STEPS 2 colour
This section of the STEPS professional guidebook (Volume 2) integrates multiple suicide‑theoretic frameworks—Baumeister’s Escape Theory, Linehan’s Reasons for Living vs. Dying, Williams’ Cry of Pain Model, Van Orden’s Hierarchical Taxonomy of Suicide (HTS), and Joiner’s Interpersonal‑Psychological Theory—into the STEPS model (Predisposition, Ideation, Intention, Action, Post‑Action, Life in Motion). For each theory the text outlines its core constructs, maps them onto the STEPS phases, and provides concrete clinical recommendations (e.g., CBT, DBT, safety planning, means restriction, resilience‑building). Detailed case studies (Priya Sharma, Jordan Thompson, Lena Tran, Mateo Alvarez) illustrate how the theories manifest in real‑world scenarios, followed by role‑play scripts that model therapist‑client‑family interactions using the respective frameworks. Throughout, the guide emphasizes assessment markers (cognitive deconstruction, negative affect, perceived defeat/entrapment, perceived burdensomeness, thwarted belongingness, dispositional/acquired/practical risk layers) and intervention points (early CBT for self‑blame, DBT skills for emotional regulation, means restriction, relapse‑prevention planning). The section concludes with synthesis of how integrating these models enhances clinicians’ ability to identify high‑risk moments, tailor interventions to the individual’s theoretical profile, and support long‑term recovery within the STEPS lifecycle.
Topics
Escape Theory within STEPS: Integration, Priya Sharma Case Study, and Role‑Play
Maps Baumeister’s five‑stage Escape Theory onto the STEPS phases (Predisposition → Life in Motion), detailing core constructs (failure to meet standards, self‑awareness, negative affect, cognitive deconstruction, escape behavior) and phase‑specific clinical recommendations (early CBT for self‑blame, safety planning, means restriction). Includes the Priya Sharma case narrative illustrating each stage and STEPS phase, and a therapist‑family role‑play script that uses the model to help the client and her sister understand the desire to escape and co‑create a safety plan.
Linehan’s Reasons for Living vs. Dying within STEST: Integration, Jordan Thompson Case Study, and Role‑Play
Integrates Linehan’s ambivalence framework (reasons for living and dying) with the STEPS model, identifying how these reasons shift across Predisposition, Ideation, Intention, Action, Post‑Action, and Life in Motion. Provides DBT‑based interventions (mindfulness, distress tolerance, emotion regulation) tailored to each phase. Features the Jordan Thompson case illustrating a teen’s competing reasons across STEPS stages, and a role‑play script for therapist‑parent dialogue that surfaces ambivalence, teaches skill rehearsal, and builds a collaborative safety plan.
Williams’ Cry of Pain Model within STEPS: Integration, Lena Tran Case Study, and Role‑Play
Describes the Cry of Pain Model’s three constructs (defeat, entrapment, hopelessness) and aligns them with each STEPS phase, offering phase‑specific interventions (cognitive restructuring, empowerment strategies, means restriction). Includes Lena Tran’s narrative showing how perceived defeat, entrapment, and hopelessness drive a suicide attempt across STEPS stages, and a role‑play scenario with the client’s mother that uses the model’s language to identify pain points and develop safety planning.
Van Orden’s Hierarchical Taxonomy of Suicide (HTS) within STEPS: Integration, Mateo Alvarez Case Study, and Role‑Play
Outlines the HTS dispositional, acquired, and practical risk layers and maps their salience onto the STEPS phases, with targeted interventions (risk‑factor screening, CBT for acquired risks, means restriction for practical risks). Presents the Mateo Alvarez case illustrating genetic, personality, learned, and situational risk factors across STEPS stages, and a role‑play script guiding therapist‑parent conversation to explore layered risks and co‑create a comprehensive risk‑reduction plan.
Joiner’s Interpersonal‑Psychological Theory within STEPS: Integration, Clinical Applications, and IPT Core Constructs
Details perceived burdensomeness, thwarted belongingness, and acquired capability, mapping each onto STEPS phases and linking to the Ideation‑to‑Action framework. Provides concrete assessment questions, CBT/DBT strategies to address burdensomeness and belongingness, and safety‑planning for acquired capability. Synthesizes how the IPT constructs intersect with other models in the STEPS lifecycle to enhance risk identification and tailored intervention.