Open Always
Email: support@globalcompose.com Call Now! +1-315 515-4588
Open Always
Email: support@globalcompose.com Call Now! +1-315 515-4588

Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review

This sample paper on (Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review) was uploaded by one our contributors and does not necessarily reflect how our professionals write our papers. If you would like this paper removed from our website, please contact us our Contact Us Page.

A Database of over Million Scholarly Resources. Start your Search Now

Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review
Chapter 1: Background of the Study

A suicidal patient is a person trying to escape from unbearable life circumstances and unable to find a way to live with life in its present form (U. S. DHHC, 2006).  Despite efforts to understand the complexity of suicide, experts have found it impossible to predict if a person will actually commit suicide (Alexander, Klein, Gray, Dewar & Eagles, 2000; Jacobs & Brewer, 2004; WHO, 2010). The ultimate goal of suicidal ideation assessments and interventions is to reduce the risk of someone who may act on suicidal thoughts. 

The experience between the suicidal patient and a professional assessing the immediacy of treatment and type of treatment needed is very important to both parties. It is vital for clinicians to be prepared to offer care congruent with that person`s needs and to help function more effectively with life circumstances.  However attempting to carry out these services can also provoke a crisis for the helper, triggering fears of making a mistake and provoking feelings of helplessness and uncertainty (Echterling, Presbury & McKee, 2005). LPCs working with clients in crisis report common physical and psychological stress reactions, ranging from anger, shock, confusion, and insomnia to burnout, demoralization, and vicarious traumatisation (Trippany, Whitekress & Wilcoxon, 2004).

A review of the literature reveals that counseling is a high burnout profession due to experiences such as compassion fatigue and vicarious trauma (Goldstein, 2007). A study in Finland (Suokas, Suominen & Lonnqvist, 2009) examined the experiences of the emergency room psychiatrist, nurses, and counselors.  The findings from the study reveal the general tendency among the emergency room staff to view attempted suicide patients positively and sympathetically. According to the American Association of Suicidology Task Force Report (Kleespies, 2009), training is needed for those who work with suicide risk assessments and decisions about care. A study in Korea (Sang, Seong, Kissinger & Ogle, 2010) examined the typology of burnout among professional counselors working in the emergency room. The study suggests that counselors may not immediately recognize burnout and disconnect with the patient and this could increase the likelihood that the counselor will devalue the story that is being presented by the client.

Today, there is also greater recognition of the challenges that crises present to the helping professional. In the midst of a mental health emergency, the counselor must manage multiple tasks rapidly assessing an unstable and potentially dangerous situation, responding in a clinically sound and ethical manner and ensuring the safety of everyone involved (Corey, Haynes, Moulton & Muratori, 2010). Clinical supervision may mitigate the risks associated with providing crisis services. By offering emotional support and guidance, supervisors can help LPCs to safely manage a hazardous situation, resolve the situation positively, and solidify their professional identity (Corey, Haynes, Moulton & Muratori, 2010; Dupre, 2011).

Purpose of the Study

The purpose of this study is to explore the lived experience of twelve Licensed Professional Counselors (LPCs) that have experience (greater than one year) in facilitating and evaluating suicidal patients in the emergency room setting.

A licensed professional counselor (LPC) who works in the ER must learn to deal with the pressure of time, intensity of affect, disruptiveness of certain behaviors, need for rapid assessment, pressure for a decision, legal and ethical aspects of decisions about dangerousness, and need for interdisciplinary consultation. The purpose of this study is to gain a better understanding of the experiences of LPCs who evaluate suicidal patients in ERs in order to determine the need for debriefing or other interventions for the counselor and the need to develop a training curriculum in the United States. The purpose of this study is to explore the experiences of licensed professional counselors while providing interventions to suicidal patients in the emergency room. Furthermore, this investigation will examine the daily experience of interactions and strategic interventions that the clinicians have used when evaluating suicidal patients.   

