“I Honestly Would Not Have Known What to Do”: An Exploratory Study of Perspectives on Client Suicide Among Vocational Rehabilitation Support Staff

Abstract

Despite the high prevalence of suicide both overall and among people with disabilities in particular, little research has explored suicide in the context of the vocational rehabilitation (VR) system or in counseling support staff in general. We analyzed the responses of 14 VR support staff who responded to an open-ended qualitative prompt regarding their experiences with suicide training and competency. Key themes included a perceived lack of and desire for more training regarding suicide, seeking and receiving suicide training outside of VR, and a perceived lack of resources for working with suicidal clients. Responses also underscored the heavy emotional impact of working with these clients, especially when one feels unprepared to do so. These results suggest that it is important to provide VR support staff with resources and training for addressing suicide in their client populations.

Keywords

suicide suicide competency vocational rehabilitation disability support staff

Get full access to this article

View all access options for this article.

References

Association of Psychology Post-doctoral and Internship Centers (2011). 2011 APPIC Match: Survey of internship applicants: Part 1. Retrieved from http://www.appic.org/Match/MatchStatistics/ApplicantSurvey2011Part1.aspx.

Condron

S. D.

Garraza

L. G.

Walrath

C. M.

McKeon

Goldston

D. B.

Heilbron

N. S.

(2015) Identifying and referring youths at risk for suicide following participation in school‐based gatekeeper training. Suicide and Life-Threatening Behavior 45: 461–476.

Cramer

R. J.

Johnson

S. M.

Mclaughlin

Rausch

E. M.

Conroy

M. A.

(2013) Suicide risk assessment for psychology doctoral programs: Core competencies and a framework for training. Training and Education in Professional Psychology 7: 1–11.

Curtin, S. C., Warner, M, & Hedegaard, H (2016). Increase in suicide in the United States, 1999–2014 (NCHS data brief, no 241). Hyattsville, MD: National Center for Health Statistics. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db241.pdf.

Dennis

Baillon

Brugha

Lindesay

Stewart

Meltzer

(2009) The influence of limitation in activity of daily living and physical health on suicidal ideation: Results from a population survey of Great Britain. Social Psychiatry and Psychiatric Epidemiology 44: 608–613.

Drapeau, C. W., & McIntosh, J. L. (2016). U.S.A. suicide 2015: Official final data. Retrieved from http://www.suicidology.org/Portals/14/docs/Resources/FactSheets/2015/2016datapgsv1b.pdf.

Giannini

M. J.

Bergmark

Kreshover

Elias

Plummer

O’Keefe

(2010) Understanding suicide and disability through three major disabling conditions: Intellectual disability, spinal cord injury, and multiple sclerosis. Disability and Health Journal 3(2): 74–78.

Glaser

B. G.

(1998) Doing grounded theory: Issues and discussions, Mill Valley, CA: Sociology Press.

Graham, M., Millanowski, A., & Miller, J. (2012). Measuring and promoting inter-rater agreement of teacher and principal performance ratings. Retrieved from http://files.eric.ed.gov/fulltext/ED532068.pdf.

10.

Hunt

B. H.

Rosenthal

D. A.

(1997) Rehabilitation counselors-in-training: A study of their levels of death anxiety and their perceptions about client death. Rehabilitation Education 11: 323–335.

11.

Hunt

Rosenthal

(2000) Rehabilitation counselors’ experiences with client death and death anxiety. Journal of Rehabilitation 66(4): 44–50.

12.

Isaac

Elias

Katz

L. Y.

Shay-Lee

Deane

F. P.

Enns

M. W.

Sareen

(2009) Gatekeeper training as a preventative intervention for suicide: A systematic review. Canadian Journal of Psychiatry 54: 260–268.

13.

Knox

Burkard

A. W.

Jackson

J. A.

Schaack

A. M.

Hess

S. A.

(2006) Therapists-in-training who experience a client suicide: Implications for supervision. Professional Psychology: Research & Practice 37: 547–557.

14.

LivingWorks. (2010). SafeTALK – Suicide alertness for everyone. Retrieved from http://www.livingworks.net/programs/safetalk/.

15.

Lund

E. M.

Andrews

E. E.

Holt

J. M.

(2014) How we treat our own: The experiences and characteristics of psychology trainees with disabilities. Rehabilitation Psychology 59: 367–375.

