Case Scenarios

G.C., an adolescent, presents to my office for follow-up after an emergency department visit following a suicide attempt. She is withdrawn, avoids eye contact, and barely speaks. She denies active suicidal ideation but states that self-cutting has provided some temporary relief from ongoing stressors. G.C. is unable to identify any other coping skills. In addition to starting a selective serotonin reuptake inhibitor, I recommend that G.C. begin dialectical behavior therapy, although it could take weeks for her to establish care with a therapist in the area.

J.S., a 49-year-old man, comes to my office with low energy, hopelessness, and intense mood swings. He states that he recently separated from his wife because of anger, financial strain, and infidelity issues. When asked about his anger, he describes intense rages. He reports multiple job changes, frequent interpersonal conflict, and debt from gambling; he states that he uses alcohol as a coping strategy for his stress. J.S. seems particularly upset when I recommend that he schedule an appointment with the clinic’s behavioral health consultant.

Both patients present with different needs that could benefit from ongoing therapy incorporating skills that facilitate emotional regulation. What guidance could I incorporate into my visits to provide interim support? Could I responsibly conduct behavioral interventions for my patients?