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Impact of Psychotherapy on Rational Suicide

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Rational Suicide in the Elderly

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Abstract

Rational suicidality or desire for hastened death is common among older adults in distress with a low likelihood of relief or expecting significant physical or mental decline that would be associated with distress and compromised personal integrity. In these cases, clinicians should first aim to delay patients’ deaths and engage them in a process of finding ways to improve their quality of life. Motivational Interviewing provides a valuable foundation for these interventions, and safety planning is important to developing patients’ ability to take responsibility for their own lives. Cognitive-behavioral, mindfulness, and acceptance skills can reduce suicidality and improve quality of life, even in brief applications. Existential concerns are a significant factor in desire for hastened death, so use of existential therapy or incorporation of some of its components is useful in addressing older adults’ rational suicidality. Interdisciplinary collaboration is also key to best understand a patient’s biopsychosocial situation, facilitate better patient care, increase patients’ resources, and increase the likelihood that patients implement strategies introduced in therapy. Clinical recommendations are made based on a review of empirical research.

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Authors and Affiliations

  1. Department of Primary Care—Mental Health Integration, VA Eastern Colorado Health Care System, 1055 Clermont Street, Denver, CO, 80220, USA

    Darryl Etter Psy.D.

  2. Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, 12801 E. 17th Avenue, Mail Stop 8117, Research 1, South Aurora, CO, 80045, USA

    Elissa Kolva Ph.D.

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  1. Darryl Etter Psy.D.
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  2. Elissa Kolva Ph.D.
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Correspondence to Elissa Kolva Ph.D. .

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Editors and Affiliations

  1. Department of Psychiatry, New York University School of Medicine, New York, New York, USA

    Robert E. McCue

  2. Department of Psychiatry, New York University School of Medicine, New York, New York, USA

    Meera Balasubramaniam

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Etter, D., Kolva, E. (2017). Impact of Psychotherapy on Rational Suicide. In: McCue, R., Balasubramaniam, M. (eds) Rational Suicide in the Elderly. Springer, Cham. https://doi.org/10.1007/978-3-319-32672-6_12

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