Positive interactions between the staff and families were seen as one strategy to accomplish this goal. This component also likely contributed to the attitude construct of TPB.
Additionally, it may have helped to modify perceived negative subjective norms about suicidal behavior, as viewing a video of others discussing suicide could lessen family member's negative beliefs about others' perceptions of their child's attempt.
Finally, a crisis interventionist served as a liaison for outpatient treatment linkage. Perceived behavioral control is another key element of the TPB, which involves one's perceived control and power of external factors that either facilitate or impede behavioral intention. Providing the family with a link between hospital- and community-based services likely strengthened the families' belief that continued treatment was possible.
Results indicated that treatment adherence post-ED visit was significantly greater for teens who received the intervention rather than treatment as usual i. The TPB could also be useful to clinicians working with suicidal individuals. As indicated by the theory, it would be important for clinicians to assess patients' behavioral intention around safety and adherence to safety plans or crisis response plans, which can be conceptualized as one form of treatment adherence. Similarly, the clinician assesses how willing the patient is to adhere to treatment recommendation e.
Using the TPB framework, clinicians could explore individuals' attitudes toward treatment for themselves in addition to subjective norms. These could include cultural factors that might impede or facilitate treatment seeking.
Assessment of these perceptions is also important when family members' attitudes can affect treatment outcome, such as with children and their parents.
This could impact parents' behavioral intentions to seek biologically or behaviorally driven treatments. Clinicians might benefit from assessing patients' beliefs as these may be correlated with treatment adherence. Exploration of cultural factors are important because individuals' beliefs about the origin of their difficulties likely influence who is deemed as an appropriate source of help.
For instance, research indicates that African American and Native American populations are more likely to seek help from religious and spiritual healers than mental health professionals Beals et al. Using a clinical and community sample of older adults, Quinn, Laidlaw, and Murray assessed attitudes toward mental health seeking. Results of their mixed qualitative and quantitative methods approach revealed that stigmatizing attitudes toward mental health problems were related to negative attitudes about aging.
However, the clinical subsample that had previous experience with the mental health system held more positive attitudes than their counterparts with no history of experience. Mary is a year-old married Latina female who was forced into early retirement by the company she served for 30 years. Financially her husband earns enough to support their household, but Mary's sense of worth has plummeted.
At the suggestion of her younger sister, whom Mary respects, she agrees to meet with a therapist. Unbeknown to her sister, Mary also agrees because she cannot shake off thoughts about killing herself, specifically overdosing on the prescription drugs she takes for physical-related ailments.
Because Mary's behavioral intention to remain safe is high, she readily reveals her plan to the therapist. The therapist explores Mary's attitudes toward suicidal behavior and where they might have come from. Mary indicates that she is not aware of anyone in her social network who has been suicidal, indicating that such thoughts are unacceptable, violating religious beliefs. Mary also endorses stigmatizing attitudes toward treatment subjective norm held by her and her loved ones. Specifically, Mary states the belief that problems can only be solved through their faith and the help of family.
Next, the therapist explores Mary's motivation to follow through with her behavioral intention to remain safe. Mary is able to name several social supports e. During the exploration Mary also realizes she is motivated to get better so that she can help other seniors who might feel worthless because their work careers are over. The therapist and Mary continue to complete her safety plan with activities she could engage in, such as walking with neighborhood friends.
With the therapist's help, Mary is able to generate effective coping statements. Should all of the identified steps in Mary's safety plan fail to decrease her suicidal ideation, she agrees to contact her husband first, followed by the sister who recommended today's session. Mary was open to the therapist being listed as a third option, but indicated a low readiness to commit to 10 weeks of CBT. She agrees to call if no one else on her plan is reachable.
Lastly, Mary agrees to safety-proof her home by placing her husband in charge of all medications. The plan is for her husband to leave her daily dosage in a pill box each morning. There are no other lethal means in Mary's home e. Mary expresses confidence and genuine excitement about her safety plan. Because Mary is not ready to engage in psychotherapy, the therapist inquired whether Mary would agree to a telephone check-in in 2 days.
Mary is agreeable to this next step. Health behavior theories have implications for individuals at risk for suicide in terms of service utilization, particularly the decision to seek treatment or follow-through with treatment recommendations and treatment adherence. In this article we have discussed three health behavior theories Health Belief Model, Stages of Change, Theory of Planned Behavior in terms of their implications for understanding and facilitating treatment linkage and adherence in suicidal individuals.
In addition, we have discussed these models' implications for a culturally informed understanding of treatment linkage and adherence. The clinical implications are numerous, ranging from asking patients to discuss the subjective norms about illness and treatment in their family to providing psychoeducation to patients about illness severity and the availability of evidence-based treatments.
National Center for Biotechnology Information , U. Author manuscript; available in PMC Oct 2. Polly Gipson and Cheryl King. Address correspondence to Polly Gipson, Ph. The publisher's final edited version of this article is available at Cogn Behav Pract.
