In-depth Analysis of Clinical Case Study on Parasuicide Counselling in Dhanvantri Critical Care Center at Erode

Dr. Sampoornam. W.*

Professor, Dhanvantri College of Nursing, Pallakkapalayam.

*Corresponding Author E-mail: sampoornamwebster@yahoo.in

ABSTRACT:

Parasuicide is an apparent attempt at suicide, commonly called a suicidal gesture, in which the aim is not death. Parasuicide is considered to be a serious public health issue. Previous parasuicide is a predictor of suicide. The increased risk of ensuing suicide sustains without decline for at least two decades. Other researchers also eke that those who attempt suicide with the intent to kill themselves can be defined as parasuicide. Studies have found that about half of those who commit suicide have a history of parasuicide. Parasuicide is utmost common in adolescents and young adults. This clinical case study focuses on counselling for parasuicidal early adulthood clients.

KEYWORDS: Parasuicide, Case study, Counselling.

INTRODUCTION:

Parasuicide refers to suicide attempts or gestures and self-harm where there is no fatal outcome. It is a non-fatal act in which a person deliberately causes injury to him or herself or ingests any prescribed or generally recognized therapeutic dose in excess. The term was first coined in Edinburgh by Norman Kreitman. Parasuicide is an active admitted indicator for future accomplishment of suicidal attempt. The greatest predictor of eventual suicide is parasuicide.

Several theories and works have shown that parasuicide and aggressiveness both have similarities and usually are manifested at the same time. Also, early adverse events in life, play an important role in the development of an abnormal expression of the impulsiveness in childhood that would lead to the manifestation of aggressive behaviours and suicidal behaviours in adulthood (Soloff PH, etal, 2002).

Suicide attempters, in fact, present higher frequency of new episodes of parasuicide (up to 20-30% in the 3-8 subsequent years) and death as a result of suicide (up to 10-14%), with a risk 100 times more elevated that the general population and 22-36 times more elevated that the population with depression. For this reason, at the moment, parasuicide is considered the parameter that better predicts suicide (Francisco Rodriguez Pulido and Manuel E. 2009).

Internationally, parasuicide occurs most frequently in the first half of the life cycle (in ages 15–44) and in most countries, rates among women exceed those among men. Yet, older adults are also at risk for parasuicidal behaviours; the Epidemiological Catchment Area study revealed a lifetime prevalence of 1.1% among adults aged 65 and older (Michelle M. Cornette, 2008).

Parasuicide rates have shown a marked increase in recent years and now consume a substantial proportion of medical services. To reduce hospital admission rates for parasuicide is probably desirable. While there has been considerable research on parasuicide, it is apparent that many of the findings have limited application to prevention. Possible dangers inherent in such experimental epidemiology are acknowledged but it is argued that aspects of the current approach to the problem of parasuicide may be in need of revision.

In this clinical case study, the clients were between 20 and 25 years of age, one and the other were students. Paraphrasing, sharing perception, theme identification, reality and reinforcement therapeutic techniques were commonly adopted in course of the counselling session. The clinical case presentation were jotted underneath

Clinical Case Study 1:

Brief suicidal history:

Client attempted parasuicide (cow dung poison mixed with water) pertaining to love failure (parents’ antagonism). Client narrated the history of love with two lads. She had foreplay with her romantic companion. Client had significant history of childhood sexual molestation and family history of suicidal attempt (niece).

Counselling Session:

Trustworthy relationship was established. Client was quite transparent in course of self disclosure. Paraphrasing, sharing perception, theme identification and reality therapeutic techniques were adopted throughout the session. Client’s ego integrity was strengthened. Environmental manipulation and entity existence were discussed and suggested client to seek the best life partner.

Clinical Case Study 2:

Brief suicidal history:

Client attempted parasuicide owing to threatening behavior (low lethal) to secure concession from her parents. Client experienced disgraced love with one chap. She developed love with another lad on compassionate ground basis. Significant history of dating and foreplay with her heartthrob.

Counselling Session:

Client’s negative cognitive assertions were dislodged. Reinforcement technique was adopted in handling the problem pointers. Client’s perplexity worked out meticulously. Reality acceptance, life transition and futuristic directions were explored. Sense of humor wroughted as platform between counselor and counselee. Client was reassured transiently.

CONCLUSION:

Parasuicide is not easily treated and repeated parasuicide results in burnout for consumers, providers and families. Parasuicide is a major concern in the general population, but particularly for the mental health system. Although few efficacy trials have been conducted, patterns of successful treatments are highlighting the strength of psychosocial treatments, particularly interventions that target attendance as an explicit part of treatment or provide treatment in the patient’s home. Despite promising findings from problem-solving interventions in the treatment of parasuicide, little is known about problem-solving difficulties that distinguish Non-Repeaters from Repeaters. The Counselling Session aided in curtailing and scaling down the suicidal ideations among the parasuicidal clients. Next review sessions were not suggested for the clients and both were reassured transiently.

REFERENCES:

1. Michelle M. Cornette, 2008. Parasuicidal Behavior. Encyclopedia of Aging and Public Health.

2. Soloff PH, Lynch KG, Nelly TM. 2002. Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. J Personal Disord.

3. Francisco Rodriguez Pulido and Manuel E. 2009. Community study on a parasuicidal population: Clinical identification of repetition risk. Eur. J. Psychiat. vol.23 no.4.

Received on 31.07.2020 Modified on 19.08.2020

Int. J. Nur. Edu. and Research. 2020; 8(4):495-496.

DOI: 10.5958/2454-2660.2020.00109.X