Few studies in the United States have been found examining the effects of suicide assessments and interventions on counselors. Counseling is a high burnout profession due to experiences such as compassion fatigue and vicarious trauma. At times, professional counselors take time to recognize the burnout and with the patient, thus making the help accorded less meaningful. A problem is present when there is inadequate counseling for suicidal patients. According to Bore and McCann (2009), suicidal patients in the emergency rooms do not get the full counseling that is required because of lack of expertise in the emergency room. This situation may create a repeat occurrence among suicidal patients. Suicidal cases in the dynamic world are on the increase and with continuous efforts, more and more about suicide is being learned and emphasis should be placed on the prevention of repeated suicide cases. It is for this reason that a study is needed to examine the experiences of licensed professional counselors who work in emergency rooms in the United States.

It is recognized that the majority of suicidal patients suffer emotionally which contributes to the reason as to why they would end their lives (James, 2005). Such situations where patients are emotionally unbalanced call for professional care to deal with the cause of their suicidal sentiments (Reeves, 2010). The crucial role played by professional counselors in averting future suicidal attempts cannot be understated, and this forms the basis for this study.

Significance of the Study

The study explores the input of experiences by professional counselors in the treatment of suicidal patients in the emergency room setting. Many LPCs will experience a client suicide in their careers (Lafayette & Stern, 2004; McGlothlin, Rainey & Kindsvatter, 2005; Strom-Gottfreid & Mowbray, 2006). It is one of the most stressful incidents, if not the most stressful incident that may happen to a mental health professional (Alexander, 2007; Coverdale, Roberts & Louie, 2007; Fang, et al., 2007; Jacobson, Ting, Sanders & Harrington, 2004; Knox, Burkard, Jackson, Schaack & Hess, 2006; Sudak, 2007).  There is documentation that counsellors who have experienced an actual client suicide reported that they felt unprepared to handle the personal and professional reactions they  experienced (Christianson & Everall, 2008; Coverdale, et al., 2007; Fang, et al., 2007; Knox, et al., 2006; Spiegelman & Werth, 2005). This exposes clients, LPCs and supervisors to a number of hazards.

This investigation uncovers conditions that may help LPCs manage crisis situations and will identify specific practices that promote counselor growth and effectiveness.  The above study is a phenomenological study and such yields a description of the lived experience of the counsellors working with suicidal patients. In suicidology, most literature concentrates on the victim and suicide survivors and thus rarely, suicidology is approached from the perspective of licensed professional counsellors (Echohawk, 2006). Through phenomenology, the study provides a detailed account of the experience of LPC’s in emergency room situations. Phenomenology is most appropriate research design for this particular study as through the narratives collected, the researcher is in a position to capture some of the details that form part of the behaviour of LPC’s in emergency room situations.

This research design also gives LPCs increased autonomy and thus is in a position to give detailed information as regards some of their experiences with suicidal patients in emergency rooms (Dyregov, Nordanger, & Dyregrov, 2003). Provision of detailed accounts by LPC’s provides a basis from which a researcher is in a position to identify some of the key themes that arise from the narratives. Such themes form the basis for conclusion and recommendations under this particular study. Conclusion and recommendations in this case shall focus some of the mechanisms that LPC’s use in a crisis situation and also some of coping mechanisms that LPC’s use. Therefore, knowledge generated from this particular study is useful to LPC’s in crisis situations where such knowledge improves their ability to cope with emergency room situations.

Research Design

This study provides insight into the experiences of counselors in emergency room settings. Information was obtained from narratives provided by counselors. The use of phenomenological questions in this study may help gain insights into the role of counselors in an emergency situation and suicide prevention/interventions in emergency room settings through narratives of the experiences of counselors.

The purpose of this phenomenological study is to gain a better understanding of the experiences of LPC’s who facilitate assessments to suicidal patients in emergency rooms. During the interview, three open-ended questions were asked using a sequential approach. Subjects were encouraged to freely express themselves (Giorgi, 1997) and include detailed information. This study utilizes a phenomenological qualitative research design. Phenomenology relates to the self reporting where participants report their individual experiences under a particular phenomena. Therefore, under phenomenological research, emphasis is placed on personal interpretation and perspective. Individuals are in a position to report their subjective experience and the researcher is expected to facilitate individual’s self reporting (Moustakas, 1994).