See other articles in PMC that cite the published article. Abstract Treatment linkage and adherence to psychotherapeutic interventions can be challenging with suicidal individuals. Table 1 Health Behavior Theories: Clinical Application to Treatment Linkage and Adherence.
Open in a separate window. Challenges of Treatment Linkage and Adherence Patients' follow-through with treatment recommendations, or treatment linkage, is sometimes poor following a psychiatric hospitalization for acute suicide risk or an outpatient evaluation suggesting severe depression with emerging thoughts of suicide.
Cultural Considerations Cultural norms that might affect ethnic minority individuals' decisions to seek and follow through with treatment are also important to our understanding of suicidal individuals' behaviors in this area. Susan HBM Incorporating Cultural Considerations Susan, a year-old African American female and single parent, agreed to adhere to her clinician's recommendation of outpatient psychotherapy after two initial sessions in which HBM constructs were successfully implemented by her clinician.
Clinical Implications of SOC for Suicidal Individuals The SOC could be applied when assessing a suicidal individual's readiness to engage in treatment, specifically an individual with a history significant for suicidal behavior. Summary In this article we have discussed three health behavior theories Health Belief Model, Stages of Change, Theory of Planned Behavior in terms of their implications for understanding and facilitating treatment linkage and adherence in suicidal individuals.
Acknowledgments We thank Ryan Hill for his assistance with this manuscript. References Adams J, Scott J. Predicting medication adherence in severe mental disorders. The theory of planned behavior. Organizational Behavior and Human Decision Processes. Ajzen I, Driver BL. Prediction of leisure participation from behavioral, normative, and control beliefs: An application of the theory of planned behavior.
Theories of reasoned action and planned behavior as models of condom use: Treatment of depression in disadvantaged women. Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: Mental health disparities in a national context. The American Journal of Psychiatry.
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Predictors of suicidal events in an open treatment trial. Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. Journal of the American Medical Association. Hispanic immigrants' perceptions of depression and attitudes toward treatments. Journal of Immigrant and Minority Health. Treatment delay in first-episode nonaffective psychosis: A pilot study with African American family members and the theory of planned behavior.
Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry. Suicide behavior among Latino and Latino adolescents: Conceptual and methodological issues. Determinants of medication compliance in schizophrenia: Emprical and clinical findings. The role of theory in HIV prevention. Challenges in assessing intent to die: Can suicide attempters be trusted? Journal of Death and Dying. The scope of health behavior and health education.
Health behavior and health education: Theory, research, and practice. John Wiley and Sons; San Francisco: Apparently, this early work gave impetus to the development of, or at least the accommodation by, different social psychological and sociological theories as to the fundamental interpersonal processes behind the link between health and social relationships.
Viswanath is an associate professor of society, human development, and health in the School of Public Health at Harvard University. This thoroughly revised edition includes the most current information on theory, My library Help Advanced Book Search. Health Behavior and Health Education: Theory, Research, and Practice.
Karen Glanz , Barbara K. The fourth edition of the landmark book, Health Behavior and Health Education , offers an accessible, comprehensive, in-depth analysis of the health behavior theories and practices that are most relevant to health education. Request an Evaluation Copy for this title.
View Instructor Companion Site. Rimer and Noel T. Redding, and Kerry E. Kelder, Deanna Hoelscher, and Cheryl L. Stamatakis, and Karen Glanz. Theory, Research, and Practice, 5th Edition. Rimer Editor , K.
Health Behavior: Theory, Research and Practice provides athorough introduction to understanding and changing healthbehavior, core tenets of the public health role. Covering theory,applications, and research, this comprehensive book has become thegold standard of health behavior texts/5(32).
This fourth edition of the classic book, Health Behavior and Health Education: Theory, Research, and Practice provides a comprehensive, highly accessible, and in-depth analysis of health behavior theories that are most relevant to health education/5(71).
The fourth edition of the landmark book, Health Behavior and Health Education, offers an accessible, comprehensive, in-depth analysis of the health behavior theories and practices that are most relevant to health education. This thoroughly revised edition includes the most current information on theory, research, and practice at individual, interpersonal, and community and group levels.3/5(2). Jul 27, · Health Behavior: Theory, Research and Practice provides a thorough introduction to understanding and changing health behavior, core tenets of the public health role. Covering theory, applications, and research, this comprehensive book has become the gold standard of health behavior Format: Hardcover.
Full-Text Paper (PDF): Health Behavior and Health Education: Theory, Research, and Practice The theory of planned behavior (TPB) and the health belief model (HBM) are two other powerful social. Health Behavior and Health Education: Theory, Research, and Practice / Edition 4 This book can help all of us in the field fine-tune the effectiveness of strategies and interventions designied to improve health-related behaviors.5/5(1).