Suicide and non-suicidal self-injury remain major public health problems in the United States. Suicide is the 10th leading cause of death and the second for young people. Suicide rates continue to increase and are now 14.5 per 100,000 in population (AAS, 2021). Non-suicidal self-injury (NSSI; e.g. cutting, self-hitting, skin picking, and burning) is a separate (but related) problem and is a major public health challenge in its own right. Data from a recent large sample study found that 17.6% of high schoolers from 8 states self-injured during the previous year (Monto et al. 2018). In Massachusetts, the most recent data are that 14.5 % of high school students and 16.8% of middle schoolers self-injured during the previous year (Mass. DOE, 2017). There is no denying an epidemic of NSSI is in our midst. Given the intensity of these problems, the distress and misery involved, and the complexity of providing help, it is crucial to keep our knowledge up-to-date and to employ the most state-of-the-art interventions available. This training will focus on what is most current and effective. The workshop will begin with an emphasis on suicide prevention. The best tool available to assess imminent risk clinically is Thomas Joiner’s Acute Suicidal Affective Disturbance (ASAD; Joiner, 2015). It is evidence-based and offers four specific dimensions that are predictive of acute suicide risk. These are: 1) a geometric increase of suicidal intent and planning in the short-term, 2) marked social and/ or self-alienation, 3) perception of hopelessness, and 4) two or more manifestation of overarousal (insomnia, nightmares, agitation, irritability). The ASAD will be explored with real world clinical examples re: managing such risk. For those who are found to be at risk using the ASAD, the logical next step is to move to Safety Planning. The training will next focus on Stanley and Brown’s evidence-based Safety Plan. It is a tool that identifies warning signs, coping skills, both personal and professional supports, restriction of means, and reasons for living. This Safety Plan also has phone app versions. The presentation will then move to Thomas Joiner’s Interpersonal Theory of Suicide. It is the most researched formulation about suicide in the world. The workshop will explore the three major components of the theory: acquired fearlessness, thwarted belongingness, and perceived burdensomeness. The theory will be employed to explain the suicide trajectories of real-world individuals. The treatments of choice for suicidality appear to be three: Dialectical Behavior Therapy (DBT), the Collaborative Assessment and Management of Suicidality.(CAMS), and Cognitive-Behavioral Therapy (CBT). Aspects of these treatments will be briefly reviewed with practical applications emphasized.The second half of the training will focus on NSSI.

Hosted by The Bridge Training Institute in Marlborough, MA for 6 CEs. For more info, visit The Bridge Training Institute's website.