Sadly, suicide has moved up to the second leading cause of death among teens and young adults (15- to 24-year-olds), with only motor vehicle accident deaths outnumbering it. Researchers have noticed trends in suicide rates among girls and young women increasing, and a recent nationwide study indicates that more than a third (37%) of young Americans aged 18-24 report having thoughts of death and suicide, and almost half (47%) show at least moderate symptoms of depression.
Furthermore, the effects of COVID-19 are compounding the issue. In fact, the researchers conducting the study mentioned above report that the rates uncovered by the survey are roughly ten times the rate observed prior to COVID-19 in the general population!
With these alarming trends in progress, many mental health providers are left searching for ways to reach out to our youth with customized tools and methods to enhance their systems of care.
Some good news is that preliminary data shows promise for using CAMS (Collaborative Assessment and Management of Suicidality) and especially the SSF (Suicide Status Form) with suicidal teens and children, and clinical trial research is being pursued to confirm and formalize that data. (COVID-19’s impact on research efforts is hindering progress, but efforts are still underway.)
CAMS Framework Overview
CAMS (Collaborative Assessment and Management of Suicidality) is an evidence-based therapeutic assessment and treatment framework that places concerted emphasis on the word “collaborative.” Therapists work hand in hand with the patient, discussing the patient’s experience in a non-judgmental fashion using the Suicide Status Form (SSF) as a guide, gathering information about the patient’s current experience and suicide risk, identifying triggers together, then working collaboratively to devise treatment and stabilization plans.
Tips for Adapting the CAMS Framework for Working with Youth
Generally speaking, the CAMS framework works very well with adolescents. In fact, in a recent study, the SSF has been found to work as well with teens, especially older teens, as it does with adults with just a few adjustments.
Here are some tips, reminders, and adjustments to consider when using CAMS with teens:
- More frequent breaks will help preserve attention span and keep focus clear.
- When COVID restrictions are lifted and in-person treatment resumes, if the teen is comfortable, be sure to sit next to them instead of across from them, to reinforce the idea that you’re on their side. For tips on working with patients during the pandemic, check out the webinar held by Dr. Moore and Dr. Jobes.
- Explain the SSF constructs to the teen to create mutual understanding.
- Be sure to allow the teen to complete the first page of the SSF themselves as you talk them through it, as encouraged in the CAMS framework to reinforce collaboration. Teens especially appreciate this since it gives them a feeling of control and lets them know you value their input.
- Also, as is standard in CAMS, allow the teen to watch as you complete page two with them. Teens particularly appreciate when you avoid the impression that you are “hiding” anything in your assessment – it’s a collaborative effort and information is shared between the two of you, building trust.
- As you guide the teen in identifying their top two drivers, explain what the goals and objectives will be.
- Explain which interventions they can use to help achieve those goals, for example, simple goals to decrease self-hate (a common driver in teens) and increase self-esteem.
- Elements from CBT, DBT for self harm skills, problem-solving, and interpersonal therapy can all be identified and used as interventions successfully with teens.
- Work together with the teen to collaboratively write treatment and stabilization plans.
It is particularly easy for teens to become overwhelmed and feel that their situation is unsurmountable. If the teen is in an acute suicidal state, try to work with them to identify the problem first. The CAMS assessment provides a guided walk-through of the teen’s life at that moment, and if a particular stressor or issue that relates to the current suicidal thoughts is uncovered early, it can be addressed quickly in treatment. CAMS has been found to be very useful in breaking down these factors into manageable pieces that the teen is able to recognize as treatable.
Dr. Jobes, the creator and developer of CAMS, recently held a webinar on Adolescent Suicide Prevention with Dr. Cheryl King. In the webinar, available on demand at the CAMS website, Dr. King talks about her extensive expertise in youth suicide prevention, focusing on risk factors for youth suicide, screen, and assessment, and discusses clinical prevention work including her YST approach.
CAMS-care offers training for CAMS-4Teens through a one-hour, on-demand video course co-led by Dr. Jobes and myself (Dr. Amy Brausch, Professor at Western Kentucky University). The course, including downloadable handouts and articles, covers the following objectives:
- Reviews the current research on treating suicide risk with teens
- Discusses 5 potential suicide “drivers” for adolescents
- Explains tips for adapting and implementing the CAMS Approach for suicidal teens
- Shares strategies for effectively working with parents and guardians of suicidal teens
CPD points are available for this course.