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Developing and validating a distress-processing model for clients in suicidal crisis Mickelson, Johanna M.

Abstract

While crisis intervention frameworks have indicated the importance of clients in suicidal crisis better understanding their distress to decrease suicidality, it is unclear how clients in suicidal crisis make sense of their distress. We used task analysis to develop and validate a sequential distress-processing model for clients in suicidal crisis based on theory and empirical observation. Online crisis chats (N = 51) with adults in suicidal crisis were coded to develop a distress-processing model for clients in suicidal crisis and corresponding observational measure. We then related clients’ distress processing to psychological outcomes using quantitative methods. We developed a sequential five-stage distress-processing model describing clients moving through (a) distress disengagement, (b) distress awareness, (c) distress clarity, (d) distress insight, and (e) application of distress insight. Our findings supported the sequential nature of our distress-processing model, and that clients with good outcomes were twice as likely as those with bad outcomes of being in a higher overall stage of distress processing. By better understanding how clients in suicidal crisis process their crisis distress, more targeted assessment and intervention can be developed.

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Attribution-NonCommercial-NoDerivatives 4.0 International