THERAPIST ATTRIBUTION OF CLIENT RESPONSIBILITY FOLLOWING MILD AND SEVERE SUICIDE ATTEMPTS

This investigation examined the judgments made by psychotherapists about suicidal clients, concentrating on the effects of environmental constraint and severity of suicide attempt. Subjects were 100 psychologists, psychiatrists, and social workers with a mean of 10.07 years of experience. Subjects responded to four case descriptions of clients who had made suicide attempts with ratings of client responsibility and client preference. Independent variables were locus/controllability of client presenting complaint (at levels of external/uncontrollable and internal/controllable) and severity of suicide attempt (at levels of mild and severe). Dependent variables were ratings of (1) client responsibility for cause of problem, (2) client responsibility for solution to problem, (3) client attractiveness, and (4) willingness to accept client into treatment. The influence of subjects' general beliefs about client responsibility on responsibility attributions were also examined. Results revealed that both environmental constraint and severity of suicide attempt were potent influences on the judgments of clinicians. Adverse environmental circumstances acted to decrease the responsibility attributed to the client for the cause of her problem, but did not affect attributions of responsibility for finding solutions. Environmental constraint also enhanced client attractiveness and increased therapist willingness to offer treatment. Increased severity of suicide attempt decreased attributions of client responsibility for solution to problems, but did not influence judgments of responsibility for cause. In addition, increased severity of attempt diminished both client attractiveness and willingness to offer psychotherapy. Finally, subjects showed consistency in their responsibility attributions across clients, but these were unrelated to statements of their general beliefs. Findings suggest that psychotherapists attribute responsibility much as do laymen and in accord with accepted attributional principles. It is proposed that locus/controllability and severity of suicide attempt both influence therapist helping behavior, to the detriment of certain clients. These findings are evaluated with regard to attributional models of helping behavior, with suggestions made for revisions.