Reasons for Living Scale

Data Entry Initials: ___________ Client’s ID # & Initials: _________________________

Date: ______________________ Date: _________________________

Second Entry: _______________ Assessment: _________ Session: ________

Date: ______________________

Reasons for Living Scale Copyright 1996 M. M. Linehan page Page 1 of 3 Yellow 07/19/04

UNIVERSITY OF WASHINGTON

BEHAVIORAL RESEARCH & THERAPY CLINICS

Linehan et. al., 1983

INSTRUCTIONS: Many people have thought of suicide at least once. Others have never considered it. Whether

you have considered it or not, we are interested in the reasons you would have for

thought were to occur to you or if someone were to suggest it to you.

On the following pages are reasons people sometimes give for

know how important each of these possible reasons would be to you at this time in your life as a reason to

yourself. Please rate this in the space at the left on each question.

Each reason can be rated from 1 (Not At All Important) to 6 (Extremely Important). If a reason does not

apply to you or if you do not believe the statement is true, then it is not likely important and you should put a 1.

Please use the whole range of choices so as not to rate only at the middle (2, 3, 4, 5) or only at the extremes (1, 6).

In each space put a number to indicate the importance to you of each reason for

1. Not At All Important (as a reason for

all).

2. Quite Unimportant

3. Somewhat Unimportant

4. Somewhat Important

5. Quite Important

6. Extremely Important (as a reason for

important).

Even if you never have or firmly believe you never would seriously consider killing yourself, it is still

important that you rate each reason. In this case, rate on the basis of

be an alternative for you

____________________________________________________________________________________

In each space put a number to indicate the importance to you of each for

1. Not At All Important 4. Somewhat

not committing suicide if thenot committing suicide. We would like tonot killnot killing yourself.not killing myself, or, does not apply to me, I don't believe this atnot killing myself, I believe this very much and it is verywhy killing yourself is not or would never.not killing yourself.Important

2. Quite Unimportant 5. Quite Important

3. Somewhat

____________________________________________________________________________________

_____ 1. I have a responsibility and commitment to my family.

_____ 2. I believe I can learn to adjust or cope with my problems.

_____ 3. I believe I have control over my life and destiny

_____ 4. I have a desire to live.

_____ 5. I believe only God has the right to end a life.

_____ 6. I am afraid of death

Unimportant 6. Extremely Important

*04202a*

04202a RFLS

NIMH 3 B 1999-2003

1. Not At All Important 4. Somewhat

Important

2. Quite Unimportant 5. Quite Important

3. Somewhat

____________________________________________________________________________________

Unimportant 6. Extremely Important

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_____ 7. My family might believe I did not love them

_____ 8. I do not believe that things get miserable or hopeless enough that I would rather be dead

_____ 9. My family depends upon me and needs me

_____ 10. I do not want to die

_____ 11. I want to watch my children as they grow

_____ 12. Life is all we have and is better than nothing

_____ 13. I have future plans I am looking forward to carrying out

_____ 14. No matter how badly I feel, I know that it will not last

_____ 15. I am afraid of the unknown

_____ 16. I love and enjoy my family too much and could not leave them

_____ 17. I want to experience all that life has to offer and there are many experiences I haven't had yet which

I want to have

_____ 18. I am afraid that my method of killing myself would fail

_____ 19. I care enough about myself to live

_____ 20. Life is too beautiful and precious to end it

_____ 21. It would not be fair to leave the children for others to take care of

_____ 22. I believe I can find other solutions to my problems

_____ 23. I am afraid of going to hell

_____ 24. I have a love of life

_____ 25. I am too stable to kill myself

_____ 26. I am a coward and do not have the guts to do it

_____ 27. My religious beliefs forbid it

_____ 28. The effect on my children could be harmful

_____ 29. I am curious about what will happen in the future

_____ 30. It would hurt my family too much and I would not want them to suffer

_____ 31. I am concerned about what others would think of me

_____ 32. I believe everything has a way of working out for the best

_____ 33. I could not decide where, when, and how to do it

_____ 34. I consider it morally wrong

_____ 35. I still have many things left to do

_____ 36. I have the courage to face life

_____ 37. I am happy and content with my life

_____ 38. I am afraid of the actual "act" of killing myself (the pain, blood, violence

_____ 39. I believe killing myself would not really accomplish or solve anything

_____ 40. I have hope that things will improve and the future will be happier

_____ 41. Other people would think I am weak and selfish.

NIMH 3 B 1999-2003

1. Not At All Important 4. Somewhat

Important

2. Quite Unimportant 5. Quite Important

3. Somewhat

____________________________________________________________________________________

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_____ 42. I have an inner drive to survive

_____ 43. I would not want people to think I did not have control over my life

_____ 44. I believe I can find a purpose in life, a reason to live

_____ 45. I see no reason to hurry death along

_____ 46. I am so inept that my method would not work

_____ 47. I would not want my family to feel guilty afterwards

_____ 48. I would not want my family to think I was selfish or a coward

____________________________________________________________________________________Unimportant 6. Extremely Important

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DBT Suggested Reading List

Interview with JoAnn Heap

Q: How do you handle conflict, which is so common, when a client storms out or shuts down? 

