Clients who suffer from depression and substance use issues are more likely to harm themselves than individuals with other psychological problems. After in-patient treatment, clinicians often rely on their own observations to measure a client’s state and determine the likelihood that the client will self-harm again. But a new study suggests that enlisting the client’s own opinion of their risk for self-harm may be a more accurate predictor of future behaviors. “Clinicians routinely talk with patients about their behavior and collaborate with them to determine appropriate courses of action,” said Jillian Peterson of the University of California, Irvine, and lead author of the study. “This context could easily accommodate a discussion of patients’ perceptions of their own risk of self-harm.” She added, “With a lifetime of experience, individuals may be in a better position than are external evaluators to predict their own behavior.” This process of self-reception involves predicting behavior not emotional reactions to situations. Research has shown that self-perception as a method of predicting is more accurate than tests and independent observations from family members, clinicians and peers.
Peterson and her team examined 147 clients who were discharged from psychiatric facilities. “We focused on psychiatric inpatients because they are at greater risk of self-harm and suicide than are outpatients, particularly during the period after hospital discharge,” said Peterson. The participants were interviewed by phone eight weeks after discharge and in person 15 weeks after discharge, both times by the same interviewer. They found that the participants who had tried to harm themselves before admittance were 75% more likely to try again, and this was accurately predicted through the self-reports. “Generally, the results suggest that patients are an important source of information about risk, perhaps because they have built the most comprehensive experience base for predicting their behavior across a range of familiar contexts,” said Peterson. “Patients are made partners through this process and are treated as experts in their own lives, which may help build a collaborative relationship with their treatment provider.”
Peterson, Jillian, Jennifer Skeem, and Sarah Manchak. “If You Want to Know, Consider Asking: How Likely Is It That Patients Will Hurt Themselves in the Future?”Psychological Assessment 23.3 (2011): 626-34. Print.
© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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