Research Projects

Current Projects Completed Projects

Pieta House is actively engaged in several research projects. A selection of current and recent research projects are summarised below. Click on the links beside each for the full report/paper.

Current Projects

The following is a brief summary of the research projects currently being undertaken in association with Pieta House. For information on any of the projects please contact the Director of Research using the Research Proposal Submission Form.

The Impact of a Planned Pieta House on Local Communities
This PhD research will evaluate key psychological indicators of well-being at a population level before, during, and after the establishment of a Pieta House centre within the community. This research is being led by Prof. Muldoon (University of Limerick) and conducted by Michelle Kearns, with support from the Irish Research Council and Pieta House.

Past Client Panel

The Past Client Panel will provide an opportunity to benefit from the unique experiences and input of clients who have completed therapy at Pieta House. We aim to trial a number of groups across the country to identify the feasibility of establishing a regular group, and the interest among our past clients.

The Pieta House School Resilience Programme

The Pieta House School Programme aims to reduce the number of deaths by suicide in secondary school children by presenting a school programme that works with students to use their strength and resilience as a resource. Following an extensive international literature review, a programme will be developed in conjunction with school principals, teachers, and students to ensure that the key issues affecting students in schools are addressed.

Development of an U18 risk and resilience scale

This research involves the development of a psychometrically sound tool to measure both risk and resiliency factors for adolescents and young people.  This is being conducted with Prof. Tim Trimble and Megan Gaffney (Trinity College Dublin), with support from Pieta House and the Irish Research Council ‘New Foundations’ Scheme.

Psychological Impact of Participating in Darkness Into Light

Darkness Into Light is the largest event in the Pieta House calendar. This research investigates the psychological impact of participating in the event. It is being conducted by Michelle Kearns and Prof. Orla Muldoon from the University of Limerick, with support from Pieta House.

Role of Family and Next of Kin in the Therapy Journey

Pieta House encourages the involvement of family members to support the client through the therapy process. This research considers the role and impact of this process, and is being conducted by Dr Adam Kavanagh (St. Patrick’s University Hospital) and Evelyn Gordon (Dublin City University) with support from Pieta House.

Therapy and Technology

While there is great potential for technology to assist the therapy and recovery process, to date this has been largely under-developed. Research conducted by Dr. Rachel Msetfi (University of Limerick) will explore the use of mobile technology in support clients during and after their time at Pieta House.

Addressing Suicide in the Travelling Community

Suicide accounts for approximately 11% of Traveller deaths per year. Men from the Travelling Community are seven times more likely to die by suicide than are men from the settled community. This study will address the use of mental health services by members of the Travelling Community, and review the barriers that may prevent members from accessing the help that they need.

Self-harming Behaviour in Women Diagnosed With Autism

Self-harming rates are typically higher among women than men. Self-harming behaviours are particularly high among individuals on the autism spectrum, however limited research has been conducted to examine the experiences of women on the spectrum. This study will examine the prevalence and function of self-harm among adult women who have been given an autism diagnosis, allowing women to provide information and insight into their own experiences.

