安全协议：减轻自杀风险的简短干预

赵嘉路; 杨泽云; 蔡智勇

doi:10.12100/j.issn.2096-5494.222017

心理学通讯 >

2022 , Vol. 5 >Issue 2: 91 - 96

DOI: https://doi.org/10.12100/j.issn.2096-5494.222017

论坛：高校心理健康

安全协议：减轻自杀风险的简短干预

赵嘉路 ,
杨泽云 ,
蔡智勇

展开

¹清华大学学生心理发展指导中心,北京 100084;
²清华大学社会科学科学院心理学系,北京 100084;
³南京审计大学心理健康教育教学部,南京 211815

赵嘉路,博士,清华大学学生心理发展指导中心讲师,中国心理学会临床心理学注册工作委员会委员、注册督导师（D-21-204）;中国心理卫生协会大学生心理咨询专业委员会常务委员,副秘书长。研究方向：自我认同、心理咨询过程/效果/伦理、人工智能与心理咨询等领域。

^*赵嘉路 jialuzhao@tsinghua.edu.cn

网络出版日期: 2024-06-14

基金资助

北京市教育委员会社科计划一般项目（SM2019 10005007）; 清华大学教育教学改革项目（ZY01_02）; 清华大学学生工作研究项目重点项目（THXSGZ2021-ZD-05）

收起

Safety Agreement: Brief Intervention for Suicidal Risk Reduction

ZHAO Jialu ,
YANG Zeyun ,
CAI Zhiyong

Expand

¹Center for Counselling and Psychological Development, Tsinghua University, Beijing 100084, China;
²Department of Psychology, School of Social Sciences, Tsinghua University, Beijing 100084, China;
³Department of Psychological Health Education, Nanjing Audit University, Nanjing 211815, China

^*ZHAO Jialu, jialuzhao@tsinghua.edu.cn

Online published: 2024-06-14

Fold

摘要

高校大学生自杀问题引起广泛关注,大学生自杀危机的预防与干预是高校心理健康服务工作的重点。安全协议是由咨询师和来访者达成的一种文字形式约定,在来访者承诺不自杀的基础上,双方共同制定一套应对策略来降低来访者自杀行为的即时风险。文章梳理总结了有关自杀危机和安全协议的文献,围绕中国心理学会临床与咨询心理学专业机构和专业人员注册系统的《安全协议》文件进行介绍和解读。该协议包括6个部分：（1）来访者承诺不自杀/自伤的明确声明;（2）协议生效的起止时间;（3）自杀危机对应行动计划;（4）危机情况可以求助的联系人和机构;（5）来访者的书面签字;（6）使用安全协议注意事项。安全协议可为开展高校学生自杀风险干预工作提供具体指导。

关键词： 自杀; 不自杀; 安全协议; 干预

本文引用格式

赵嘉路 , 杨泽云 , 蔡智勇 . 安全协议：减轻自杀风险的简短干预[J]. 心理学通讯, 2022 , 5(2) : 91 -96 . DOI: 10.12100/j.issn.2096-5494.222017

Abstract

Suicidal issues of college students have attracted widespread attention, and prevention and intervention of suicide crisis are the focus of mental health services in colleges. Safety agreement is a written agreement between the consultant and client. On the basis of clients’ promise of not committing suicide, both parties jointly work out a set of coping strategies to reduce the immediate risk of suicide. This article sorts out and summarizes the literature on suicide crisis and safety agreement, and it introduces and interprets around the safety agreement documents issued by the Registration Working Committee for Clinical Psychology of Chinese Psychological Society. The agreement consists of six parts: (1) an explicit statement of the client’s promise not to commit suicide / self-injury; (2) the start and end time of the agreement; (3) suicide crisis response action plan; (4) the contact person and institution that can be reached out for helping in crisis situations; (5) written signature of clients; (6) precautions for the use of safety agreement. The safety agreement can provide specific guidance for the implementation of intervention in college.

