Advances in Mental Health

Promotion, Prevention and Early Intervention

ISSN: 1838-7357 (Print) 1837-4905 (Online) Journal homepage: http://www.tandfonline.com/loi/ramh20

ASSIP – Attempted Suicide Short Intervention

Program. A manual for clinicians

Karolina Krysinska

To cite this article: Karolina Krysinska (2016) ASSIP – Attempted Suicide Short Intervention
Program. A manual for clinicians, Advances in Mental Health, 14:1, 75-77, DOI:
10.1080/18387357.2015.1123514

To link to this article: http://dx.doi.org/10.1080/18387357.2015.1123514

Published online: 12 Jan 2016.

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 Advances in Mental Health, 2016
Vol. 14, No. 1, 75–77

BOOK REVIEW

ASSIP – Attempted Suicide Short Intervention Program. A manual for clinicians, edited by
Konrad Michel and Anja Gysin-Maillart, Götingen, Hogrefe Publishing, 2015, x + 114 pp.,
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€41.95 (print edition), ISBN 978-0-88937-476-8

ASSIP – Attempted Suicide Short Intervention Program: A manual for clinicians presents an inno-
vative therapy approach to working with individuals who have attempted suicide, based on the
theory of goal-oriented action and narrative interviewing (Michel & Valach, 1997). This short
intervention programme was developed by experienced mental health practitioners and research-
ers, Dr Konrad Michel, a clinical psychiatrist and a psychotherapist, and Dr Anja Gysin-Maillart,
a clinical psychologist and a psychotherapist, both affiliated with Bern University, Switzerland.
Dr Michel is also the initiator of the Aeschi Working Group (http://www.aeschiconference.
unibe.ch/aeschiconference8.html), an international group of clinicians and researchers focusing
on the therapeutic approach to the suicidal patient and developing new perspectives for health
professionals. ASSIP is based on the accumulated theoretical and research-based insights from
the Aeschi approach (Michel & Jobes, 2010).
ASSIP involves three 90-minute therapy sessions: a narrative interview (first session), video
playback (second session) and formulating the patterns leading to the suicidal crisis (third
session). The optional fourth session involves re-exposure. These sessions are followed by a
series of letters sent to the patient over the period of two years. ASSIP is not a stand-alone
therapy; it should complement, not replace, the usual clinical management and follow-up treat-
ment after a suicide attempt. This short intervention programme can be implemented in a wide
a range of treatment settings, including inpatient, outpatient or day hospital settings; however,
according to the authors, the intervention is not suitable for suicidal patients with a Borderline
Personality Disorder or psychotic disorders.
The book consists of three complimentary parts. The first part provides a brief but comprehen-
sive overview of what is known about suicide and attempted suicide, including definitions, epi-
demiology, risk and protective factors, models of suicidal behaviour, prevention, psychological
treatments and pharmacotherapy. The second part is the actual ASSIP therapist manual. It presents
the core theoretical concepts of ASSIP: treatment engagement and building a therapeutic alliance,
provision of a ‘secure base’, the concept of ‘suicidal mode’, the model of suicide as an action and
the principles of narrative interviewing. What follows are step-by-step descriptions of the three (or
four) ASSIP therapy sessions, which are followed by an ongoing letter contact with the patient.
This part of the book also presents detailed psychotherapy room requirements, instructions how to
start, how to structure and how to end the sessions, and information how to maintain ongoing
contact with the patient via letters. In addition, this part of the manual discusses practical difficul-
ties that may arise while using ASSIP, including problems during the narrative interviewing and
video playback, and offers a range of tips and solutions based on authors’ clinical experience. The
third, final part of the book contains 13 appendices. These include template information sheets for
patients and health professionals, a consent form for video recording, a homework text for
 76 Book Review

