Planning for Safety

AND Post-Traumatic

Growth

Goal 1: Stabilize

Baseline: Crisis

Three Goals

Goal 2: Recover

Three Goals

Goal 2: Recover

Three Goals

Goal 3: Grow

First Goal: Stabilizing

▪ From “imminent risk” to [tolerable] “high risk”

▪ Pause actions and plans – not thoughts and feelings

▪ Possibility of a positive future – even if improbable

▪ Initial safety planning

▪ Regaining balance

Stabilize

Baseline: Crisis

Safety Planning

First Goal: Stabilizing

Safety Planning Intervention (SPI)

▪ Brief and helpful therapy

▪ With a plan to take home.

▪ Created for use in the Emergency Department

▪ Now used in many more places.

▪ Research evidence: Less suicidal, Better follow-through

▪ Depends on QUALITY and USE over time

http://suicidesafetyplan.com/Home_Page.html

Safety Planning reduces risk

▪ After emergency risk of severe injury or death

▪ After determining ‘flight risk’

▪ After documenting patient risk

▪ Incorporates risk factors

▪ Aligns with risk screening instruments

▪ Can follow a full risk assessment

▪ Outline risk in the safety plan

Is risk the focus forever?

Recover

Wellness focus

Second Goal: Recover (Back to baseline)

What is our focal point?

Suicide

Life

Focusing on Wellness

▪ From “high risk” to ‘OK’ baseline / pre-crisis level

▪ Dimensions of Wellness▪ Emotional health: perceptions

▪ Physical health: capacity

▪ Spiritual health: belief

▪ Social health: tangible and emotional support

▪ Financial: basic needs and continuity of care

▪ Occupational: employment

▪ Environmental: living space

▪ Intellectual: job or free-time pursuits

Suicide and Recovery-oriented outcomes

▪ Suicidal crisis – trauma

▪ Post-traumatic stress vs

▪ Recovery

▪ After Recovery, work on resilience

Resilience: Ability to bounce back after crisis

Suicide and Post-Recovery

▪ Resilience

▪ Reflection

▪ Post-Traumatic Growth

Goal 2: Recover

Goal 3: Grow

Third Goal: Growing from the crisis

Post-Traumatic Growth

▪ Happens after initial coping with trauma

▪ Happens after recovery (“return back to pre-trauma functioning”)

▪ Involves finding meaning and benefits

▪ Includes learning that creates change beyond pre-trauma level

▪ Evidenced by transformation or qualitative change in functioning

Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology—A critical review and introduction of a two component model. Clinical psychology review, 26(5), 626-653

Post-Traumatic Growth and Coping

▪ Meta-analysis 1: Gender and PTG

▪ traumas (cancer, HIV, bereavement, earthquake)

▪ Women > Men on PTG

▪ Hypothesized cause: Ruminative thought (deliberative positive reappraisal) and “emotion focused” coping

Vishnevsky, T., Cann, A., Calhoun, L. G., Tedeschi, R. G., & Demakis, G. J. (2010). Gender differences in self-reported posttraumatic growth: A meta-analysis. Psychology of women quarterly, 34(1), 110-120.

Post-Traumatic Growth and Coping

▪ Meta-analysis 2: Coping

▪ Positive reappraisal coping had largest effect (benefit finding)

▪ Religious coping, social support, and optimism also helped

Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of loss and trauma, 14(5), 364-388.

Reflecting: What is the goal?

Stage 3: Reflecting: Two Paths for growth

Post-Traumatic Growth

▪ Overall experience

▪ Philosophy about ‘life’ in general

▪ Gestalt impression of crisis

▪ Life mission or values

▪ Evaluation of self (capabilities, strength, virtues)

▪ Life lessons

Post-Suicidal Growth

▪ Specific crisis experience

▪ Information about person

▪ Details of the crisis

▪ Critical beliefs and values

▪ Personal risk and protection

▪ Personal priorities

▪ Self-defining quality of life

▪ Examining relationships affected

Post-Traumatic Growth: Character Strengths

▪ All character strengths correlated with PTG

▪ Particularly high:▪ Kindness

▪ Bravery

▪ Gratitude

▪ Hope

▪ Religiousness

Peterson, C., Park, N., Pole, N., D'Andrea, W., & Seligman, M. E. (2008). Strengths of character and posttraumatic growth. Journal of Traumatic Stress: Official Publication of the International Society for Traumatic Stress Studies, 21(2), 214-217.

Post-Suicidal Growth: Experiential knowledge

Signs (events)

Warning Informing

Withdrawing

Isolating? Priorities

Giving Away

Preparing?Valued people

Safety Plan revision toward growth

▪ Warning signs

▪ Explore underlying thoughts/feelings

▪ Understand values and priorities

▪ Internal coping

▪ Refine based on styles and preferences

▪ Enhance based on strengths

▪ Warning signs

▪ Coping Strategies

▪ Social situations / distractions

▪ People who assist in crisis

▪ Professional help

▪ Safe environment

Safety and Growth Planning

Safety Plan Growth Plan

▪ Needs / Values / Strengths

▪ Ways to improve coping

▪ Ways to improve social network

▪ People who promote growth

▪ Professional resources for growth

▪ Wellness environment

Question & Answer

DeQuincy A. Lezine, Ph.D.

Lived Experience Academy

drlezine@livedexp.academy

Continue learning how to support

Post-Suicidal Growth!

https://livedexp.academy