Key words： suicide; non-suicide; safety agreement; intervention

参考文献

[1] 陈建梅, 艾明, 况利, 王敏建, 沈岩, 李大奇, … 陈建梅. (2010). 重庆市大学生自杀意念的调查. 中华流行病学杂志,31(3), 290-293.
[2] 崔玉华, 方明昭, 马长锁. (1998). 大学生自杀者社会心理因素和临床特点. 中国临床心理学杂志,6(3), 177-179.
[3] 梁漱溟. (1996). 梁漱溟全集(第一卷). 济南:山东人民出版社.
[4] 刘凤云. (2020). 大学生自杀现状调查及相关因素分析. 心理月刊,15(22), 47-49. doi: 10.19738/j.cnki.psy.2020.22.021
[5] Jobes D. A.(2020). 自杀风险的评估与管理: 一种合作式的方法 (李凌等译). 北京:中国轻工业出版社.
[6] 王寒, 武昱, 姜丽, 杨丽, 李凌. (2019). 不自杀协议在自杀风险评估与管理中的应用. 中国临床心理学杂志,27(5), 1067-1072. doi: 10.16128/j.cnki.1005-3611.2019.05.044
[7] 韦耀阳. (2013). 不自杀协议在中学生自杀干预中的应用. 中小学心理健康教育, (4), 13-15. doi: 10.3969/j.issn.1671-2684.2013.04.005
[8] 文崇一, 萧新煌. (2006). 中国人: 观念与行为.南京:江苏教育出版社.
[9] 杨国枢. (2004). 中国人的心理与行为:本土化研究. 北京:中国人民大学出版社.
[10] 朱彤. (2011). 大学生自杀预防及危机干预策略研究(硕士学位论文). 浙江师范大学, 金华.
[11] 祝一虹, 陈凯旋, 杨逸云, 刘艳, 莫敏佳, 朱婉儿. (2018). 心理咨询来访大学生自我伤害想法或行为的相关因素. 心理学通讯,1(2), 117-123.
[12] Andreasson K., Krogh J., Wenneberg C., Jessen H. K. L., Krakauer K., Gluud C.,.. Nordentoft M. (2016). Effectiveness of dialectical behavior therapy versus collaborative assessment and management of suicidality treatment for reduction of self-harm in adults with borderline personality traits and disorder-a randomized observer-blinded clinical trial.Depress Anxiety, 33(6), 520-530. doi: 10.1002/da.22472
[13] Assey, J. L. (1985). The suicide prevention contract.Perspect Psychiatr C, 23(3), 99-103. doi: 10.1111/j.1744-6163.1985.tb00263.x
[14] Bryan C. J., Mintz J., Clemans T. A., Burch T. S., Leeson B., Williams S.,.. Rudd M. D. (2018). Effect of crisis response planning on patient mood and clinician decision making: A clinical trial with suicidal US soldiers.Psychiatr Serv, 69(1), 108-111. doi: 10.1176/appi.ps.201700157
[15] Bryan C. J., Mintz J., Clemans T. A., Leeson B., Burch T. S., Williams S. R.,.. Rudd M. D. (2017). Effect of crisis response planning vs. contracts for safety on suicide risk in US Army Soldiers: A randomized clinical trial. J Affect Disorders, 212, 64-72. doi: 10.1016/j.jad.2017.01.028
[16] Chesin M. S., Stanley B., Haigh E. A. P., Chaudhury S. R., Pontoski K., Knox K. L.,.. Brown G. K. (2017). Staff views of an emergency department intervention using safety planning and structured follow-up with suicidal veterans.Arch Suicide Res, 21(1), 127-137. doi: 10.1080/13811118.2016.1164642
[17] Comtois K. A., Jobes D. A., S O’Connor S., Atkins D. C., Janis K., E Chessen C.,.. Yuodelis-Flores C. (2011). Collaborative assessment and management of suicidality (CAMS): Feasibility trial for next-day appointment services.Depress Anxiety, 28(11), 963-972. doi: 10.1002/da.20895
[18] Davidson M. W., Wagner W. G., & Range L. M. (1995). Clinicians’ attitudes toward no-suicide agreements. Suicide Life Threat Behav, 25(3), 410-414.
[19] Davis S. E., Williams I. S., & Hays L. W. (2002). Psychiatric inpatients’ perceptions of written no-suicide agreements: An exploratory study.Suicide Life Threat Behav, 32(1), 51-66. doi: 10.1521/suli.32.1.51.22180
