M. David Rudd, The Assessment and Management of Suicidality

Abstract

‘‘The Assessment and Management of Suicidality,’’ which is part of the Practitioner’s Resource Series, provides a concise overview of how to assess and manage suicidal clients. Dr. Rudd emphasizes many aspects of clinical care including the importance of using precise technology, e.g., threat versus gesture, and distinguishing acute from chronic risk. The importance of the therapeutic relationship in conducting an accurate and thorough assessment is emphasized. The volume also covers other important risk factors that need to be assessed with suicidal clients, such as stressors, hopelessness, and impulsivity. The section on clinical management of the suicidal client includes a discussion of the pros and cons of no-suicide contracts. The book closes with a discussion of the importance of thorough documentation by the therapist, as well as the value of seeking consultation from other professionals whenever managing a suicidal client. ‘‘The Assessment and Management of Suicidality,’’ has many strengths. It is very easy to read, and provides useful tables, figures and appendices which will very likely enhance adoption of the materials by clinicians. Rudd meets his goal of providing a ‘‘pocket reference’’ for clinicians and trainees. The Standard Suicide Risk Assessment form provides all that is needed for a clinician to perform a thorough interview of a suicidal client. One form—the Commitment to Treatment Statement (CTS)—is particularly useful. Rather than using a ‘‘no-suicide’’ contract, Rudd advocates use of the CTS, which details the importance of attending and actively participating in therapy and implementing a crisis plan when needed. The Crisis Response Plan is also very useful, as it outlines what steps the client can take before contacting a friend or professionals. A minor weakness of the outline is Rudd’s decision not to include material on theory. He refers to his conceptualization of suicide risk as Fluid Vulnerability Theory. A brief description on the theory and its relation to his management strategies might have been useful. There is no discussion of the psychotherapy of suicidal clients but again this was not the stated purpose of the volume. Nonetheless, the author discusses how to use a thorough assessment of the suicidal client and his/her history of suicidal ideation and behavior in a therapeutic manner. This clearly written, well-organized book contains a brief but thorough summary of established practices as well as some innovative material that is very useful. Novice practitioners to seasoned clinicians should have this volume on their bookshelves. It provides in one slim book all that is needed to know on how to manage clients in crisis and in the few weeks after the acute episode of sucidality.