Completed Projects

2015

Title: Client Personal Recovery and Recovery-Orientation of an Irish Suicide Intervention Charity  
Reference: Conway, C., Surgenor, P.W.G., Thekiso, T.B., Moore, A., Campion, A., Twomey, A., Rush, G. (2015) Client Personal Recovery and Recovery-Orientation of an Irish Suicide Intervention Charity. Irish Journal of Psychological Medicine, paper under review  
Summary: Recovery is a key goal for individuals who are dealing with mental health challenges. This study aimed to evaluate the recovery-oriented approach taken by Pieta House. This aims to empower clients by instilling hope and respect, actively involving the client in care and service planning, and linking them with peer and advocacy groups. The study found high levels of client and therapist agreement in relation to empowering the client, working with the client as an individual and working with the client to develop life goals.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Early Attrition Among Suicidal Clients  
Reference: Surgenor, P. W. G., Meehan, V., & Moore, A. (2015). Early Attrition among Suicidal Clients. British Journal of Guidance and Counselling, paper under review  
Summary: High rates of attrition (or client drop out) are common in therapy. To better understand why some clients might suddenly end therapy this study compared clients who left therapy before it was completed and clients who continued in therapy. Results showed that clients were significantly more likely to drop out if they were self-referred, had no contact with healthcare services, or had lower levels of suicidal ideation. The study also identified the significant role of suicidal ideation and the clients’ pathway into services in maintaining therapy attendance.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Predictive Role of Risk and Protective Factors Before and After Suicide Intervention Therapy  
Reference: Surgenor, P.W.G. (2015) Predictive role of risk and protective factors before and after suicide intervention therapy. Irish Journal of Psychology, paper under review  
Summary: While research has increasingly identified risk factors (those that increase the risk of suicide) and protective factors (those that protect against suicide), there has been little research into the impact and predictability of these factors before and after a client engages in therapy. Pre-therapy physical activity was found to be a protective factor, and the end of a relationship, expressing suicidal thoughts, having a suicide plan were the greatest risk factors. Post therapy these were no longer identified as risk factors. The findings have implications for our understanding of the permanence and classification of risk factors, and for the potential ability of different intervention approaches to effectively reduce the impact of these.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: The Role of Connectedness on the Paths to and from Suicide  
Reference: Aherne, Coughlan & Surgenor, P.W.G.  (2015) The Role of Connectedness on the Paths to and from Suicide. The Counselling Psychologist, in preparation  
Summary: The current study aimed to develop an understanding of suicide by exploring the role of connectedness in people becoming suicidal and in people recovering from suicide. Psychotherapists from Pieta House were interviewed in relation to their understandings of connectedness and suicide. The study found that the connection an individual has with themselves is crucial for all other connections. The quality of connections that a person has with their family was also found to be important in relation to whether or not they would become suicidal. The relationship developed in therapy was found to be vital for a person who is suicidal in redeveloping their sense of connectedness.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Ten Recommendations for Effective School-based, Adolescent, Suicide Prevention Programs  
Reference: Quinn, P., Surgenor, P.W.G. & Hughes, C. (2015) Ten recommendations for effective school-based, adolescent, suicide prevention programs. School Mental Health, paper under review  
Summary: School-based suicide prevention programs are one of the key strategies to address suicide in adolescence. This study reviewed the numerous suicide prevention programs implemented globally in recent years to provide informed recommendations for the development of effective school-based programs for adolescents. The study identified a variety of programme styles and presented ten recommendations for school programmes with reference to: length of programme, flexibility of content, identifying the appropriate presenter for the programme, delivery style, and programme content.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Implementing a Theoretical Self-harm and Suicide Intervention Model into Therapeutic Practice  
Reference: Surgenor, P.W.G, Moore, A., O’Connor, C., Lenehan, L., Kiely, M. & Devlin, N. (2015) Implementing a theoretical self-harm and suicide intervention model into therapeutic practice. Cognitive and Behavioral Practice, paper under review  
Summary: While a range of therapeutic approaches have been designed to target suicidal behaviours, most lack the necessary detailed practical strategies for implementation, resulting in a lack of clarity for therapists and limited practical use. The goal of this paper was to help therapists in their application of a theoretical therapy approach to a practical therapy environment by providing clear goals and strategies for each aspect of the therapy program. The paper outlines the steps used in Pieta House to work with clients throughout the process of therapy. It describes the three stages that clients move through over the course of their therapy, and it describes the goals and practical strategies for each stage.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: A Mixed Methods Exploration of Self-Harm Among Irish Adults in a Clinical Setting  
Reference: O’Sullivan, J. & Surgenor, P. W. G. (2015) A Mixed Methods Exploration of Self-Harm Among Irish Adults in a Clinical Setting. In preparation  
Summary: While a number of studies have been conducted in relation to the demographics of self-harm, few studies have taken an in-depth look at the lived experience of those dealing with self-harm. The current study combines demographic data with interviews conducted with former Pieta House clients. It offers an account of the functions of self-harm, the personal experiences of those dealing with self-harm (particularly in relation to age, gender and sexual orientation), and it examines the relationship between self-harm and suicidal ideation.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Perceptions of the Relationship between Self-Harm and Suicide in Ireland’s Tiger Teens  
