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Suicide and Psychotherapy

Suicide and Psychotherapy
 

The current paper deals with the analysis of the article “Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide: Preliminary Findings” by Martin J. Heisel et al (2009). The article presents preliminary findings regarding older patients with considerable risk of suicide. The article is based on the use of classical statistical methods with the interpretation from the point of view of psychotherapy. Twelve adults were used as an empirical basis for research; all of them expressed thoughts regarding the possibility of suicide. Thus, they could serve for the purposes of testing the authors’ hypothesis. These patients participated in weekly sessions of interpersonal psychotherapy. The mean age of all participants was 70.5 years, and the standard deviation was equal to 6.1 years. One patient was subsequently excluded because he had significant cognitive problems. Preliminary results demonstrate that the proposed method is an effective tool of dealing with suicide thoughts. It has a number of implications for older adults with similar problems.

On this basis, it is possible to evaluate the strengths and weaknesses of this research and formulate relevant recommendations that may contribute to further progress in the given scientific area. First of all, it seems reasonable to use empirical testing for the verification of the authors’ hypothesis. As it is problematic to assess the potential effectiveness of this method in pure theoretical way, it is necessary to create such experiments and use statistical tools for the close examination of the patients’ response. In order to provide a reliable testing the population under study should be homogenous; in other words, they should possess identical or similar characteristics that may be compared and evaluated with the help of statistics.

Thus, it is reasonable to choose the group where the age of each participant is more than 60 years. However, in the given case, theentire procedure is not perfect. First of all, participants are heterogeneous, and it makes the ultimate conclusions less reliable. Although it is impossible to have a set of absolutely identical patients in the sphere of psychotherapy, the variance in the given case is comparatively large. The variation coefficient equals to 6.1 / 70.5 * 100% = 8.7%; it is significant taking into account that there are only 12 participants in the sample. Moreover, one of the patients had some cognitive problems and was even removed from further investigation and empirical testing.

Another problem is low reliability of the results due to a small set of participants (Atkins, 2014). As their number is only 12 (or even 11 at the end of the research), the testing error is very high, and it is unreasonable to make recommendations that the proposed interpersonal psychotherapy is a significant and effective method of dealing with suicide thoughts. It should be stressed that these considerations do not mean that the proposed technique is ineffective and should not be adopted; it merely means that this hypothesis requires additional empirical testing and verification.

 

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It seems that the authors recognize that their study is not final in this area and needs additional elaborations as they stress that their results are “preliminary findings” (p. 156). However, they suggest that the substantial reduction of symptoms indirectly supports their initial hypothesis about the effectiveness of their method in psychotherapy. The authors also admit that “controlled trials are needed to further evaluate those findings” (p. 156). It seems that more deep research should be provided in this field, and a higher amount of empirical information should be collected. On this basis, it will be possible to make more adequate recommendations.

Another important aspect is that in this case, the initial hypothesis should not be necessarily either completely approved or rejeccted. It means that there is a possibility that there is statistically significant positive relationship between the proposed method of psychotherapy and suicide symptoms; however, it does not mean that the proposed system is perfect and further investigation may be needed that will allow optimizing the entire treatment process.

The authors included in their sample the patients with death ideation, suicide ideation, and depressive symptoms (p. 158). It is reasonable at the preliminary stage when it is necessary to evaluate the effectiveness of the proposed method in general. At the same time, at subsequent stages, it may be helpful to deal with these sub-groups separately as their symptoms are different, and they may require different treatments. There is also a possibility that the proposed type of interpersonal psychotherapy will be beneficial and significant for only some sub-groups while for others, it will not generate any considerable effect (Shedler, 2010). In order to fulfill this elaboration, a much larger sample of participants is needed. Then, it will be possible to verify the initial hypothesis in relation to the population in general and to each sub-group in particular.

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Another recommendation for further improvement of this study refers to the examination of the influence of the proposed method on other patient groups especially on the younger generation (Leichsenring & Rabung, 2008). As the risks of committing suicide are typical not only for the older adults, it is reasonable to include into investigation the rest of the population. Although it requires additional material and non-material resources, the obtained results may have a substantial theoretical and practical effect. It will be possible to understand whether different groups are subject to the same risk factors or not. It will also be possible to determine what the dynamics of suicide symptoms and the optimal strategy of dealing with such patients are.

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