Citation

Carmel A, Templeton E, Sorenson SM, Logvinenko E. Cogn. Behav. Pract. 2018; 25(4): 449-459.

Copyright

(Copyright © 2018, Association for Advancement of Behavior Therapy, Publisher Elsevier Publishing)

DOI

10.1016/j.cbpra.2018.02.001

PMID

unavailable

Abstract

The Linehan Risk Assessment and Management Protocol (LRAMP) is an empirically supported, comprehensive framework used to assess suicide risk and protective factors, and provide a guide for the therapist to consider reasonable options for intervening on suicidal behavior. This protocol includes a structured checklist for assessing, managing, and documenting suicide risk. It also structures the documentation to clearly describe the presentation, assessment, in-session interventions, decision-making process, and follow-up to other members of the treatment team. This paper describes a case in which the LRAMP was used to guide the assessment, intervention, and documentation of the suicidal behavior of a patient, "Ann," being treated with outpatient Dialectical Behavioral Therapy in a community mental health clinic. Each section of the LRAMP is discussed as it was used with this complex patient, who had history of high utilization of acute psychiatric services. Application of the LRAMP included the assessment of risk and protective factors, and the use of an individualized crisis plan that engaged the patient, her family, the therapist, and the clinical team, to decrease acute risk, continue outpatient treatment, and avoid inpatient hospitalization. The considerations for documenting clinical decision-making with chronically suicidal patients are discussed. © 2018

Language: en

Keywords

adult; human; suicide; female; case report; head injury; bipolar disorder; major depression; suicidal behavior; risk assessment; crisis intervention; substance abuse; bulimia; eating disorder; mental disease; socioeconomics; clinical article; length of stay; cognitive defect; priority journal; behavior therapy; nuclear magnetic resonance imaging; falling; family history; problem solving; patient attitude; social status; demography; medical documentation; risk management; high risk patient; health care utilization; dialectical behavior therapy; neuropsychological test; educational status; Article; brain damage; dialectical behavioral therapy; Linehan Risk Assessment and Management Protocol