Reference: Surgenor, P.W.G., Meehan, C., & Kiely, M. (2015). Perceptions of the Relationship between Self-Harm and suicide in Ireland’s Tiger Teens. Journal of Adolescent Health, paper under review  
Summary: Much research into self-harm is quantitative and based on clinical samples. The aim of this research was to get information and advice on self-harm from adolescents in their own words. Adolescents depicted self-harm as a complex and varied behaviour. While the vast majority stated there was no suicidal intent in their behaviour they did report an increase in frequency and intensity, and stated that they would consider suicide if they could no longer self-harm. The findings offer profound insights and practical implications that have the potential to direct therapy for self-harm.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Assumptions of Homogeneity in Transferring a Therapeutic Suicide Intervention Programme Across Three Irish Cities  
Reference: Surgenor, P.W.G. & Kaulen, K.A.M. (2015) Assumptions of homogeneity in transferring a therapeutic suicide intervention programme across three Irish cities. Public Health, paper under review  
Summary: Therapy at all Pieta House centres across Ireland utilises the same therapeutic programme (the PH-SIM). This research aims to analyse the transferability of the therapeutic approach used in Pieta House to test the assumption that this uniform approach is equally beneficial to clients presenting to Pieta House centres in Dublin, Limerick, and Cork. Higher levels of suicidal risk were reported in one centre, while differences were also noted in risk and protective factors in different locations. This suggests that a therapy programme developed in one location cannot be automatically transferred to a different location. Differences between cities suggest that the one-size-fits-all approach may not be a suitable model for expansion, and that local-level research is required to establish similarities and differences to inform amendments to the original programme where necessary.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Understanding Help-seeking Amongst University Students: The Role of Group Identity, Stigma and Exposure to Suicide and Help-seeking  
Reference: Kearns, M., Muldoon, O.T., Msetfi, R.M. & Surgenor, P.W.G (2015) Understanding help-seeking amongst university students: The role of group identity, stigma and exposure to suicide and help-seeking. Frontiers in Psychology, 6, 1462. DOI: 10.3389/fpsyg.2015.01462  
Summary: Despite a high prevelance of suicidal ideation and mental health challenges in university students, the stigma of mental health difficulties can present a barrier to formal help-seeking. Social identity theory states that help received from an ingroup source (a group that a person identifies as belonging to) is more welcome and less threatening to one’s identity than that from a source perceived as outgroup (a group that they feel they do not belong to). This study hypothesized that students' stigma towards seeking help from their university mental health service would differ based on the strength of their identification with the university. Unexpectedly, higher levels of group identification, in this case identification with the university, were found to predict higher levels of stigma of help-seeking from the ingroup. Thus students who identified more strongly with their university demonstrated higher stigma in seeking help from university mental health services.  
More info: Paper accessible from http://journal.frontiersin.org/article/10.3389/fpsyg.2015.01462/abstract  
Title: Self-harm and the Unknown Population  
Reference: Moore, A. & Surgenor, P.W.G (2015). Self-harm and the unknown population. In preparation  
Summary: The prevalence of self-harm has been significantly under-estimated. The present study aimed to bridge the gaps in knowledge by exploring help-seeking behaviours and experiences of healthcare services among clients who have and have not presented to their G.P. or Emergency Department for self-harm. Findings highlight the stigma that exists in relation to self-harm, a lack of service awareness in relation to accessibility and availability among individuals and their families, and a lack of understanding among healthcare professionals. Young people also discussed the potentially harmful perception of the normality of self-harm.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: Investigating the Combined Role of Cognitive and Psychodynamic Variables in Explaining Suicidality in the General Population  
Reference: Ahmed, Z., Gordon, M. & Surgenor, P.W.G. (2015). Investigating the Combined Role of Cognitive and Psychodynamic Variables in Explaining Suicidality in the General Population. In preparation  
Summary: This study explored the thinking patterns of people who are experiencing suicidal ideation. It was found that feeling trapped without a solution, and prediction of negative future events were both strongly related to suicidal ideation. Although expected, a fantasy of escaping from difficulties was not found to be predictive of suicidal ideation.  
More info: Contact us using the online form for a pre-publication draft of this paper  
Title: An Exploration of the Recovery Process during a Protective Factors-Based Suicide Intervention Therapy  
Reference: Groarke, H., Surgenor, P.W. G, & Spies, M. (2015). An exploration of the recovery process during suicide intervention therapy.  
Summary: The purpose of this study was to identify changes that occurred in the initial stages of therapy at Pieta House. A comparison of pre-therapy and mid-therapy measures revealed that clients reported significant improvements in their perceived level of support and ability to cope in a range of areas. Follow up interviews identified five key factors in their improvement: the therapeutic relationship (the supportive and affirming relationship with the therapist); a new life perspective (positive changes in how clients viewed themselves and their lives); psychoeducation (how they developed information on positive mental health, coping skills, and self-awareness); experiences of therapy (elements which were challenging but rewarding); and the recovery process (where they identified the path they were on and where it would take them).  
More info: Contact us using the online form for a pre-publication draft of this paper  