Phenomenological qualitative research design encompasses a variety of data collection methods. These include focus meeting, interviews, conversations and participant observation and as such, the researcher is expected to ensure that he or she identifies the method most appropriate for his or her research (Langdridge, 2007). Under the above form of research design, the researcher should ensure that there is maximum output and also minimum interference. Therefore, the researcher should avoid undue influence that affects the self reporting among the participants.

Moreover, under phenomenological qualitative research design, there is a need for delicate balance between establishing confidence and rapport with the study participants and ensuring that the researcher does not interfere with the process of self reporting (Lester, 1999). Establishment of good rapport is important towards ensuring that all participants provide adequate and correct information on the issues under investigation.

The researcher finds phenomenological qualitative research design relevant to the study as the main purpose of the study is to explore the experiences of licensed professional counselors working with suicidal patients in the emergency rooms. The researcher collected information from licensed professional counselors and as such, the researcher is expected to create rapport with counselors. The counselors provided information related to their experiences while working with suicidal patients in the emergency rooms.

Research Question and Hypothesis

The overarching research question was: What is the lived experience of clinicians during an emergency room encounter with a patient who are suicidal? The result of this study provides a fundamental understanding of the importance of supervision for LPC’s who evaluate suicidal patients in an emergency room setting.

The following sub questions guided data collection and analysis:

  • What have you experienced when evaluating suicidal patientswithin the emergency Room setting?
  • Which cases amongst all the cases that you have treated, have stood out and made your perception of how to handle suicidal cases change?

            3.) How have these experiences shaped your personal& professional life as a counselor?

4.) What type of training, supervision, and follow-up did you receive when completing suicidal assessments and interventions in the emergency room setting?

Alternative Hypothesis

            The results of this study provide a fundamental understanding of the importance of supervision for LPC’s who evaluate suicidal patients in an emergency room setting.

Assumptions and Limitations

Those concerned with the training of licensed professional counsellors and their development have discussed the need for counsellors to be able to form clinical judgments based on personal and professional awareness, but this may not necessarily be a part of their training (Stoltenberg et al., 2008).  Foster and McAdams note that education and preparation for client suicide attenuates the impact of the suicide, and that weekly supervision is a healthy place to provide preparation and education. 

McAdams and Foster (2002, p. 234) conducted a study involving 241 professional counsellors and surveyed that almost one fourth of the respondents experienced the suicide of a client they were treating. The impact of client suicide on counsellors can result in severe and long-term consequences. From a review of the literature McAdams and Foster (1999) concluded that client suicide could induce acute reactions in therapists (depression, intrusive thoughts and memories, shock, self-blame, and guilt), anniversary stress reactions to the event and pathological grief reactions. Further, the subjects in their study said supervisory support system was the most useful to them in their recovery process, followed by personal support systems, contact with the surviving family, and education and training. While supervision was reported as the most beneficial intervention after a suicide crisis, subjects said it was the least accessible to them.

A review of the literature reveals that good supervision can protect LPCs from the deleterious effects of crisis work, reduce the incidence of secondary trauma, and enhance the LPC‘s resolve and self-efficacy (Dupre, 2011; Salston & Figley, 2003). However, crisis supervision is frequently not provided and has not been adequately addressed in the literature. Traditional models of supervision do not meet the specific needs of LPCs working with clients in crisis. The standard practice of providing one hour of scheduled weekly supervision following a client and LPC interaction is both inappropriate and insufficient during crisis events. Nevertheless, virtually all of the supervision literature is based on that assumption (Hipple & Beamish, 2007). Moreover, very little published supervision research has been conducted that focuses exclusively on the crises that LPCs encounter working in the field. Studies are typically conducted by university-based counsellor educators, utilizing graduate students as research participants (Crockett, Byrd, Erford & Hayes, 2010). Finally, although accreditation boards, such as the Council for Accreditation of Counselling and Relate Educational Programs, require training in crisis services and supervision, they offer no clear guidelines about supervisory responsibilities or protocols during mental health emergencies.

From a review of the literature on crisis intervention, two conclusions become clear. First, most intervention models are protocol driven. The primary focus of crisis response is seen as taking action rather than – being with survivors. Few scholars emphasize the relational aspects of the work. Second, there is virtually no discussion in the crisis intervention literature about the supervision experiences or needs of LPCs working with suicidal patients in emergency room setting.

