Guest columnist Amy Timmins: Learning the skills to help turn around suicide risk



SEPTEMBER 16, 2021

In 2019, suicide was the 10th leading cause of death overall in the United States, claiming the lives of more than 47,500 people. In addition, 12 million adults age 18 or older seriously thought about suicide, while 3.5 million made suicide plans, and 1.4 million made a suicide attempt.

When someone we know or admire commits suicide, we wonder how we, someone, anyone, might have stepped in to prevent it. We wonder what despair they must have been feeling to get to this point. And we can only imagine the answer since they will never be able to tell us.

When an individual has already made a suicide attempt, they are at higher risk of making another one. Turning this risk around, while helping people reduce other self-harming behaviors and build lives that feel worth living, is what the Dialectical Behavior Therapy (DBT) team at ServiceNet has been doing for nearly three decades.

Beginning in 1993, soon after the therapy was first introduced by Marsha Linehan in her book, “Cognitive-Behavioral Treatment of Borderline Personality Disorder,” 1st Edition (otherwise known as the “bible” of DBT), ServiceNet clinicians began using DBT with women who were in a residential step-down program following their hospitalization for a suicide attempt. A few years later, when ServiceNet opened its clinic, it was the first community mental health center in the nation to offer DBT in an outpatient setting.

Whether offered in the hospital, at a step-down program, or through an outpatient clinic, the DBT model recognizes suicidal behavior as a person’s attempt to solve a problem that otherwise feels unsolvable. DBT works by helping clients better understand which factors in their lives are contributing to suicidal and other self-harming behaviors, and to identify and use more positive problem-solving strategies.

As the DBT approach balances acceptance and validation with the encouragement and support needed for people to make changes, clients learn specific DBT skills they can use to tolerate their urges to engage in these behaviors, to reduce painful emotions without resorting to life-threatening behaviors, and to improve difficult relationships that may be contributing to their suicide risk.

DBT therapists use a detailed protocol to assess and manage episodes of increased suicide risk. In group sessions, clients learn the DBT skills of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. During individual therapy, they focus on applying DBT skills and strategies to help them achieve their specific treatment goals. In between sessions, when clients need help using DBT skills during a crisis, their individual therapist is available to them by telephone for coaching. And DBT therapists participate on a therapist consultation team which is focused on helping them provide the most effective treatment possible.

“As therapists, we use the DBT skills, ourselves — at work, at home with our families, and in the rest of our lives,” said Dan Millman, director of ServiceNet’s DBT Program. “Being on this team is as rewarding as it is demanding, and best of all is hearing from clients about how it changed their lives.”

Since 1993, thousands of people have been helped by DBT, including celebrities who have discussed their experiences publicly. Lady Gaga has stated that DBT helped her through a rock bottom mental health crisis in her life and gave her the skills to keep moving forward. “It’s a really strong way of learning how to live, and it’s a guide to understanding your emotions,” she said.

DBT takes time and commitment — by clients and therapists alike. “When people are able to nonjudgmentally observe and analyze their own behavior, and their often-painful thoughts and feelings,” noted Millman, “they are that much better equipped to manage any number of difficult situations down the road — including those that might previously have resulted in suicidal thoughts and behaviors.”

To learn more about DBT at ServiceNet, go to or contact the Outpatient Clinics by phone at 413-584-6855.

If you are in crisis, call the toll-free National Suicide Prevention Lifeline (NSPL) at 1-800-273-TALK (8255), available 24 hours a day, seven days a week. The service is available to anyone. All calls are confidential.

Amy Timmins is vice president of community relations at Northampton-based ServiceNet.

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