2014

Title: An exploration of early therapy termination within an Irish community-based crisis intervention service for suicide and deliberate self-harm
Reference: Moore, A., Surgenor, P.W. G, & Spies, M. (2014). An exploration of early therapy termination within an Irish community-based crisis intervention service for suicide and deliberate self-harm. Manuscript submitted to Psychotherapy Research.
Summary: The aim of the research was to explore levels of early therapy termination among clients attending Pieta House. The influence of client demographic, clinical, healthcare utilisation and service use variables on risk of drop-out was also examined. Higher baseline symptom severity including depression and suicidal ideation, higher social support, previous attendance at therapy and engagement with the General Practitioner (GP) were found to predict a higher number of sessions attended. Clients who dropped out were characterised by lower symptom severity in relation to suicidal ideation and deliberate self-harm and lower engagement with the GP. The findings suggest that clients presenting with lower symptom severity and lesser GP engagement may represent a subtype of clients at risk of drop-out. The findings indicate the importance of engaging GPs in referring clients to Pieta House, and the need to tailor service provision to meet the needs of clients identified as at risk of drop-out.
Download: Click here to download a copy of the report 
Title: A hidden population: An exploratory service-based study of Deliberate Self-Harm (DSH) in Ireland
Reference: Quinn, P., McGilloway, S., & Surgenor, P.W.G. (2014). A hidden population: an exploratory service-based study of Deliberate Self-Harm (DSH) in Ireland. Manuscript under submission. 
Summary: Given concern that rates of DSH may in reality be six times the reported 12,000 presentations to Irish hospitals in 2012, there was a need for a broader understanding of DSH in Ireland. This study aimed to ascertain the nature of DSH from the perspective of a national service provide in Ireland (Pieta House), and to assess client’s views of the service. This is the first study in Ireland to explore DSH from a service provider’s perspective and the first to provide an insight in to the "hidden population" of people who engage in DSH, but who do not present at hospitals for treatment and are, therefore, not included in routinely available statistics. A need for a greater awareness of DSH and its links to suicidal ideation and behaviour in the general population is indicated.
Download: Contact Dr Sinéad McGilloway at NUIM for more information on this research
Title: The predictive role of risk and protective factors before and after suicide intervention therapy
Reference: Surgenor, P.W.G. (2014). Predictive role of risk and protective factors before and after suicide intervention therapy.  Manuscript submitted to Irish Journal of Psychology.
Summary: Research has increasingly identified risk factors (those that increase the risk of suicide) and protective factors (those that protect against suicide), though there has been little research into the impact and predictability of these factors before and after engaging in a therapeutic intervention. This research aimed to identify and compare the presence and predictive impact of risk and protective factors on suicidal ideation before and after an intervention. Results indicated a difference in the significant factors and their predictive impact before and after therapy, and raised questions over the permanence and classification of risk factors, and the potential ability of different intervention approaches to effectively reduce the impact of these factors.
Download: Click here to download a copy of the report 
Title: Developing the Pieta House Suicide Intervention Model: A quasi-experimental, repeated measures design
Reference: Surgenor, P.W.G, Freeman, J., & O’Connor, C. (2014). Developing the Pieta House Suicide Intervention Model: A quasi-experimental repeated measures design. Manuscript submitted to BMC Psychology.
Summary: While most crisis intervention models adhere to a generalised theoretical framework, the lack of clarity around how these should be enacted has resulted in a proliferation of models, most of which have little to no empirical support. This research aimed to: propose a suicide intervention model that would resolve the client’s suicidal crisis by decreasing their suicidal ideation and improve their outlook through enhancing a range of protective factors: and to assess the impact of this model on negative and positive outlook. Analyses revealed that negative outlook was significantly lower, and positive outlook significantly higher, after therapy, providing support for the proposed model.
Download: Click here to download a copy of the report 
Title: How psychotherapists work, cope and detach in a suicide intervention organisation: An exploratory study
Reference: Connellan, R. (2014). How psychotherapists work, cope and detach in a suicide intervention organisation: An exploratory study. Unpublished dissertation.
Summary: Based on in-depth interviews with counsellors who have experience of suicidal and non-suicidal clients this research aimed to investigate the issues associated with psychotherapists in a crisis intervention setting to better understand how they work, cope and detach from the area of suicide intervention. Analysis identified five key themes, including: factors influencing the decision to work in crisis intervention; enhanced sense of responsibility for suicidal clients; fear of loss and relapse; personal attributes; and the role of ethics and boundaries.
Download: Contact connellanrory@eircom.net for more information on this research 
Title: Pieta House Suicide Intervention Workshop: Diocese of Kerry
Reference: Surgenor, P.W.G. & Moore, A. (2014). Pieta House Suicide Intervention Workshop: Diocese of Kerry. Unpublished report presented to the Irish Episcopal Council. 
Summary: A review of the literature revealed the need for additional research into the provision and support for members of the clergy who deal with those who are suicidal or have expressed suicidal ideation. This research involved an evaluation of the impact of a bespoke training workshop for Irish priests and pastoral members in the Diocese of Kerry.
Results demonstrate that almost half (48%) had been asked for advice or guidance in relation to suicide, while three quarters (76.2%) reported that they had previously dealt with suicide in their capacity as a priest. Levels of confidence in supporting and advising parish members in relation to suicide were significantly increased following the workshop.
Download: Click here to download a copy of the report 

