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Papeles del Psicólogo

On-line version ISSN 1886-1415Print version ISSN 0214-7823

Pap. Psicol. vol.44 n.2 Madrid May./Aug. 2023  Epub Oct 16, 2023

 

Book Review

Psychology manual on suicidal behavior

Manual de Psicología de la conducta suicida

Jorge Barraca-Mairal1 

1Universidad Camilo José Cela, Spain

Manual de Psicología de la Conducta Suicida [Psychology Manual on Suicidal Behavior]. Al-Halabí, Susana; Fonseca-Pedrero, Eduardo. Pirámide, 2023.

Concern for intervention in suicidal ideation and behavior has gained considerable momentum in recent years. This is not surprising, bearing in mind the shocking numbers of deaths due to this cause (it is estimated, for Spain, that one death occurs approximately every two hours), which have been publicized more than ever in the media and via the Internet. This collective awareness of a problem that has existed for too many years has galvanized public opinion, part of the political class and, of course, different associations and groups. But it is also influencing clinical and health psychologists to become aware of the need to improve their training and update their professional practices in order to better manage these challenging situations.

In this context, the publication of the extraordinary Manual de Psicología de la Conducta Suicida [Psychology Manual On Suicidal Behavior] has filled a gap with its length, depth, thematic plurality, and topicality, both in terms of research data and in terms of theories, frameworks, and perspectives. It is not, however, a text that was thrown together at the drop of a hat, without in-depth research or attention to detail; quite the contrary, it is a manual that covers the reality of suicide as a whole, presents detailed and well-tested interventions, and demonstrates a great depth of reflection. Furthermore, the writing of the chapters has been entrusted to academic and clinical psychologists, all of them Spanish; without drawing from the usual North American manuals or other previous texts1 which, as far as the psychologist's particular activity is concerned, are now surpassed by the novelty, size, and quality of this new publication.

The first thing to note is the organization of the more than seven hundred pages in clear and logical thematic blocks, as follows: firstly (in Block I), we are introduced to the phenomenon of suicidal behavior, and four chapters are dedicated to the conceptualization of this behavior, the explanatory models (with special attention to the contextual perspective), the association between self-injury and suicidal behavior in childhood and adolescence, and the legal framework. Subsequently (Block II), we find the necessary section on prevention, with the description—over several chapters—of the general intervention strategies, the work in educational contexts or with vulnerable groups, and the specific programs carried out in Spain. In Block III, we come to the essential content for health psychologists, with the description of the assessment (interview, instruments) and the psychological approach to suicidal behavior, that is, types of interventions and their evidence-based evaluation, work in crisis situations, and the hospital and Spanish National Health System approach. But if the previous block seems to be the core for psychologists in practice, Block IV is no less so, dealing with postvention, i.e., work after suicide attempts or death, which is another of the usual activities for many professionals in clinics and health centers. There are chapters on the management of grief and intervention with survivors, references to useful resources available on the Internet, the media, good practices in psychological care, and—no less important or timely—a chapter on the self-care of the therapist who deals with this always difficult and challenging problem. A final Block (V) includes a chapter on future perspectives and challenges in suicide prevention.

The length of the description in the previous paragraph, although necessarily concise, will give a better understanding of the variety and breadth of the content of this manual, as well as its broad spectrum of potential readers and consultants. All types of professionals, associations, educators, researchers in the field, public and private institutions, now have an essential reference in the text by Professors Al-Halabí and Fonseca-Pedrero. The compilers, in presenting this book—and as is usual in their editorial work, as seen in other works on psychological intervention—have proposed highly practical chapters, which, in all cases, together with the numerous bibliographical references (general and recommended), incorporate summaries, a section of key terms, web links and, in the intervention chapters, practical clinical cases, some of which are described in remarkable detail.

However, in the opinion of the author, the most interesting contribution of this text, and the reason why it will become a work of reference, does not lie in the amassed information—rich and complex though it may be—on suicidal behavior, but in the analysis or approach with which it is treated. The manual is not a more or less ordered juxtaposition of chapters on the subject, it has an essential basic approach and a central theme: to understand suicide as a behavior, with all that this involves. Therefore, both in the chapters on conceptualization and the explanatory theories (already mentioned, of contextual orientation), but also in those on intervention (with special attention to cognitive-behavioral and dialectical-behavioral therapy), we find a basic approach: to present the phenomenon of suicide as something multi-causal, multi-contextual, and diverse, depending on the circumstances and people; that is, understood based on the broadest functional analysis. This perspective is the opposite of that of a society and media that are interested in suicide, but continually fall into the linear, if not simplistic explanation; and that, under the influence of movies, series, and best-sellers, go to the extreme of believing it possible for an epidemic of suicides to be generated by a virus, a genetic mutation, an environmental pollution, a totalitarian environment, a series of teenagers or, indeed, hypnosis. Or equally, that any adolescent who is bullied at school or has negligent parents or disappointments or traumatic experiences will be a sure prey to suicide.

Less than a year ago, Marc Caellas published2 a small volume dedicated to the suicide notes left by illustrious personalities, especially in literature, culture, and art (e.g., V. Wolf, W. Benjamin, E. Salgari, K. Cobain, S. Zweig, R. Akutagawa, G. Sanders, L. Lugones, etc.). Although this is a simple and humble essay, compiling and linking the words of these notes, as well as commenting on them with some possible reasons about the lives of these characters, the interesting thing about this booklet lies in discovering the enormous variety of alternatives that can be glimpsed in the motivations, keys, and readings of the act of ending one's own life, the "crime of passion" that suicide always is. In this way, one discovers (or rediscovers) the incomprehensibility of this human reality. But delving a little deeper, covering a part of this knowledge within psychology, with a functional and practical approach, the manual by Al-Halabí and Fonseca-Pedrero summarizes an excellent body of research and offers strategies to help the many people with whom psychologists have to work in perhaps the most transcendent moment of their lives.

In conclusion, it is an extensive, coherent, and necessary book, a reference work for researchers, but, above all, for active psychologists in the hospital, educational, and clinical fields, those who collaborate with associations, those who create community prevention programs, and any professional who wishes to update their knowledge on the management of suicidal behavior, to know the best practices and help those affected and their families before and after.

1It is obligatory here to mention texts such as the one directed by Andoni Anseán Ramos: Suicidios: manual de prevención, intervención y postvención de la conducta suicida [Suicides: Manual on the Prevention, Intervention, and Postvention of Suicidal Behavior] (Ed. FSM, 2015); or the one coordinated by Michel A. Reyes Ortega and Kirk D. Strosahl: Guía clínica de evaluación y tratamiento del comportamiento suicida [Clinical Guidelines for the Assessment and Treatment of Suicidal Behavior] (Ed. Manual Moderno, 2020).

2Caellas, M. (2022). Notas de suicidio [Suicide Notes]. Ed. La Uña Rota, SL.

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