patients, ready-to-use tools for the assessment of suicide risk, psychological pain and suicidal
struggle, six standardised letters and two detailed case examples.
Drs Michel and Gysin-Maillart have written an important book which offers valuable insights
into the working of the ‘suicidal mind’ (Shneidman, 1998) and practical solutions for working
with suicidal patients. The book addresses the crucial challenge of involving suicidal patients
who may have low treatment engagement and treatment compliance. ASSIP seems to be a prom-
ising solution for the problem of emergency departments being a ‘revolving door’ for suicidal
patients and presents an innovative way to utilise the ‘window of opportunity’ which opens
when patients have reached a hospital after a suicide attempt (Larkin & Beautrais, 2010). In
that moment of crisis and vulnerability people may be willing to seek help from (mental)
health professionals who are ready to listen and to hear their stories.
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The manual provides information on the accumulating empirical evidence on the effective-
ness of ASSIP. In recent years ASSIP has been used by the authors in treatment of over 300
patients. While the book was being published, in German in 2013 (Gysin-Maillart & Michel,
2013) and in English in 2015, a randomised controlled trial involving 120 patients was being con-
ducted in collaboration with the Psychology Department of Bern University. The outcomes of this
two-year follow-up study should be published in the near future (Jobes, Au, & Siegelman, 2015).
The book has been written and edited with much attention to the detail. It includes drawings
illustrating the structure of the sessions and practical tips, for example, the patient and the thera-
pist siting at a table side-by-side during a session, and interacting during the initial narrative inter-
view and later, the video playback. The authors provide detailed recommendations regarding the
arrangement of chairs and the camera(s) for the first session and the video recorder with a monitor
for the second (and the optional fourth) session. The book includes clinical vignettes, for example,
how to start a narrative interview and how to initiate the video playback. A number of crucial con-
cepts, such as ‘a therapist as a secure base’ and the ‘suicidal mode’, are pointed out in the text and
explained using text boxes. The authors even provide a template and practical advice how to
prepare an electronic version of a hope leporello, that is, a wallet size card for the patient with
a written formulation of long term goals, personal warning signs, and safety strategies for
future suicidal crises.
One (minor) point of critique: unfortunately, the website recommended by the authors where
the update regarding the progress of the (now still ongoing) randomised controlled trial should be
available, www.assip.ch, could not be found. It is rather unfortunate as having access to the infor-
mation regarding the trial can be of much interest to an interested reader and in time, provide
additional support regarding effectiveness of ASSIP.
In conclusion, ASSIP – Attempted Suicide Short Intervention Program: A manual for clini-
cians by Dr Konrad Michel and Dr Anja Gysin-Maillart can be highly praised as an important
and innovative book. It can be recommended to clinicians working with patients who have
attempted suicide and to researchers who are looking for inspiration for high quality intervention
studies.

References
Gysin-Maillart, A., & Michel, K. (2013). Kurztherapie nach Suizidversuch ASSIP – Attempted Suicide Short
Intervention ProgramTherapiemanual. Bern: Verlag Hans Huber.
Jobes, D. A., Au, J. S., & Siegelman, A. (2015). Psychological approaches to suicide treatment and preven-
tion. Current Treatment Options in Psychiatry, 2(4), 363–370.
Larkin, L. L., & Beautrais, A. L. (2010). Emergency departments are underutilized sites for suicide preven-
tion. Crisis, 31(1), 1–6.
Michel, K., & Jobes, D. (Eds.) (2010). Building a therapeutic alliance with the suicidal patient. Washington,
DC: American Psychological Association.
 Book Review 77

Michel, K., & Valach, L. (1997). Suicide as goal-directed action. Archives of Suicide Research, 3(3),
213–221.
Shneidman, E. S. (1998). The suicidal mind. Oxford: Oxford University Press.

Karolina Krysinska
NHMRC Centre of Research Excellence in Suicide Prevention, Black Dog Institute,
University of New South Wales
k.krysinska@unsw.edu.au
© 2016, Karolina Krysinska
http://dx.doi.org/10.1080/18387357.2015.1123514
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