A: Focus on the here and now, clients cannot process the past, they also have great difficulty processing past emotions.  Focus on how the client currently feels, where they feel it in their body.  Share with client that it is normal to feel that way, and how they managed that feeling.  Also ask what they could have done differently to manage feelings.  JoAnn reiterated that psychodynamic processing has a place after clients can regulate emotions, not go home and cut or experience suicidal ideation.  DBT provides clients with the tools , skills and knowledge to manage their emotions and struggles in a healthy way, so that they can process painful past events with a therapist who has a psychodynamic approach. 

JoAnn also shared that she shocked her clients, especially her adolescent clients because she “never gave up on them”.  She discussed expressing intense belief that they patient will overcome and acquire skills.  She emphasized that this will always demand patience on the therapist’s end since we tend to so desperately want our clients to magically feel better as quickly as possible. 

Q: How do you promote motivation to help clients stop parasuicidal behavior?

A:  Firgure out what they want.  Maybe they don’t know so she helps them consider common areas of concern like peer or familial relationships.  JoAnn said girls commonly state that they want a boyfriend or an improved relationship with their current boyfriend.  She said she emphasizes that she wants to work on that area of concern with them.  States that DBT is a research proven therapy.  Typically asks a client: Can you see yourself accomplishing your goal while cutting?  Also state- “cutting may scare him”, “Im worried about working with you if you are cutting yourself”, “I would be horrified to lose you”.  “Are you getting what you want now”?  “Have you ever done anything hard? “ If discontinued the use of drugs or alcohol WOW emphasize how difficult you know that must have been and how impressed you are by their strength.  How that strength will help them on this journey. Consider and ask, “What do you think will get in the way of you meeting your goal”  “I have a lot to teach you”. 

EMPHASIZE ITS GOING TO BE HARD

Q:  What are 1 or 2 important lessons you have learned as a DBT therapist? 

A:  Apologizing to the client or patient when you make a mistake.  JoAnn reiterated that she has made many mistakes and that I will make many mistakes too, which will be okay.  Always recognize and apologize for mistakes with clients.  When you are feeling stuck with a patient, when you feel you aren’t helping them or making progress in some way JoAnn emphasized the importance of sharing that feeling with a client as long as you had a plan of attack to solve issue.  She said whether you go home and plan an alternative way to address issue or ask client if it is okay with them to allow a session to be observed by her colleagues and provide suggestions.  She discussed how important staff and supervision consultations were in DBT because this work can be frustrating and clients will disappoint me as a therapist. 

Most difficult part of being a DBT therapist: worrying about clients and their SI.  JoAnn emphasized how easy it is to lose sleep over client’s wellbeing.  She also stated that as a therapist who cares a great deal for her clients, typically “does too much work for their patients”.  This means that we tend to want to see improvement in our clients so bad that we forge ahead or engage in therapy before the client is ready or motivated.  JoAnn said she learned that by telling clients that she does not believe they are ready for therapy, really causes clients to say YES I am lets get started!  Revere psychology is apparently a useful skill for DBT therapists. 

Q: When a client says, “I love you” or “You are the best therapist I have ever had”, how do you address these comments? 

A:  JoAnn said she would validate these feelings and not feel concerned about the client’s boundaries.  She said she would remind client that it is her goal for the client not to need her that they are working together so that the client does not need therapist.  Emphasize the strengths and abilities are already within the client, that the therapist is simply facilitating the process.  She said she would address physical expressions of love but not verbal. 

Case Example Discussion

Pt discuss hurt and disappointment in parent because they were physically, verbally and emotionally abusive to them their entire life.  JoAnn said to focus on describing that. “I think your mom was doing the best she could, but something was missing concerning her ability to appropriately provide care to you.  Your mother lacked the skills, tools, knowledge, or emotional capability to provide you the love and guidance you needed.  Therapy can teach you things that your mother could not.  You are not your mother.” 

Still would like to learn more about boundaries and appropriateness concerning sharing personal examples and stories with clients.  “I would be terrified to lose you if you cut”  It would hurt me deeply if you committed suicide”