Definition of Terms

Suicidal patient: an individual who has thoughts of wanting to harm themselves or end their life. Suicidal Survivor:  people who have lost a loved one to suicide (Jordan & McIntosh, 2011). Licensed Professional Counselor: A master’s level counselor who is licensed by the State of Pennsylvania to practice in a clinical setting to provide therapy to clients

Expected Findings

Most studies related to suicides focus on the victims and thus little focus is given to the other people involved including suicide survivors and professional counselors. A suicide survivor refers to an individual who experiences high levels of emotional and psychological distress as a result of a suicide (Claassen & Larkin, 2005). While adequate support is provided to suicide survivors, professional counselors who experience high levels of vicarious trauma might not be in a position to access such help.

 Counselors just like suicide survivors are affected by the death of their clients. This has both personal and professional consequences and yet, professional counselors are expected overcome such obstacles. Due to the nature of the fast-paced environment of an emergency room setting, professional counselors may not have enough time to recover from traumatic events. This may affect them in many ways including vicarious trauma and compassion fatigue (Reeves, 2010).

Counselors are expected identify behavior associated with suicide ideation. However, due to work related factors such fatigue and vicarious trauma, some of the counselors in emergency room settings might not be in a position to identify signs and symptoms associated with suicide ideation (Baraff, Janowicz & Asarnow, 2006). Counselors, therefore, might experience secondary trauma as a result of suicides in the emergency rooms (Goldstein & Buongiorno, 1984). This may affect a counselors’ productivity and the ability to predict and prevent suicides in emergency room settings.

This study provides insight into the experiences of counselors in emergency room settings. Information was obtained from narratives provided by the counselor. The use of phenomenological questions in this study helped gain insights into the role of counselors in an emergency situation and suicide prevention/interventions in emergency room settings through narratives of the experiences of counselors. A comprehensive review of the literature regarding Licensed Professional Counselors will be explored in the next chapter.

 

 

 

 

 

 

 

 

 

 

Chapter Two: Literature Review
Introduction

To provide a context for this dissertation, a review of the literature was conducted to provide a foundation and need for the suggested study.  In addition, material describing the evaluation and management of suicidal emergencies and models of service delivery in emergency departments are discussed. The chapter concludes with a discussion of the legal and psychological risks in treating patients with behavioral emergencies, which are heightened for professional counselors who lack the needed training and supervision needed to process and reflect on the challenging daily interactions that LPC’s have with suicidal patients in the emergency room setting.

Effects of Suicidal Patients upon Counsellors

Most studies related to suicides focus on the victims and thus little focus is given to professional counselors (Claassen & Larkin, 2005). While adequate support is provided to suicide survivors, professional counselors who experience high levels of vicarious trauma might not be in a position to access such help.

Due to the nature of the fast-paced environment of an emergency room setting, professional counselors may not have enough time to recover from traumatic events. This may affect them in many ways such as vicarious trauma and compassion fatigue (Reeves, 2010). Counselors are expected to recognize and assess the risk of behavior associated with suicide ideation. However, due to work related factors such fatigue and vicarious trauma, some of the counselors in emergency room settings might not be in a position to identify signs and symptoms associated with suicide ideation (Baraff, Janowicz & Asarnow, 2006).

A suicidal patient is a person trying to escape from unbearable life circumstances and unable to find a way to live with life in its present form (U. S. DHHC, 2006).  Despite efforts to understand the complexity of suicide, experts have found it impossible to predict if a person will actually commit suicide (Alexander, Klein, Gray, Dewar & Eagles, 2000; Jacobs & Brewer, 2004; WHO, 2010). The ultimate goal of suicidal ideation assessments and interventions is to reduce the risk of someone who may act on suicidal thoughts. 

The experience between the suicidal patient and a professional assessing the immediacy of treatment and type of treatment needed is very important to both parties. It is vital for clinicians to be prepared to offer care congruent with that person`s needs and to help function more effectively with life circumstances.  However, attempting to carry out these services can also provoke a crisis for the helper, triggering fears of making a mistake and provoking feelings of helplessness and uncertainty (Echterling, Presbury & McKee, 2005). Licensed Professional Counsellors who evaluate clients in crisis do report common physical and psychological stress reactions, ranging from anger, shock, confusion, and insomnia. Others include burnout, demoralization, and vicarious traumatisation (Trippany, Whitekress & Wilcoxon, 2004).

