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A Grounded Theory of Suicidality in Children Ten and Younger

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A Grounded Theory of Suicidality in Children Ten and Younger Old Dominion University ODU Digital Commons Counseling & Human Services Theses & Dissertations Counseling & Human Services Summer 2014 A Grounded Theory of Suicidality in Children Ten and Younger Katherine Angela Heimsch Old Dominion University Follow this and additional works at: https://digitalcommons.odu.edu/chs_etds Part of the Counseling Psychology Commons, and the Mental and Social Health Commons Recommended Citation Heimsch, Katherine A.. "A Grounded Theory of Suicidality in Children Ten and Younger" (2014). Doctor of Philosophy (PhD), Dissertation, Counseling & Human Services, Old Dominion University, DOI: 10.25777/ 50jd-ft95 https://digitalcommons.odu.edu/chs_etds/64 This Dissertation is brought to you for free and open access by the Counseling & Human Services at ODU Digital Commons. It has been accepted for inclusion in Counseling & Human Services Theses & Dissertations by an authorized administrator of ODU Digital Commons. For more information, please contact [email protected]. A GROUNDED THEORY OF SUICIDALITY IN CHILDREN TEN AND YOUNGER by Katherine Angela Heimsch B.A. May 2004, Rider University M.A. May 2009, Rider University Ed.S. December 2010, Rider University A Dissertation Submitted to the Faculty of Old Dominion University in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY COUNSELING OLD DOMINION UNIVERSITY August 2014 Approved by: Danica G. Hays (Director) Alan M. Schwitzer (Member) ABSTRACT A GROUNDED THEORY OF SUICIDALITY IN CHILDREN TEN AND YOUNGER Katherine Angela Heimsch Old Dominion University, 2014 Director: Dr. Danica G. Hays Once every two days in the United States, a child aged 5 to 14 years old dies by suicide (World Health Organization, 2010). When viewed on a spectrum that includes suicidal ideation, verbalizations, behaviors, and attempts, the problem of youth suicidality is actually far greater than the numbers of completed suicides suggest (Cheng, Tao, Riley, Kann, Ye, Tian...Hu, 2009). This study examined suicidality in children ages 10 and younger, and included the characteristics of suicidal children, factors that influence childhood suicidality, and treatment implications. The researcher conducted 12 semi­ structured qualitative interviews with experienced treatment providers and performed a content analysis on 22 treatment charts of children identified as being suicidal in order to construct a grounded theory on childhood suicidality. This study found a core category of childhood suicidality, which resulted in 4 axial codes related to the spectrum suicidality present in children 10 and younger, including: suicidal ideation, verbalization, behaviors, and attempts. Through 21 open and 6 focused codes, it was also shown that suicidal children present with a range of behavioral and emotional disruption. A total of 6 axial codes interpreted causal conditions of childhood suicidality, including: abuse & neglect, separation from a primary caregiver, other trauma & stressors, negative familial influences, mental illness, and physical illness. Treatment implications were also found, and included 1 axial code of psychiatric interventions, as well as a researcher-developed theoretical code the primary researcher has labeled The RESCUE Model for Childhood Suicidality, which provides a framework for treatment that teachers, counselors, parents and other caregivers can use when they encounter suicidal children 10 and younger. Finally, barriers to the effective treatment of childhood suicidality were also discussed as a mediating factor to the success of treatment interventions. Keywords: children, suicidality, treatment V This thesis is dedicated to the suicidal children who have not yet been identified. 1 promise to keep working for you. ACKNOWLEDGEMENTS This dissertation would not have been possible without the contributions of several important people. Dr. Hays: Thank you for honoring my unique path that led to the completion of this dissertation. Even though I was away from campus, I always felt as though your voice was with me, present and encouraging. You are a true inspiration as an educator, researcher, and a superwoman. Dr. Schwitzer: It was a pleasure working with you in every role that I held at Old Dominion University. I have most appreciated your sense of humor, your reassurance that everything will be okay, and your excellent taste in restaurants in Ghent. Dr. Sanzo: Thank you for jumping on board with this project sight unseen. Your guidance and support is appreciated more than you know. Nathan: I met you the 3rd week of my doctoral program and you have been my loyal partner and friend ever since. The role of being partner to a doc student is itself worthy of a Ph.D. Thank you for putting up with - but also supporting - the countless hours of counseling talk, the crazy always-changing schedules, the dozens of presentation rehearsals (for which you provided truly excellent feedback!), and my mood lability. As I’ve promised over and over...if you’ve loved me through this process, you will love me even more now that it’s done. I love you. Mom: You have been editing my homework since PreK and I’m happy to announce that this is the very last assignment! I can now say with certainty that staying in the Haddonfield School District was worth the effort. I’m proud to be your daughter, the doctor. Words cannot express my gratitude for your support, encouragement, and belief in my abilities to accomplish such a momentous task. Love you forever, always your Moon. Dad: 1’ ve always known that you’ve been in my comer for everything that1 do. Love you tons. EJH/Pinky: Thank you for being that competitive younger sibling that drove me toward success. I appreciate your support in this process. (I love you, Lacey, Tyson, & Carly!) Hsin-Ya: I had hoped to make friends at my new school, but never could I have imagined that through this doctoral program I would gain a sister. You are a true example of a counselor and I am inspired by your bravery, hard work, and thoughtfulness. David & Matthew: We competed like siblings, got in trouble like siblings, and supported each other like siblings. Thank you both for the laughter and love. Heather: I could NOT have gotten through this process without your friendship. Thank you for explaining things when I didn’t understand, talking me down when 1 got anxious, and always always believing in me. Your optimism helped me to accomplish this milestone. Squiggle. (Hi Paul!) To the cohorts that came before me (especially SH, CGFP, BM, MM, LD, JSM, KB, TB, JM, and EB): You really set the bar high andI am proud to have followed in your footsteps. Thank you all for your warm welcome to ODU and Norfolk, as well as your modeling, advice, understanding, patience, jokes, friendship, girls’ nights, country music, rurality, diversity, the same article on my desk 8 times, and general awesomeness. Boom! Katlyn: I’m so glad that this journey to Norfolk turned out better than we had first expected! Thank you for being a friend before, during, after, and always. I love you, #2! To my work family (especially Mary & V):Thank you for “planting the seed” in me to be the best clinician I can be, and for always offering me a place to come home to. IX TABLE OF CONTENTS Page ABSTRACT....................................................................................................................................... ii ACKNOWLEDGEMENTS........................................................................................................... vi TABLE OF CONTENTS................................................................................................................ ix LIST OF TABLES......................................................................................................................... xiv LIST OF FIGURES........................................................................................................................xv CHAPTER ONE: INTRODUCTION............................................................................................ 1 Statement of the Problem .................................................................................................... 1 Rationale for the Study .......................................................................................................3 Brief Summary of Relevant Literature............................................................................ 5 Study Purpose .......................................................................................................................7 Research Questions ..............................................................................................................8 Definition of Terms ..............................................................................................................9 Children.....................................................................................................................9 Adolescents ............................................................................................................ 10 A dults ...................................................................................................................... 10 Suicidality.............................................................................................................. 10 Suicidal Ideation ................................................................................................... 10 Suicide Plan ...........................................................................................................10
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