“It’s Awful When We Get It Wrong”: An Exploratory Qualitative Study of Vocational Rehabilitation Counselors’ Perspectives on Suicide

Abstract

Despite the high prevalence of suicide among people with disabilities, little research has explored suicide in the context of the vocational rehabilitation (VR) system. We analyzed the responses of 27 VR counselors who responded to an open-ended qualitative prompt regarding their experiences with suicide training and competency. Key themes included a desire for more training on suicide and the experience of seeking and receiving suicide training and experience outside of VR. Responses also underscored the heavy emotional impact of working with suicidal clients, especially when one feels unprepared to do so. These results suggest that it is important to provide VR counselors with resources and training for addressing suicide in their client populations.

Keywords

suicide vocational rehabilitation counselors disability rehabilitation counseling

Get full access to this article

View all access options for this article.

References

Commission on Rehabilitation Counselor Certification (2016) Code of professional ethics for rehabilitation counselors, Schaumburg, IL: Author.

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.

Council for Accreditation of Counseling & Related Educational Programs. (2016). 2016 CACREP standards. Retrieved from http://www.cacrep.org/wp-content/uploads/2017/08/2016-Standards-with-citations.pdf.

Council on Rehabilitation Education. (2011). CORE accreditation standards. Schaumburg, IL: Author. Retrieved from http://www.cacrep.org/wp-content/uploads/2017/07/CORE-Standards-for-Rehabilitation-Counselor-Education-Programs.pdf.

Cramer

R. J.

Bryson

C. N.

Eichorst

M. K.

Keyes

L. N.

Ridge

B. E.

(2016) Conceptualization and pilot testing of a core competency-based training workshop in suicide risk assessment and management: Notes from the field. Journal of Clinical Psychology. 73(3), 233–238. doi:10.1002/jclp.22329.

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

Hedegaard

(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. Washington, DC: American Association of Suicidology. Retrieved from http://suicideprevention.nv.gov/uploadedFiles/suicidepreventionnvgov/content/SP/CRSF/Mtgs/2018/2016_AAS_USA_data.pdf.

10.

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.

11.

Glaser

B. G.

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

12.

Graham

Millanowski

Miller

(2012) Measuring and promoting inter-rater agreement of teacher and principal performance ratings, Washington, DC: Center for Educator Compensation Reform, U.S. Department of Education, Office of Elementary and Secondary Education, Retrieved from http://files.eric.ed.gov/fulltext/ED532068.pdf.

13.

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.

14.

Hunt, B. H., & Rosenthal, D. A. (2000). Rehabilitation counselors' experiences with client death and death anxiety. Journal of Rehabilitation, 66(4), 44–50.

15.

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.

16.

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.

17.

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

18.

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.

19.

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.

20.

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.

21.

Lund, E. M., Schultz, J. C., Nadorff, M. R., Galbraith, K., & Thomas, K. B. (2017). Experience, knowledge, and perceived comfort and clinical competency in working with suicidal clients among vocational rehabilitation counselors. Rehabilitation Counseling Bulletin, 60, 54–63.

22.

McConnell

Hahn

Savage

Dubé

Park

(2015) Suicidal ideation among adults with disability in western Canada: A brief report. Community Mental Health Journal. 52(5), 519–526. doi:10.1007/s10597-015-9911-3.

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, R., Tanney, B., Tierney, R., & Land, W. (1999). ASIST (Applied Suicide Intervention Skills Training) trainer’s manual. Calgary, Canada: LivingWorks 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. doi:10.1002/aur.1375.

30.

Strauss

A. L.

Corbin

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