16.

Lund

E. M.

Andrews

E. E.

Holt

J. M.

(2016) A qualitative analysis of advice from and for trainees with disabilities in professional psychology. Training and Education in Professional Psychology 10: 206–213.

17.

Lund

E. M.

Nadorff

M. R.

Seader

(2016) The relationship between suicidality and disability when accounting for depressive symptomology. Rehabilitation Counseling Bulletin 59: 185–188.

18.

Lund

E. M.

Nadorff

M. R.

Winer

E. S.

Seader

(2016) Is suicide an option? The impact of disability on suicide acceptability in the context of depression, suicidality, and demographic factors. Journal of Affective Disorders 189: 25–35.

19.

Lund

E. M.

Schultz

J. C.

Nadorff

M. R.

(2017) The factor structure, internal consistency, and convergent validity of two suicide assessment competency measures in vocational rehabilitation counselors. Rehabilitation Counseling Bulletin 60: 20–27.

20.

Lund

E. M.

Schultz

J. C.

Nadorff

M. R.

Galbraith

Thomas

K. B.

(2017a) Experience, knowledge, and perceived comfort and clinical competency in working with suicidal clients among vocational rehabilitation counselors. Rehabilitation Counseling Bulletin 60: 54–63.

21.

Lund

E. M.

Schultz

J. C.

Nadorff

M. R.

Galbraith

Thomas

K. B.

(2017b) Psychometric properties of two self-report suicide assessment and intervention competency measures in a multistate sample of vocational rehabilitation support staff. Australian Journal of Rehabilitation Counseling 23(1): 52–68.

22.

McConnell

Hahn

Savage

Dubé

Park

(2015) Suicidal ideation among adults with disability in western Canada: A brief report. Community Mental Health Journal 52: 519–526.

23.

McHale

Felton

(2010) Self‐harm: What’s the problem? A literature review of the factors affecting attitudes towards self‐harm. Journal of Psychiatric and Mental Health Nursing 17: 732–740.

24.

Pompili

Forte

Palermo

Stefani

Lamis

D. A.

Serafini

Girardi

(2012) Suicide risk in multiple sclerosis: A systematic review of current literature. Journal of Psychosomatic Research 73: 411–417.

25.

Quinett

(1995) Question, persuade, refer: Ask a question save a life [Booklet], Spokane, WA: QPR Institute.

26.

Ramsay

Tanney

Tierney

Land

(1999) ASIST (Applied Suicide Intervention Skills Training) trainer’s manual, Calgary, Canada: Living Works Education.

27.

Saunders

K. E.

Hawton

Fortune

Farrell

(2012) Attitudes and knowledge of clinical staff regarding people who self-harm: A systematic review. Journal of Affective Disorders 139: 205–216.

28.

Schmitz

W. M.

Allen

M. H.

Feldman

B. N.

Gutin

N. J.

Jahn

D. R.

Kleespies

P. M.

Simpson

(2012) Preventing suicide through improved training in suicide risk assessment and care: An American Association of Suicidology Task Force report addressing serious gaps in US mental health training. Suicide and Life-Threatening Behavior 42: 292–304.

29.

Segers

Rawana

(2014) What do we know about suicidality in autism spectrum disorders? A systematic review. Autism Research 7: 507–521.

30.

Smart

J. F.

(2008) Disability, society, and the individual, 2nd ed. Austin, TX: Pro Ed.

31.

Strauss

A. L.

Corbin

(1990) Basics of qualitative research: Grounded theory procedure and techniques, Newbury Park, CA: Sage.

32.

Wetzel

H. H.

Gehl

C. R.

Dellefave–Castillo

Schiffman

J. F.

Shannon

K. M.,

Paulsen

J. S.

Huntington Study Group (2011) Suicidal ideation in Huntington disease: The role of comorbidity. Psychiatry Research 188: 372–376.

33.

Wong

D. W.

Chan

Da Silva Cardoso

Lam

C. S.

Miller

S. M.

(2004) Rehabilitation counseling students’ attitudes toward people with disabilities in three social contexts: A conjoint analysis. Rehabilitation Counseling Bulletin 47(4): 194–204.