Holding Hope: Eliot Clinician Willow’s Journey with John through CAMS and the Lifeline Letter
My client, John, is a college student who came to Eliot’s Tri-City Community Behavioral Health Center (CBHC) with a history of depression, self-harm, and suicide attempts. By the time he arrived, John had experienced severe depressive symptoms, social anxiety, self-injurious behavior, and suicidal ideation. He was very guarded with providers, including me, but once he and I formed a rapport I wrote a letter of support for his decision to take a medical leave for the spring semester to focus more on his mental health treatment. He received a PHP referral but got too overwhelmed in group treatment settings to continue, and he agreed to start CAMS, an evidence-based approach to treating people suffering from serious thoughts of self-harm. CAMS is a comprehensive approach in which patients work closely with their providers to identify and address key drivers of their suicidal ideations. The framework is based on 40 years of ongoing clinical research and is rooted in patient-centered strategies. Unfortunately, John did not come to his first scheduled CAMS session and subsequently stopped responding to my messages.
Given the high risk and acute crisis, it was very difficult for me to let go of this client. In consultation with Doug Katz, Eliot’s Director of Clinical Services, he told me about the Lifeline Letter study, which found that regular contact from a caring person can help suicidal people feel more connected and stay alive. I wrote a handwritten letter to my client to send along with his discharge summary, letting him know that I was here and holding hope for him and that he could come back to treatment any time. Five months later, he did, and he requested to work with me again. This time, he stayed with the program and completed CAMS, and we’re now working on improving his self-esteem, challenging negative thoughts, and tolerating and regulating his emotions.
What the Lifeline Letter and CAMS have in common is how they apply the best evidence and research available while also honoring the uniqueness of each individual client and therapist. CAMS is best understood as a framework guiding the assessment and treatment planning for suicidal clients. It’s not one-size-fits-all; it’s a template. Within the CAMS protocol there is room to utilize any number of other modalities and interventions to address the client’s unique drivers to suicide.
Most agencies have policies around suicide that are focused more on managing risk than improving outcomes. No-suicide contracts are sometimes still used in spite of overwhelming evidence that they do not work. By contrast, Eliot CBHC administers the Columbia-Suicide Severity Rating Scale (C-SSRS) weekly to identify increased risk, has all clinicians trained in CAMS, and offers biweekly CAMS supervision with a leading expert. Through Eliot’s generous professional development stipend, I’m also trained to deliver Dialectical Behavioral Therapy (DBT), another evidence-based intervention for suicide and self-injurious behaviors.
Contrary to the widespread myth, talking about suicide does not increase risk. It saves lives. In the words of Marsha Linehan, we simply have to dare to go “where angels fear to tread.” I’m proud to be part of an organization that understands this and equips clinicians with the tools we need to help clients not only stay alive but to cultivate lives worth living.
Kyle’s Path to Resilience with Eliot’s Support
When Kyle first sought help at Eliot’s Danvers CBHC, he was in crisis. Following a suicide attempt, he came to Eliot’s CBHC emergency services, knowing he needed to confront his deep-seated traumas, anxiety, and depression. However, circumstances made it difficult for Kyle to attend in-person appointments, creating a barrier to his initial recovery journey. But rather than letting this challenge hinder his progress, Kyle and Eliot’s team found creative solutions to ensure he received the tailored care he needed.
Despite initial hurdles, Kyle’s determination to improve his life shone through. He began meeting with his clinical providers via telehealth, consistently showing up and engaging in his therapy. As he worked through his traumas, Kyle also embraced new coping skills such as acceptance strategies and grounding techniques, allowing him to navigate life with a renewed sense of purpose and capacity to adapt to challenges. His suicidality decreased to remission, as well, through Eliot’s commitment to agency-wide Zero Suicide training and service delivery.
In addition to therapy, Kyle connected with peer support staff who shared their own lived experiences, offering insight and side-by-side companionship. These meetings often took place in community settings, like local coffee shops or comic book stores, where they could bond over shared interests and cultivate a sense of belonging. These outings weren’t just about fun—they provided Kyle with a safe space to explore his goals and aspirations, helping him to envision a future filled with possibilities.
Kyle’s social anxiety, once a significant obstacle, gradually began to ease. What started as a struggle to order a coffee in public became an empowering journey of self-expression and independence. With each interaction, Kyle grew more comfortable with himself, finding the courage to venture out into the world on his own terms.
Depression, another formidable barrier for Kyle, also became more manageable with the support of Eliot’s team. Kyle, who once shared that “taking care of myself is really hard,” now approaches each day with a commitment to being the best version of himself., and his journey to self-confidence is a testament to his resilience and the power of recovery.
Today, Kyle continues to work with his care team multiple times per week, focusing on new goals like finding employment and eventually securing his own housing. His story is one of resilience, strength, and the belief that recovery is possible—with the right supports and an unwavering determination to succeed.