A review of the literature reveals that counseling is a high burnout profession due to experiences such as compassion fatigue and vicarious trauma (Goldstein, 2007). A study in Finland (Suokas, Suominen & Lonnqvist, 2009) examined the experiences of the emergency room psychiatrist, nurses, and counselors.  The findings from the study reveal the general tendency among the emergency room staff to view attempted suicide patients positively and sympathetically. According to the American Association of Suicidology Task Force Report (Kleespies, 2009), training is needed for those who work with suicide risk assessments and decisions about care. A study in Korea (Sang, Seong, Kissinger & Ogle, 2010) examined the typology of burnout among professional counselors working in the emergency room. The study suggests that counselors may not immediately recognize burnout and disconnect with the patient and this could increase the likelihood that the counselor will devalue the story that is being presented by the client.

Today, there is also greater recognition of the challenges that crises present to the helping professional. In the midst of a mental health emergency, the counselor must manage multiple tasks- rapidly assess an unstable and potentially dangerous situation, respond in a clinically sound and ethical manner, and ensure the safety of everyone involved (Corey, Haynes, Moulton & Muratori, 2010). Clinical supervision may mitigate the risks associated with providing crisis services. By offering emotional support and guidance, supervisors can help LPCs to safely manage a hazardous situation, resolve the situation positively, and solidify their professional identity (Corey, Haynes, Moulton & Muratori, 2010; Dupre, 2011).

A licensed professional counselor (LPC) who works in the ER must learn to deal with the pressure of time, intensity of affect, disruptiveness of certain behaviors, need for rapid assessment, pressure for a decision, legal and ethical aspects of decisions about dangerousness, and need for interdisciplinary consultation. The purpose of this study is to gain a better understanding of the experiences of LPCs who evaluate suicidal patients in ERs in order to determine the need for debriefing or other interventions for the counselor and the need to develop a training curriculum in the United States. The purpose of this study is to explore the experiences of licensed professional counselors while providing interventions to suicidal patients in the emergency room. Furthermore, this investigation examines the daily experience of interactions and strategic interventions that the clinicians have used when evaluating suicidal patients. 

McAdams and Foster (2002, p. 234) conducted a study involving 241 professional counsellors and surveyed that almost one-fourth of the respondents experienced the suicide of a client they were treating. The impact of client suicide on counsellors can result in severe and long-term consequences. From a review of the literature McAdams and Foster (1999) concluded that client suicide could induce acute reactions in therapists (depression, intrusive thoughts and memories, shock, self-blame, and guilt), anniversary stress reactions to the event and pathological grief reactions. Further, the subjects in their study said supervisory support system was the most useful to them in their recovery process, followed by personal support systems, contact with the surviving family, and education and training. While supervision was reported as the most beneficial intervention after a suicide crisis, subjects said it was the least accessible to them.

Theoretical Orientation for the Study

This study is grounded in constructivist self-development theory (CSDT) as described by Lisa McCann and Laurie Pearlman (1990). The proposed research provides critical insights into the lived experience of LPCs working with suicidal patient assessments and interventions in the emergency room (ER) setting and associated cumulative stress. The general panacea for treating trauma has been focused on treating patients and close relatives experiencing suicide trauma in ER. The overwhelming amount of counseling that LPCs face in ER blurs their emotional and psychological responses to suicide traumas. Because the study provides a detailed narrative of LPCs working with suicidal patients in the ER, CSDT can be applied to the experience of these participants. It is anticipated that this theoretical application supports the psychological trauma experienced. Suicide is a serious public health problem, taking more lives worldwide than war and homicide combines (Stolberg, 2002). The U. S. Department of Health and Human Services (2001, p. 2) has also said that suicides account for twice as many deaths than HIV/AIDS. In the United States, suicide is the 11th leading cause of death, resulting in over 32,000 deaths per year (Centre for Disease Control and Prevention, 2007).

