Doctor’s new approach to suicide prevention involves the patient

PERRYSBURG – To Dr. David Jobes, the current approach to suicide risk is bankrupt.
Typically, a therapist asks questions of a passive patient, makes a diagnosis and treats the symptoms,
which may include hospitalization and the signing of a promise not to commit suicide.
But Jobes, a keynote speaker Friday at the Wood County Suicide Prevention Coalition Conference, has
formulated a new approach to suicide prevention that empowers the suicidal person in developing his own
therapy. Jobes is a professor of psychology and the associate director of clinical training at the
Catholic University of America in Washington, D.C.
Many times, he observed, the suicidal person believes himself to be helpless, and that the only control
left in life is whether or not to end it. So Jobes’ program, called CAMS, for Collaborative Assessment
and Management of Suicidality, tries to see the issue through the patient’s eyes.
"The patient is the boss, the expert of the struggle," he explained.
"With CAMS, you want the patient to be a big part of the treatment. You want him to fight for life
and be the co-author of his own treatment."
Because interest in suicide prevention is relatively new – there were no studies as of 10 years ago –
Jobes said there are now only 46 studies in the world’s literature on the treatment of suicide.
"46 is small pickin’s. (In comparison) there are 36 studies on arachnophobia (a fear of spiders).
Out of 46 studies, we basically know what doesn’t work. Only 16-17 show what does work."
But Jobes’ CAMS program is being added to that list of studies. The Army is currently conducting a study
among its suicidal soldiers at Fort Stewart, Ga., using CAMS.
Both the Army and Marines Corps are finding a high suicide rate among their men and women, especially
during the last five years.
As part of his CAMS program, which Jobes took 15 years to develop, he designed an easy patient assessment
tool called the Suicide Status Form. In keeping with empowering the patient, the person and therapist
fill in the SSF together while seated next to each other.
On the form the patient lists the stressors in his or her life (empty nest, overweight, anxiety, etc.);
plus reasons for living and reasons for wanting to die.
The tool helps the patient learn more about his or her own suffering, while showing the clinician if the
person is suicidal based on relationship troubles or self hate.
"Knowing which orientation helps the clinician focus on the right treatment," said Jobes.
As part of treatment, the patient agrees to attend appointments for three months, reduces or eliminates
access to lethal means (gun, pills, rope), develops and uses a Coping Card and creates interpersonal
supports.
The Coping Card has the client list five activities to do if feeling suicidal and enlists crisis support
from a family member or friend.
"Does it work? Yes, it does," said Jobes. He has found that eight to 10 sessions have worked
for a clinician to help a patient end his idea to commit suicide. CAMS patients have been found to have
more optimism and hope.
"Patients like it. When patients like their care, they retain their treatment better."