Self-determination theory and the collaborative assessment and management of suicidality

Abstract

Purpose The collaborative assessment and management of suicidality (CAMS) is a first-encounter suicide-specific brief intervention that motivates suicidal individuals for voluntary treatment engagement and choosing life. How the intervention works, however, has not been theoretically explained. The purpose of this paper is to explain the effectiveness using self-determination theory (SDT). Design/methodology/approach The paper focuses the theoretical examination on the philosophy of care and the clinical procedures of the CAMS suicide intervention. SDT is used as the theoretical lens of the examination. Findings The underlying philosophy of care and the clinical procedures of CAMS enhance the autonomy, relatedness and competence of the client in the first encounter. The paper proposes that fulfilling these basic human needs results in the intervention outcomes of treatment engagement and choosing life for the time being. Research limitations/implications The research is limited to the examination of the documented clinical procedures and philosophy of care. Further research applying SDT to the design and empirical testing of therapeutic interventions for suicide prevention is warranted. Practical implications Clinicians working with suicidal clients need to empathically address suicidal individuals’ motivation to engage in voluntary treatment and reduce controlling and autonomy-thwarting approaches. Social implications Suicidal behaviour is conventionally considered the manifestation of a mental disorder characterized by limited informed decision-making. The success of CAMS points to the contrary. Despite their suffering, many suicidal individuals make informed decisions about treatment with the support of an empathetic clinician. Originality/value CAMS has not previously been theoretically explained. This paper explains the effectiveness of the intervention in engaging suicidal clients in further treatment through SDT.