Piacentini, Rotheram-Borus, & Cantwell (1995)
propose a Cognitive-Behavioral, highly structured, 6-session, family
treatment program directed towards creating more positive family
relationships. Brent, et al (2003) compared the effectiveness of three
different Psychosocial approaches to helping depressed and suicidal
teens. And, finally, Asarnow, Jaycox, and Tompson (2001) reviewed
the research covering different methods of intervening with young
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