Client suicide is thought to be one of the most stressful crisis situations faced by counsellors and other mental health professionals (Alexander, 2007; Coverdale, Roberts & Louie, 2007; Fang, et al., 2007; Jacobson, Ting, Sanders & Harrington, 2004; Knox, Burkard, Jackson, Schaack & Hess, 2006; McAdams III & Foster, 2002; Misch, 2003; Sudak, 2007).  Strom-Gottfried and Mowbray (2006) report significant consequences in terms of professional and personal reactions to a client suicide, including feeling negligent, alone, and confused. Other commonly reported reactions include shock, guilt, anger, betrayal, shame, feelings of inadequacy and embarrassment (Alexander, 2007; Lafayette & Stern, 2004; McAdams & Foster, 2000; Pilkinton & Etkin, 2003; Ting et al., 2006). Of all the things that counsellors are exposed to and have to take action on, the suicide of a patient is the trauma to them, both interpersonally and legally (Sudak, 2007, p. 333). Few counsellors escape experiencing the suicide of a patient during their careers. After effects of a client suicide often becomes common knowledge in workplaces such as a community mental health clinic or hospital emergency room, which may lead to such vulnerability and scrutiny. Many mental health professionals fear being targeted for blame at risk management meetings and fear lawsuits (Tillman, 2006).

Stolberg (2002) suggests there is no single event in psychotherapy that carries more emotional impact on the part of the counsellor as a suicidal crisis (p. 415). In order to be competent and protect themselves and their clients, skills, knowledge, sensitivity, ability, and fortitude on the part of the counsellor are critical. The role of the counsellor can have frightening and have traumatic consequences leading to compassion fatigue.  According to McAdams and Keener (2008), the rate of frequency of severe client crises confronting human service professionals has escalated to such proportions that crises have been referred to as an ‘occupational hazard‘ in the professional literature.

This brings to light the importance of being prepared for a client suicide, because the likelihood of experiencing a client suicide is high for mental health professionals. Licensed professional counselors have the professional responsibility to become prepared to assess and intervene with patients with suicidal ideation in an emergency room. A review of the literature on this aspect of mental health counselling will broaden our knowledge about crisis by promoting an understanding of how LPCs understand and experience these events.

The Need for Training Regarding Suicidal Assessments and Interventions

Those concerned with the training of licensed professional counsellors have discussed the need for counsellors to be able to form clinical judgments based on personal and professional awareness, but this may not necessarily be a part of their training (Stoltenberg et al., 2008).  Foster and McAdams (2002) note that education and preparation for client suicide (threats, risks, assessments, interventions) attenuates the impact of the suicide on the mental health counsellor, and that weekly supervision is a healthy place to provide preparation and education. 

The Need for Supervision Regarding Suicidal Assessments and Interventions

A review of the literature reveals that good supervision can protect LPCs from the deleterious effects of crisis work such as reducing the incidence of secondary trauma, and enhance the LPC‘s resolve when providing care for suicidal patients and self-efficacy (Dupre, 2011; Salston & Figley, 2003). However, crisis supervision is frequently not provided and has not been adequately addressed in the literature. Traditional models of supervision do not meet the specific needs of LPCs working with clients in crisis. The standard practice of providing one hour of scheduled weekly supervision following a client and LPC interaction is both inappropriate and insufficient during crisis events. Nevertheless, virtually all of the supervision literature is based on that assumption (Hipple & Beamish, 2007). Moreover, very little published supervision research has been conducted that focuses exclusively on the crises that LPCs encounter working in the field. Studies are typically conducted by university-based counsellor educators, utilizing graduate students as research participants (Crockett, Byrd, Erford & Hayes, 2010). Finally, although accreditation boards, such as the Council for Accreditation of Counselling and Relate Educational Programs, require training in crisis services and supervision, they offer no clear guidelines about supervisory responsibilities or protocols during mental health emergencies.

From a review of the literature on crisis intervention, two conclusions become clear. First, most intervention models are protocol driven. The primary focus of crisis response is seen as taking action rather than – being with survivors. Few scholars emphasize the relational aspects of the work. Second, there is virtually no discussion in the crisis intervention literature about the supervision experiences or needs of LPCs working with suicidal patients in emergency room setting.

