Adolescents’ Suicidal Thinking and Reluctance to Consult General Medical Practitioners

Appropriate help-seeking is widely recognized as a protective factor, and vital for early treatment and prevention of mental health problems during adolescence. General medical practitioners (GPs), that is, family doctors, provide a vital role in the identification of adolescents with mental health problems and the provision of treatment as well as access to other specialists in mental health care services. The current study examined the association between suicidal ideation and intentions to seek help from a GP for suicidal thoughts, emotional problems and physical health problems, using a sample of 590 Australian high school students that was 56.7% female and aged 13–18 years (M = 15.56 years, SD = .66 years). Higher levels of suicidal ideation and general psychological distress were related to lower intentions to seek help from a GP for suicidal and physical problems. The results suggest that even at subclinical levels, increases in suicidal ideation or psychological distress may lead to help avoidance. School personnel and other gatekeepers need to be aware of this trend in order to be more assertive in encouraging and supporting appropriate help-seeking for mental health problems. School health promotion programs should consider including information to explicitly address the help-negation process.     

The role of the therapist in offender treatment

Although best practice dictates that offender programs should be based within a cognitive behavioral therapy (CBT) orientation, little is known about the impact of the therapist in delivering the program content, and therapist behaviors that can enhance the therapeutic process. In this paper we review the existing literature on process issues with general offenders and sexual offenders and attempt to highlight the importance of therapist behaviors in therapeutic treatment strategies. We conclude that therapists can use the therapeutic relationship to build trust and rapport, and that training should specially aim to enhance these skills.     

Attachment styles and violence in child molesters

Abstract

It has been suggested that sexual offenders lack the capacity to engage in or to maintain intimate relationships and that their attachment styles are insecure. The present study tested some of the implications of this theory with a group of incest offenders, nonfamilial child molesters, nonsex offenders, and nonoffenders recruited from the local community. Subjects completed a self-report questionnaire detailing their characteristic relationship style, and the level of violence employed by all sexual offenders was obtained from institutional files. Nonfamilial child molesters were five times more likely to report a fearful avoidant relationship style than a secure style compared to the community group. When they rated the degree to which they considered themselves to be fearful avoidant, the ratings of the nonfamilial child molesters were significantly higher than the ratings of community subjects and incest offenders. Incest offenders did not differ from community controls or from nonsex offender controls. Of the pooled group of child molesters, dismissively avoidant offenders employed higher levels of aggression in their offences than did secure or fearful avoidant offenders. These results are discussed in the light of current theory, and suggestions for future research and treatment initiatives are offered.