Better Treatment Through Understanding Suicide in LGBTQIA+ Community
As clinicians work to better understand the nuances of treating patients of different backgrounds, such as those in the LGBTQIA+ community, it's important to explore why some patients may be considering suicide. Jody M. Russon, PhD, assistant professor at Virginia Tech, examines 2 theories that clinicians can use to better understand these at-risk patients as well as their circumstances: (1) Thomas Joiner's Interpersonal Theory of Suicide; and (2) Minority Stress Theory. Developed in partnership with the American Foundation for Suicide Prevention as part of the Suicide Prevention 360 initiative, her session titled “Working With Suicidal Clients From the LGBTQIA+ Community: Recommendations for Treatment,” aimed to share clinical pearls and recommendations for clinicians working with patients in this community.
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For more information on the Suicide Prevention 360 initiative that aims to develop and deliver critical educational resources for mental health clinicians and other medical professionals aimed at preventing suicides, visit the landing page.
Jody Russon, PhD, is an assistant professor of human development and family science at Virginia Tech. She joined the Department of Human Development and Family Science after completing a three-year postdoctoral research fellowship in family intervention science in Philadelphia. She has focused her career on adaptation, implementation, and dissemination science in family psychotherapy. Her research is dedicated to vulnerable youth, particularly LGBTQ+ adolescents and young adults struggling with suicide, depression, trauma, and disordered eating.
Her teaching and supervisory experience is focused on applied skills for family therapy researchers and practitioners. Russon is a certified trainer and supervisor in one of the only empirically supported youth suicide treatment models, attachment-based family therapy. She is also a person-of-the-therapist (POTT) instructor and clinical supervisor.
Read the Transcript:
Psych Congress Network: In your session at Psych Congress, you identified 2 theories that can help clinicians understand suicide in the LGBTQIA+ community. What are those 2 theories and their utility in this clinical context?
Dr Jody Russon: So a couple of theories help us understand why there is this concern of suicide in this particular population. We think about Thomas Joiner's interpersonal theory of suicide, which I talk a bit about in my session at Psych Congress. So 2 concepts in the interpersonal theory of suicide by Thomas Joiner help us understand the interrelatedness of our personal relationships and our sense of self to our suicidal desire.
And Thomas Joyner talks about two concepts. Perceived burdensomeness: "I bring other people down. My family, my friends would be better off without me," and thwarted belongingness: "Who are my people? Where do I belong? Where do I fit in?" When we have these 2 constructs active in combination with habituation to painful circumstances—that can mean physical or emotional, and access to lethal means—this puts us in a storm of risk for suicidal desire or suicidal behavior. And so that's one theory that we have to think about that's important.
The other, specifically when we're talking about LGBTQIA+ individuals, is minority stress theory. So there are 2 concepts that we want to think about in minority stress theories. So there are distal stressors, those stressors that are further away from us, again, bullying, victimization, rejection in our environments; and then those proximal stressors that impact us: internalized homophobia, for example. And so when we think about the interaction between proximal and distal stressors, we start to understand the complicated relationship between our environments and our perceptions of ourselves.
And we can all relate to that. If we walk around in the world feeling that people aren't going to accept us for a core element of who we are, we expect people not to tolerate us or to treat us differently, then we're going to interact in that world differently than if we did feel accepted. We might withdraw. We might get angry. We're social beings; we're going to respond to our immediate environments, and so it becomes a self-fulfilling prophecy, whereas if this is what we expect from other people, we're going to behave in a certain way that keeps us disconnected, which is what we want to fight against.