 Those concerned with the training of licensed professional counsellors and their development have discussed the need for counsellors to be able to form clinical judgments based on personal and professional awareness, but this may not necessarily be a part of their training (Stoltenberg et al., 2008).  Foster and McAdams (2002) note that education and preparation for client suicide attenuates the impact of the suicide, and that weekly supervision is a healthy place to provide preparation and education. 

McAdams and Foster (2002, p. 234) conducted a study involving 241 professional counsellors and surveyed that almost one fourth of the respondents experienced the suicide of a client they were treating. The impact of client suicide on counsellors can result in severe and long-term consequences. From a review of the literature McAdams and Foster (1999) concluded that client suicide could induce acute reactions in therapists (depression, intrusive thoughts and memories, shock, self-blame, and guilt), anniversary stress reactions to the event and pathological grief reactions. Further, the subjects in their study said supervisory support system was the most useful to them in their recovery process, followed by personal support systems, contact with the surviving family, and education and training. While supervision was reported as the most beneficial intervention after a suicide crisis, subjects said it was the least accessible to them.

A review of the literature reveals that good supervision can protect LPCs from the deleterious effects of crisis work, reduce the incidence of secondary trauma, and enhance the LPC‘s resolve and self-efficacy (Dupre, 2011; Salston & Figley, 2003). However, crisis supervision is frequently not provided and has not been adequately addressed in the literature. Traditional models of supervision do not meet the specific needs of LPCs working with clients in crisis. The standard practice of providing one hour of scheduled weekly supervision following a client and LPC interaction is both inappropriate and insufficient during crisis events. Nevertheless, virtually all of the supervision literature is based on that assumption (Hipple & Beamish, 2007). Moreover, very little published supervision research has been conducted that focuses exclusively on the crises that LPCs encounter working in the field. Studies are typically conducted by university-based counsellor educators, utilizing graduate students as research participants (Crockett, Byrd, Erford & Hayes, 2010). Finally, although accreditation boards, such as the Council for Accreditation of Counselling and Relate Educational Programs, require training in crisis services and supervision, they offer no clear guidelines about supervisory responsibilities or protocols during mental health emergencies.

From a review of the literature on crisis intervention, two conclusions become clear. First, most intervention models are protocol driven. The primary focus of crisis response is seen as taking action rather than ―being with survivors. Few scholars emphasize the relational aspects of the work. Second, there is virtually no discussion in the crisis intervention literature about the supervision experiences or needs of LPCs working with suicidal patients in emergency room setting.

Statistical Increase in Mental Health-related Emergency Department Visits

Dawe (2004) presents evidence that the number of mentally ill patients presenting at emergency departments is on the rise internationally. Larkin et al. (2005) cite data that confirms that in the U.S. alone from 1992 to 2004, mental health-related visits to emergency departments increased from 4.9% to 6.3%. Several years later, Larkin, Smith, and Beautrais (2008) cite their nation-wide study of 974 million visits to emergency departments in the United States. They found that of these visits, 52.8 million or 5.4% were primarily for mental health problems:

While the annual number of overall ED visits rose 20% over the decade, or an average of 2% per year, the per-person trend for mental health-related visits increased almost 40%, from 17.1 ED visits per 1000 persons in 1992 to 23.6 visits per 1000 persons in 2001…; the corresponding proportion of ED visits due to mental illness increased 28% during the decade, from 48.7 per 1000 ED visits in 1992 to 62.5 in 2001. (p. 74) 

Larkin et al. (2009) also conclude that mental-health patients are the fastest growing component of emergency department visits. They suggest that emergency departments are rich sites for training professionals who are entering the mental-health field. Furthermore, these sites can become important for establishing databases to capture data regarding mental health frequent users, substance abusing and substance seeking patients. Models exist for cancer and cardiovascular disease; these can be adapted for suicide-attempt patients as well as substance abuse patients.

