A Handful of Doctors are Working to Revolutionize How We Think about Self-Harm

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In contrast to the “no-harm” contracts some therapists used to ask their patients to sign, promising they will not kill themselves, this article describes two innovative therapies that involve patients and their therapists working together collaboratively to prevent suicide. The therapies also address the suicidal behavior itself rather than the underlying causes like depression and anxiety. With Collaborative Assessment and Management of Suicidality (CAMS), the therapist asks the patient to suggest causes for his or her suicidal behavior. They then work together to address those triggers and develop a crisis management plan to use if the person considers attempting again. The creator of CAMS, David Jobes, said, “It forms an alliance, and it focuses on what to do next instead of what not to do.” The alliance is important in providing motivation to live. Research has shown that suicidal outpatients who are treated with CAMS have fewer suicidal thoughts for a 12-month period than those given traditional treatment. A newer approach in Switzerland, the Attempted Suicide Short Intervention Program (ASSIP), also involves the patient and therapist developing a plan together for managing suicidal behavior based on the patient’s description of the events leading to the attempt. Initial studies have shown that ASSIP may be able to decrease re-attempts by up to 80 percent.

Spark Extra! For more information on treatment for suicidality, see the treatment section of the Zero Suicide Toolkit.