The CAMS framework is first and foremost a clinical philosophy of care. It is a therapeutic framework for suicide-specific assessment and treatment of a patient’s suicidal risk. It is a flexible approach that can be used across theoretical orientations and disciplines for a wide range of suicidal patients across treatment settings and different treatment modalities.
The clinician and patient engage in a highly interactive assessment process and the patient is actively involved in the development of their own treatment plan. Every session of CAMS intentionally utilises the patient’s input about what is and is not working. All assessment work in CAMS is collaborative; we seek to have the patient be a ‘co-author’ of their own treatment plan.
In terms of CAMS philosophy, the clinician’s honesty and forthrightness are key elements. For any patient teetering between life and death, there can be no more important component of care than direct and respectful candour when suicidal risk is present. The CAMS clinician endeavours to understand their patient’s suffering from an empathetic, non-judgmental, and intra-subjective perspective. The clinician never shames or blames a suicidal person for being suicidal; we endeavour to understand this struggle through the eyes of the suicidal patient.
PROVEN INTERVENTIONS & TREATMENTS FOR SUICIDE
Dr. David Jobes describes evidence-based suicide-specific clinical interventions and treatments for those at risk of suicide or those who are suicidal. These interventions and treatments have been proven to work through replicated randomised controlled trials (RCTs), which is important to ensure that not only do they work effectively, but to know for certain that they cannot do harm.
Evidence-Based Psychological Treatments for Suicide
There are three evidence-based (randomised controlled trials) interventions and treatments that are designed to directly target suicide risk. These interventions have demonstrated effectiveness in reducing suicidality in general, as well as significantly reduce suicide attempts, increase hope and reasons for living and improve clinical retention. This video briefly describes these effective suicide interventions and treatments:
- Dialectical Behaviour Therapy (DBT for self harm)
- Cognitive Behaviour Therapy (CBT): Suicide Prevention (CT-SP) and Brief CBT
- Collaborative Assessment and Management of Suicidality (CAMS)
FREQUENTLY ASKED QUESTIONS
Why is CAMS the best choice for suicide prevention?
CAMS stands for the ‘Collaborative Assessment and Management of Suicidality’. CAMS is first and foremost a clinical philosophy of care. It is a therapeutic framework for suicide-specific assessment and treatment of a patient’s suicidal risk. It is a flexible approach that can be used across theoretical orientations and disciplines for a wide range of suicidal patients across treatment settings and different treatment modalities.
This is the first time I'm hearing about CAMS. Is CAMS considered a best practice?
Yes, the Joint Commission issued a Sentinel Event Alert on February 24, 2016 titled Detecting and Treating Suicidal Ideation in all Settings. In recommendations for Behavioural Health Treatment and Discharge, CAMS was identified as one of three “evidence-based clinical approaches that help to reduce suicidal thoughts and behaviours.” In 2017, the CDC released Preventing Suicide: A Technical Package of Policy, Programs, and Practices. CAMS was identified as a treatment for people at risk of suicide (page 37).
Our organisation already uses a screening risk assessment measure for suicide. I understand that CAMS is used for risk assessment so why would we need to add another screening tool?
While CAMS emphasises a therapeutic assessment of suicidal risk, it is much more than a screening or risk assessment tool. Guided by a multi-purpose clinical tool called the “Suicide Status Form” (SSF), CAMS guides the patient’s treatment through a suicide-specific assessment, a suicide-specific treatment plan focusing on patient-defined “drivers” of suicide (i.e., those problems that lead to suicidality), tracks the ongoing risk, and facilitates clinical outcomes and dispositions. By monitoring suicide risk in this active manner, we are able to move away from attempting to predict risk of suicide, which is ineffective and not recommended (as per NICE guidance).
So CAMS is not just a screening or risk assessment tool, so what else does it do?
Beyond merely assessing suicidal risk, CAMS is a proven clinical intervention that reliably and effectively treats patient-defined suicidal drivers leading to rapid reductions in suicidal ideation, overall symptom distress, depression, and hopelessness. In addition, there are promising data for decreasing suicide attempts and self-harm behaviours. These results are based on 8 published clinical trials, 3 published randomised controlled trials (RCTs), and one unpublished randomised controlled trial (RCT).
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