Owens et al. (2010) indicate that of the 95 million emergency department (ED) visits by adults in the United States, 12.0 million (or 13%) were mental health and/or substance abuse-related (MHSA, 2010). Their data indicates that of these 12 million patient visits, over 7.6 million visits (or 63% of mental health-related visits or 8% of all visits) are related to mental health disorders alone, 3.0 million visits (or 25% of mental health-related visits or 3% of all visits) are related to substance abuse disorders, and over 1.4 million visits (or 12% of mental health-related visits or 1.5% of all visits) are related to co-occurring MHSA disorders (p. 2). The most common MHSA- related ED visits are for mood disorders (42.7%), followed by anxiety disorders (26.1%), alcohol disorders (22.9%), drug disorders (17.6%), schizophrenia and other psychoses (9.9%), and intentional self-harm (6.6%). Of all MHSA-related ED visits, nearly 41% (4.8 million) “resulted in hospital admission- an admission rate that is over two and a half times that for ED visits related to other [non-MHSA] conditions” (p. 2). This increase in emergency department visits makes preparation for treating these disorders for a student preparing for a career in psychology a must if the profession is to meet the needs of emergency departments in the U.S.

Sharing is: CARING

Are you looking for homework writing help? Click on Order Now button below to Submit your assignment details.

Homework Writing Help
We Can Help you with this Assignment right now!
Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review

Are you looking for homework writing help on (Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review)?Well, you can either use the sample paper provided to write your paper or you could contact us today for an original paper. If you are looking for an assignment to submit, then click on ORDER NOW button or contact us today. Our Professional Writers will be glad to write your paper from scratch.

 

We ensure that assignment instructions are followed, the paper is written from scratch. If you are not satisfied by our service, you can either request for refund or unlimited revisions for your order at absolutely no extra pay. Once the writer has completed your paper, the editors check your paper for any grammar/formatting/plagiarism mistakes, then the final paper is sent to your email.

Writing Features

Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review

Privacy| Confidentiality

Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review

We do not share your personal information with any company or person. We have also ensured that the ordering process is secure; you can check the security feature in the browser. For confidentiality purposes, all papers are sent to your personal email. If you have any questions, contact us any time via email, live chat or our phone number.

Our Clients Testimonials

  • I appreciate help on the assignment. It was hard for me but am good to go now

    Impact of pollution on Environment
  • Am happy now having completed the very difficult assignment

    Creative Message Strategies
  • Your writer did a fine job on the revisions. The paper is now ok

    Ethics: Theory and Practice
  • The paper was so involving but am happy it is done. Will reach you with more assignments

    Title: Privatization in or of America
  • I expected perfection in terms of grammar and I am happy. Lecturer is always on our head but was pleased with my paper. Once again, thanks a lot

    Title: Bundaberg Inquiry
  • The paper looks perfect now, thank to the writer

    Health Care Systems
  • You helped me complete several other tasks as you handled paper. wonna thank you

    Critique Paper on Political Change
A Short List of our Services
Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review

Related Articles

Sample Dissertation Chapter Paper on The Lived Experiences of Licensed Professional Counselors (LPC’s) Providing Emergency Room Interventions and Assessments to Suicidal Patients: A Phenomenological Review

Analyze the Nursing Roles in providing Comprehensive care in a Variety of Community Health Settings

Community Settings This week’s graded topics relate to the following Course Outcomes (COs). CO3: Plan prevention and population-focused interventions for vulnerable populations using professional clinical judgment and evidence-based practice. (POs...
Read More

Case Study Assignment on Ethical Issues in Asia-Pacific business

Case study assignment on Ethical Issues in Asia-Pacific business For this assignment, students will write a case study report in 2,000 words based on a case identified with circumstance or...
Read More

Sample Report Paper on The proposed reward system and strategy for the big city university

A good reward system should motivate workers. It should also attract and retain the same workers. On the contrary, a bad reward system does not do either of these things....
Read More

Management of PCOS through Homoeopathy-A case report

Introduction PCOS is the acronym for Polycystic Ovarian Syndrome. It is the most common endocrine disorder of women in their reproductive period manifested by irregular menstrual cycles and polycystic ovaries,...
Read More

Get more from us…

Would you like this sample paper to be sent to your email or would you like to receive weekly articles on how to write your assignments? You can simply send us your request on how to write your paper and we will email you a free guide within 24-36 hours. Kindly subscribe below!

Email Address: support@globalcompose.com