Treatment Interventions

Following up with the previous blog about suicide and how we can prevent the numbers from rising, here are a number of available treatment options. As each kind of therapy is uniquely different, I've delineated some popular treatment modalities in some detail for you to get a clearer sense of the many options out there.

Treatment options

INPATIENT:

Hospitalization: Individual may need to be hospitalized until stabilized and no longer a threat to themselves.

Residential Facility: Here the individual is provided an individual therapist, a psychiatrist for medication management as well as partaking in group therapy and experiential and recreational therapy. This supportive environment addresses their needs on many levels as well as planning  for integrating back into their home life while continuing outpatient treatment.

OUTPATIENT:

Individual Therapy sessions: Depending on the need individual therapy may once, twice or three times per week.

There are many forms of treatment and many different therapists. Finding the right therapist can feel daunting and at the same time when you find the right person for treatment you will experience a sense of relief and a knowing that you are on the pathway to healing.

Below are some popular treatment modalities proven to be successful in treatment of depression and reducing suicidality.

PSYCHOTHERAPY TREATMENT MODALITIES

Cognitive Behavioral Therapy(CBT) focuses on the development of coping strategies targeting solving current problems and changing unhelpful thoughts and patterns in the mind, shifting beliefs and attitudes, behaviors and helping to regulate emotions.

Dialectical behavior therapy (DBT) is a therapy designed to help people suffering from mood disorders as well as those needing to change unhelpful patterns and behaviors such as self-harm, substance abuse and suicidal ideation. Research has proven this modality to be incredibly successful. DBT combines standard shifting of thoughts and behavior techniques towards regulation emotions, reality testing as well as teaching skills in tolerating distress, acceptance and mindfulness and improving interpersonal relationships.

Internal Family Systems (IFS)  IFS sees consciousness as composed of various "parts" or subpersonalities, each with its own perspective, interests, memories, and viewpoint. IFS believes that every part of the person has a positive goal for the person, even if its actions seem counterproductive. IFS divides these parts into three types—managers, exiles, and firefighters.

Psychodynamic Psychotherapy Psychodynamic therapy is designed to help patients explore the full range of their emotions, including feelings they may not be aware of. Bringing to light unconscious elements of their life into present life experience, psychodynamic therapy helps individuals understand how their behavior and mood are affected by unresolved issues. Utilizing insights and newfound awareness they then are equipped to choose different behaviors and choose alternate options to responding to issues and making better life choices.

Expressive/Art Therapy  Therapists use creative process to help clients increase insight, cope with stress, work through traumatic experiences, increase cognitive, memory and neurosensory abilities, improve interpersonal experiences and achieve greater self-fulfillment. In expensive therapies, the process of creation is emphasized, and the "final product" is less of importance. Expressive therapies believe that  people heal through the use of imagination. 

Eye movement desensitization and reprocessing (EMDR)  is a form of psychotherapy developed by Francine Shapiro. It is used to  help reduce symptoms associated with Post Traumatic Stress Disorder. When one experiences a trauma, their coping mechanisms are overwhelmed and therefore their memory and associated stimuli inadequately process the information. The experience is stored in an isolated memory network which causes distress when the individual recalls the memory.. The goal of EMDR is to reduce the long-lasting effects of distressing memories by engaging the brain's natural adaptive information processing mechanisms, offering relief to the symptoms.

Somatic Experiencing is an approach developed by Peter Levine to resolve trauma.  The goal of somatic experiencing is to shift awareness to healing, positive states, "pendulating" between positive states and trauma-related, activated, stressful states. Levine refers to "titration" as the process of introducing  small doses of trauma-related states (that are tolerable) to expand the person's capacity to hold, and subsequently release the trauma from the body. Doing this allows the individual to experience relief and promote long lasting integration and recovery.

Neurofeedback Neurofeedback (NFB) is  a type of biofeedback that uses  brain activity, most commonly electroencephalograph,  to teach self-regulation of brain function.  Regulation of the self teaches the central nervous system to function better. Sensors are placed on the scalp to measure activity. The measurements are displayed using sound or video, and the brain is observed in action from moment to moment, and thereafter the  information is shown back to the person.  he brain is "rewarded" for changing its own activity to more adaptive, helpful patterns. Neurofeedback strengthens the brain's ability to regulate itself and helps in treatment of  anxiety, depression, and the emotional issues. 

GROUPS:

Dialectical Behavioral Therapy Groups  DBT Skills Group is comprised of 4 modules1) Core Mindfulness- skills to learn how to be present in the moment and achieve greater attentional control 2)Distress Tolerance-skills to survive a crisis without making it worse 3)Emotion Regulation-skills to identify and change painful or intolerable emotions 4)Interpersonal Effectiveness-skills to effectively improve and manage interpersonal relationships without losing one's self-respect. These skills are helpful to reducing impulsivity of self destructive behavior while teaching the brain to better survive really tough emotions. In using those skills, the individual can use their energy to build a life worth living with focus on relationship, interpersonal skills and goals for life.

Psycho-Educational Groups Receiving psycho-education is a foundational necessity in understanding how to create a change as you first need to understand current defenses at play. Knowledge is power and getting educated give you a comprehensive understanding of why you're doing what you're doing as well as knowing that you're not crazy; rather you can learn new ways of dealing with ongoing events or stressors in ways that work better for your mind, body and energy. It is also important to understand and address any underlying or hidden trauma that may be present and be playing a silent yet powerful role.

THE FAMILY'S ROLE

In some instances the family's involvement is essential and necessary. Other instances may not allow for it or may prove to be unhelpful to treatment. Speak to your therapist about what is most helpful to your specific situation.  Denial may be strong and a good therapist will help notice and stop reenactments of unhelpful family patterns as well as addressing overt or covert codependency traits that keep family in a toxic dynamic or environment that prevents healing. Good family work starts the family and their healing as well as strengthens each person while the individual is doing their own healing.

MEDICATION MANAGEMENT:

It is important for the individual to be assessed and evaluated by a psychiatrist who has knowledge about suicidality. Treating the underlying biological component is a must. Medication increases the effects of certain neurotransmitters which are chemicals that relay messages between your brain cells. Depending on the need, medication helps the brain release a healthy, balanced dose of serotonin and dopamine so that the individual can engage in the therapeutic process as wholesomely as possible.

Healing is possible. People have walked this path and so can you.  

"THE JOURNEY OF A THOUSAND MILES BEGINS WITH ONE STEP"                                              -LAO TZU