Planning for Safety

AND
Post-Traumatic
Growth
 Three Goals

Baseline: Crisis

Goal 1: Stabilize
 Three Goals

Goal 2: Recover
 Three Goals

Goal 2: Recover
Goal 3: Grow
First Goal: Stabilizing
▪ From “imminent risk” to [tolerable] “high risk”
▪ Pause actions and plans – not thoughts and feelings
▪ Possibility of a positive future – even if improbable
▪ Initial safety planning
▪ Regaining balance
First Goal: Stabilizing

Baseline: Crisis

Safety Planning
Stabilize
Safety Planning Intervention (SPI)
▪ Brief and helpful therapy
▪ With a plan to take home.
▪ Created for use in the Emergency
Department
▪ Now used in many more places.
▪ Research evidence: Less suicidal, Better
follow-through
▪ Depends on QUALITY and USE over time
http://suicidesafetyplan.com/Home_Page.html
Safety Planning reduces risk
▪ After emergency risk of severe injury or death
▪ After determining ‘flight risk’
▪ After documenting patient risk
▪ Incorporates risk factors
▪ Aligns with risk screening instruments
▪ Can follow a full risk assessment
▪ Outline risk in the safety plan
Is risk the focus forever?
Second Goal: Recover (Back to baseline)

Recover
Wellness focus
What is our focal point?
Life

Suicide
 Focusing on Wellness
▪ From “high risk” to ‘OK’ baseline / pre-crisis level
▪ Dimensions of Wellness
▪ Emotional health: perceptions
▪ Physical health: capacity
▪ Spiritual health: belief
▪ Social health: tangible and emotional support
▪ Financial: basic needs and continuity of care
▪ Occupational: employment
▪ Environmental: living space
▪ Intellectual: job or free-time pursuits
Suicide and Recovery-oriented outcomes
▪ Suicidal crisis – trauma

▪ Post-traumatic stress vs
▪ Recovery

▪ After Recovery, work on

resilience
Resilience: Ability to bounce back after crisis
Suicide and Post-Recovery
▪ Resilience

▪ Reflection

▪ Post-Traumatic Growth
Third Goal: Growing from the crisis

Goal 2: Recover
Goal 3: Grow
Post-Traumatic Growth
▪ Happens after initial coping with trauma
▪ Happens after recovery (“return back to pre-trauma functioning”)
▪ Involves finding meaning and benefits
▪ Includes learning that creates change beyond pre-trauma level
▪ Evidenced by transformation or qualitative change in functioning

Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology—A

critical review and introduction of a two component model. Clinical psychology
review, 26(5), 626-653
Post-Traumatic Growth and Coping
▪ Meta-analysis 1: Gender and PTG
▪ traumas (cancer, HIV, bereavement, earthquake)
▪ Women > Men on PTG
▪ Hypothesized cause: Ruminative thought
(deliberative positive reappraisal) and “emotion focused” coping

Vishnevsky, T., Cann, A., Calhoun, L. G., Tedeschi, R. G., & Demakis, G. J. (2010). Gender
differences in self-reported posttraumatic growth: A meta-analysis. Psychology of
women quarterly, 34(1), 110-120.
Post-Traumatic Growth and Coping
▪ Meta-analysis 2: Coping
▪ Positive reappraisal coping
had largest effect (benefit finding)
▪ Religious coping, social support, and optimism also helped

Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as
factors contributing to posttraumatic growth: A meta-analysis. Journal of loss and
trauma, 14(5), 364-388.
Reflecting: What is the goal?
Stage 3: Reflecting: Two Paths for growth
Post-Traumatic Growth
▪ Overall experience
▪ Philosophy about ‘life’ in general
▪ Gestalt impression of crisis
▪ Life mission or values
▪ Evaluation of self (capabilities,
strength, virtues)
▪ Life lessons
Post-Suicidal Growth
▪ Specific crisis experience
▪ Information about person
▪ Details of the crisis
▪ Critical beliefs and values
▪ Personal risk and protection
▪ Personal priorities
▪ Self-defining quality of life
▪ Examining relationships affected
Post-Traumatic Growth: Character Strengths
▪ All character strengths correlated with PTG
▪ Particularly high:
▪ Kindness
▪ Bravery
▪ Gratitude
▪ Hope
▪ Religiousness

Peterson, C., Park, N., Pole, N., D'Andrea, W., & Seligman, M. E. (2008). Strengths of
character and posttraumatic growth. Journal of Traumatic Stress: Official Publication of the
International Society for Traumatic Stress Studies, 21(2), 214-217.
Post-Suicidal Growth: Experiential knowledge
Signs
(events)

Warning Informing

Withdrawing Giving
Away

Isolating? Priorities Valued

Preparing?
people
Safety Plan revision toward growth
▪ Warning signs
▪ Explore underlying
thoughts/feelings
▪ Understand values and
priorities

▪ Internal coping
▪ Refine based on styles and
preferences
▪ Enhance based on strengths
Safety and Growth Planning
Safety Plan
▪ Warning signs
▪ Coping Strategies
▪ Social situations / distractions
▪ People who assist in crisis
▪ Professional help
▪ Safe environment
Growth Plan
▪ Needs / Values / Strengths
▪ Ways to improve coping
▪ Ways to improve social network
▪ People who promote growth
▪ Professional resources for growth
▪ Wellness environment
 Question & Answer

Continue learning
DeQuincy A. Lezine, Ph.D. how to support
Lived Experience Academy Post-Suicidal Growth!

drlezine@livedexp.academy https://livedexp.academy