[20] DeBeer B. B., Matthieu M. M., Kittel J. A., Degutis L. C., Clafferty S., Qualls N.,.. Morissette S. B. (2019). Quality improvement evaluation of the feasibility and acceptability of adding a concerned significant other to safety planning for suicide prevention with veterans.JMHC, 41(1), 4-20. doi: 10.17744/mehc.41.1.02
[21] Descant, J. J., & Range, L. M. (1997). No-suicide agreements: College students’ perceptions.College Student Journal, 31(2), 238-242.
[22] Drye R. C., Goulding R. L., & Goulding M. E. (1973). No-suicide decisions: Patient monitoring of suicidal risk.Am J Psychiatry, 130(2), 171-174. doi: 10.1176/ajp.130.2.171
[23] Edwards, S., Harries, M. (2007). No-suicide contracts and no-suicide agreements: A controversial life.Australas Psychiatry, 15(6), 484-489. doi: 10.1080/10398560701435846
[24] Edwards, S. J., & Sachmann, M. D. (2010). No-suicide contracts, no-suicide agreements, and no-suicide assurances: A study of their nature, utilization, perceived effectiveness, and potential to cause harm.Crisis, 31(6), 290-302. doi: 10.1027/0227-5910/a000048
[25] Ellis T. E., Green K. L., Allen J. G., Jobes D. A., & Nadorff M. R. (2012). Collaborative assessment and management of suicidality in an inpatient setting: Results of a pilot study.Psychotherapy (Chic), 49(1), 72-80. doi: 10.1037/a0026746
[26] Ellis T. E., Rufino K. A., Allen J. G., Fowler J., & Jobes D. A. (2015). Impact of a suicide-specific intervention within inpatient psychiatric care: The collaborative assessment and management of suicidality.Suicide Life Threat Behav, 45(5), 556-566. doi: 10.1111/sltb.12151
[27] Farrow, T. L. (2002). Owning their expertise: Why nurses use ‘no suicide contracts’ rather than their own assessments.Int J Ment Health Nurs, 11(4), 214-219. doi: 10.1046/j.1440-0979.2002.00251.x
[28] Ferguson M., Rhodes K., Loughhead M., McIntyre H., & Procter N. (2021). The effectiveness of the safety planning intervention for adults experiencing suicide-related distress: A systematic review.Arch Suicide Res, 1-24. doi: 10.1080/13811118.2021.1915217
[29] Jobes D. A.(2006). Managing suicidal risk: A collaborative approach. NY: Guilford Press.
[30] Kayman D. J., Goldstein M. F., Dixon L., & Goodman M. (2015). Perspectives of suicidal veterans on safety planning: Findings from a pilot study.Crisis, 36(5), 371-383. doi: 10.1027/0227-5910/a000348
[31] Klonsky, E. D., & May, A. M. (2015). The three-step theory (3ST): A new theory of suicide rooted in the “ideation-to-action” framework.Int J Cogn Ther, 8(2), 114-129. doi: 10.1521/ijct.2015.8.2.114
[32] Levandowski B. A., Cass C. M., Miller S. N., Kemp J. E., & Conner K. R. (2017). An intervention with meaning: Perceptions of safety planning among Veteran Health Administration providers.Crisis, 38(6), 376-383. doi: 10.1027/0227-5910/a000433
[33] Lewis, L. M. (2007). No-harm contracts: A review of what we know.Suicide Life Threat Behav, 37(1), 50-57. doi:10.1521/suli.2007.37.1.50
