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Professionals need a good understanding of self before they can understand others.

AWARE protects against undue influences in the act of clinical decision making. Intended to make practice safer, its use in clinical supervision or multidisciplinary case reviews should bolster practice by making individuals and/or teams who assess people in suicidal crisis, mindful of the implicit effect of the AWARE factors.

The five factors are:
Anxiety (generated/diffused in):
●Patient
●Family/carer/friend
●Referrer
●Triaging/assessing practitioner

Weighting (of symptoms elicited):
●Diagnosis (comorbidity - personality disorder/alcohol or substance misuse)
●Course of illness (acute/chronic/acute on chronic)
●Factors considered outside core remit (relationships/finances/accommodation/employment/family - carer availability)

Agenda (elicited in):
●Referrer
●Patient
●Family
●Practitioner
●Team

Resources (identified or not):
●Beds
●Home treatment capacity

Experience (generalised from):
●Same patient to different presentation
●Other patients from the same diagnostic group 
●Other patients from the same demographic profile
●Past adverse events

These episode dives deep into Anxiety and discusses why we see what we want to see.

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Episode 13 introduces the ASSESS module and provides a broad overview of the 6 chapters in ASSESS. It then dives into attitudes towards suicide. The key messages to remember are:

Stop – Pause
Attitudes towards suicide influence decisions, 

Attitudes towards suicide influence rapport and empathy,  

Attitudes towards suicide influence care and support we offer.

Reflect – Rewind
Recognise your attitudes

Recognise how these might have influenced decisions and care you have provided

Engage in open, candid discussion within your team, be prepared to learn from the past

Start – Play
If your attitudes are adversely influencing care provision seek help

Personal therapy

Additional supervision

Monitor through ongoing reflective practice

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Dr Stan Steindl is an Australian clinical psychologist with over 20 years experience as a therapist, trainer and researcher. He is has an active clinical practice and is passionate about motivational interviewing (MI) and compassion focused therapy (CFT). And he teaches and presents on these topics around the world!

Stan shares some deep insights about Motivational Interviewing and how it can be used to navigate the delicate ambivalence that exists in the mind of a person in suicidal distress, the fight between reasons for living and reasons for dying. Stan talks about advanced listening and how some of the core MI skills of Open Questions, Affirmations, Reflections and Summaries can be used evoke change talk.

You can learn more about Stan at Clinical Psychologist | Dr Stan Steindl

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In this episode Manaan reveals the 3 practice shifts that lie at the foundation of a new program called 7 SAFE Steps. The are:

• Prediction to Prevention
• Past to Future
• Deficits to Assets

These 3 shifts will bring progress to the practice of care provision for those in suicidal distress, they are an automatic consequence of the mindset shift from top to TAP. 

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Meet Ashley P Evans, Psychiatric Mental Health Nurse Practitioner from Waco, Texas.

Here is a bit about Ashley in her own words:

I am from Auburn, Alabama...WAR EAGLE! I received my Bachelors degree from Florida State University...GO 'NOLES! When I initially went to college, I was Pre-Med Psychology, but it didn't take me long to convince myself that I was not "good enough" in math and science, so I quickly changed my major to something completely different - International Affairs with a minor in Religion. 

 I moved back to Alabama after graduation and began working in the insurance industry. I convinced myself that climbing the corporate ladder was "good enough" for me, so I obtained a Masters in Healthcare Administration to make myself more marketable for the company.  After changing roles several times within the company, I noticed that something was gnawing at me. Something deep inside my heart was yearning for something far greater than what my employer could offer me. My heart wanted to care for people. I wanted to truly touch lives from a clinical perspective. Read more at https://www.psychlifeteeco.com/

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The episode brings together the key messages from all 10 episodes. It can be used as a refresher or for someone new to PROTECT it will provide a quick overview of the CORE module

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Episode 10 will be diving deep into the 5 values of Relational Safety:

• Courage
• Curiosity
• Compassion
• Collaboration and 
• Commitment 

and translating these values into action. 

Episode 10 is full of catch phrases, some of the highlights are, patient is not in the way, patient is the way, listen with fascination, mind open – mouth shut, cant walk through water without getting wet, an explicit promise of recovery, things will get better and soon. What was yours? Get in touch at www.progress.guide . 

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Part 2 of Empathy in Action introduces the Values of Relational Safety:

•  Courage: to be present and suspend the desire to help
•  Curiosity: in taking the time to listen and recognizing reasons and emotions 
•  Compassion: in sharing the person’s darkness without judgement 
•  Commitment: to reframe suicidal thoughts and acts as a desire to be pain-free 
• Collaboration: to coproduce the journey ahead based on mutual respect

The listener also learns about the Equation of Empathy in Action and the Pain Relief Dialogue

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In part 1 of Empathy in Action, the listener is introduced to the key mindset shift that underlies Relational Safety, from TOP to TAP. This supports a transition from attempting to establish "what's the matter with you" to "what matters to you".

Providing healthcare professionals contemporary knowledge about how the forms they fill can actually serve the real function for which they were designed is crucial in suicide prevention. Remember paperwork for proper work. The real function is to guide a conversation, a conversation that is at the heart of relational safety. This can be achieved by moving from top to tap. Don’t seek to establish what’s the matter with you, rather what matters to you. You can be a vector for spreading this knowledge at your work, do share the podcast. You can access all the information at www.progress.guide. We would love to hear your thoughts, email us at [email protected]. 

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The episode provides a novel way to describe risk and steers professionals away from high, medium and low risk stratification. The listener will be introduced to:

• Longitudinal Risk
• Unaddressed Risk
• Cross-sectional Risk

On the way to formulating an opinion of clear and imminent risk. This is a far more nuanced approach and a meaningful attempt at conducting a person centered risk assessment. 

The listener will also be presented with the evidence base which leaves very little doubt about the futility of risk categorisation.

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