The Hope Institute - A Model for Next-Day Care for Suicide Risk Using CAMS and DBT
Mini Workshop 2 - The Hope Institute - A Model for Next-day Care for Suicide Risk Using CAMS and DBT
Friday, November 18, 2022
8:00 AM – 9:30 AM EST
Location: Marquis Ballroom C, 9th Floor
Earn 1.5 CE Credit
Keywords: Evidence-Based Practice, Suicide, Service Delivery Level of Familiarity: Basic to Moderate Recommended Readings: Swift, J. K., Trusty, W. T., & Penix, E. A. (2021). The effectiveness of the Collaborative Assessment and Management of Suicidality (CAMS) compared to alternative treatment conditions: A meta-analysis. Suicide and Life-Threatening Behavior, DOI: 10.1111/sltb.12765 Brausch, A. M., O’Connor, S. S., Powers, J. T., McClay, M. M., Gregory, J. A., & Jobes, D. A. (2020). Validating the Suicide Status Form for the Collaborative Assessment and Management of Suicidality in a psychiatric adolescent sample. Suicide and Life-Threatening Behavior, 50, 263-276. DOI: 10.1111/sltb.12587 Adrian, M., Blossom, J. B., Chu, P. V., Jobes, D., & McCauley, E. (2021). Collaborative assessment and management of suicidality for teens: a promising frontline intervention for addressing adolescent suicidality. Practice Innovations, DOI: 10.1037/pri0000156
Suicide risk remains high in the United States and the approval of 988 is expected to result in a significant increase of crisis calls from individuals who are experiencing suicide thoughts and behaviors. Many systems of care are not prepared for the impending influx of crisis referrals. Even now, individuals experiencing suicidal crises struggle to access mental health care and typically must wait weeks for comprehensive risk assessment and referrals to outpatient care. Next-day appointments are ideal for individuals at risk, yet most are not able to receive them. The Hope Institute was created as a model for connecting crisis referrals from 988 to next-day appointments. These institutes aim to provide in-person or telehealth services for suicidal patients, using the Collaborative Assessment and Management of Suicidality (CAMS) framework and DBT skills groups. Both CAMS and DBT are evidence-based treatments for suicide risk in adults and adolescents. The goal of both CAMS and DBT is to help suicidal patients manage suicide thoughts and behaviors on an outpatient basis as much as possible, while also addressing individualized drivers of suicide as a focus of treatment and learning alternate ways of coping. Both are focused on helping patients find hope and meaning, and identify and strengthen reasons for living. Hope Institutes have the potential to provide services to a large number of patients in all types of geographic areas, including those that are underserved, while eventually becoming self-sufficient through reimbursements from insurance and Medicaid. This mini-workshop will provide an overview of the Hope Institute model, as well as the CAMS Framework® and its evidence base for decreasing suicide ideation and increasing hope in both adults and adolescents.
Outline: • CAMS o Review CAMS treatment framework Therapeutic assessment Suicide-specific treatment framework that focuses on suicide risk first Treatment plan includes stabilization plan and interventions tailored to “drivers” of suicide, individualized for each client Focus on collaboration, honesty, and empathy o Implementation of CAMS Training model Overview of how to use CAMS in different settings Overview of using CAMS with adults and adolescents Face-to-face and telehealth adaptations o Evidence-base for CAMS Randomized clinical trials On-going clinical trials for adolescents Meta-analysis of treatment studies
• The Hope Institute (THI) o Research shows: Inpatient hospitalization may cause more damage Most individuals are more suicidal upon discharge o Current systems do not account for either of these factors o THI follows research to create a new model of service delivery Next day appointments via outpatient or telehealth Evidence-based models and interventions using CAMS and DBT Stabilization in an average of 5-6 weeks Referrals to ongoing therapy for those that need additional services o THI bridges “The Lethal Gap” o THI Provides up to 4 sessions per week CAMS individual sessions with trained clinicians (1-2 per week) DBT skills group options (0-3 per week) o Outcomes 100% success to date Successful closures • Adults 6 weeks • Adolescents 5.2 weeks o Clinicians Appropriate training and supervision in models Structured approach providing support and building a team environment Weekly consultation meetings based on the DBT model
Learning Objectives:
At the end of the session, the learner will be able to:
Describe the CAMS framework for assessing, managing, and treating suicide risk.
Describe the evidence-base for CAMS and understand how it can be applied in multiple clinical settings with adolescents and adults.
Describe the model for The Hope Institute and its potential to provide next -day evidence-based care for individuals with suicide risk.
Long-term Goal: Become familiar with an evidence-based treatment for suicide (CAMS), and how it can be implemented into a next-day service-delivery model for suicidal patients to reduce hospitalizations.