[34] McMyler, C., & Pryjmachuk, S. (2008). Do ‘no-suicide’ contracts work?J Psychiatr Ment Health Nurs, 15(6), 512-522. doi: 10.1111/j.1365-2850.2008.01286.x
[35] Miller, M. C. (1999). Suicide-prevention contracts: Advantages, disadvantages, and an alternative approach. In D. G. Jacobs (Ed.), The Harvard Medical School guide to suicide assessment and intervention(pp. 463-481). Wiley, Hoboken, NJ: Jossey-Bass.
[36] Miller M. C., Jacobs D. G., & Gutheil T. G. (1998). Talisman or taboo: The controversy of the suicide-prevention contract.Harvard Rev Psychiat, 6(2), 78-87. doi: 10.3109/10673229809000314
[37] Nuij C., van Ballegooijen W., de Beurs D., Juniar D., Erlangsen A., Portzky G.,.. Riper H. (2021). Safety planning-type interventions for suicide prevention: Meta-analysis.Br J Psychiatry, 219(2), 419-426. doi: 10.1192/bjp.2021.50
[38] Rozek, D. C., & Bryan, C. J. (2020). Integrating crisis response planning for suicide prevention into trauma-focused treatments: A military case example.J Clin Psychol, 76(5), 852-864. doi: 10.1002/jclp.22920
[39] Rozek D. C., Keane C., Sippel L. M., Stein J. Y., Rollo-Carlson C., & Bryan C. J. (2019). Short-term effects of crisis response planning on optimism in a US Army sample. Early Interv Psychia, 13(3), 682-685. doi: 10.1111/eip.12699
[40] Rudd M. D., Joiner T., & Rajab, M. H. (2001). Treating suicidal behavior: An effective, time-limited approach NY: Guilford Press An effective, time-limited approach. NY: Guilford Press.
[41] Rudd M. D., Mandrusiak M., & Joiner Jr, T. E. (2006). The case against no-suicide contracts: The commitment to treatment statement as a practice alternative. J Clin Psychol, 62(2), 243-251. doi: 10.1002/jclp.20227
[42] Simon, R. I. (1999). The suicide prevention contract: Clinical, legal, and risk management issues. J Am Acad Psychiatry, 27(3), 445-450.
[43] Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk.Cogn Behav Pract, 19(2), 256-264. doi: 10.1016/j.cbpra.2011.01.001
[44] Stanley B., Brown G. K., Brenner L. A., Galfalvy H. C., Currier G. W., Knox K. L.,.. Green K. L. (2018). Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department.JAMA Psychiatry, 75(9), 894-900. doi: 10.1001/jamapsychiatry.2018.1776
[45] Stanley B., Brown G. K., Currier G. W., Lyons C., Chesin M., Knox K. L. (2015). Brief intervention and follow-up for suicidal patients with repeat emergency department visits enhances treatment engagement.Am J Public Health, 105(8), 1570-1572. doi: 10.2105/AJPH.2015.302656
[46] Stanley B., Chaudhury S. R., Chesin M., Pontoski K., Bush A. M., Knox K. L.,.. Brown G. K. (2016). An emergency department intervention and follow-up to reduce suicide risk in the VA: Acceptability and effectiveness.Psychiatr Serv, 67(6), 680-683. doi: 10.1176/appi.ps.201500082
[47] World Health Organization. (2019). Newsroom/Fact sheets/Detail/Suicide. Retrieved June 3, 2022, from https://www.who.int/news-room/fact-sheets/detail/suicide

Options

文章导航

模态框（Modal）标题

摘要

本文引用格式

Abstract

参考文献