2013

Title: Recovery & Resilience: Gender Differences in Suicide Intervention Treatment at Pieta House
Reference: Surgenor, P. W. G. (2013). Recovery & Resilience: Gender Differences in Suicide Intervention Treatment at Pieta House. Paper presented at the 27th World Congress of The International Association for Suicide Prevention, Oslo, September 2013.
Summary: The aim of this research was to explore the extent to which the Pieta House Suicide Intervention Model (PH-SIM) promotes resilience by developing personalised protective factors, and to establish the extent of gender differences in this process. Levels of depression and suicidal ideation were significantly lower, and self-esteem and protective factors against suicide were significantly higher than crisis levels one month and three months after treatment had been completed.
The findings suggest that: engagement in the PH-SIM is likely to be equally effective for male and female clients in terms of recovery and establishing resilience; there is no requirement for separate, gender-specific treatment models; and that the focus for addressing male suicide should not be on whether intervention models work, but on how to convince males to seek help in the first instance.
Download: Click here to download a copy of the report
Title: Can men talk if their lives depend on it? Gender differences in a dialogue-based suicide intervention program at Pieta House, Ireland.
Reference: Surgenor, P. W. G. (2013). Can men talk if their lives depend on it? Gender differences in a dialogue-based suicide intervention program at Pieta House, Ireland.  Paper presented at the 46th Annual Conference of the American Associations of Suicidology, Texas, April 2013.
Summary: Given the well-established gender differences communication and help-seeking behaviour, this research aimed to establish whether men and women benefit equally from the dialogue-based treatment model used.
Results revealed that both males and females had significant higher self-esteem and protective factors against suicide, and significantly lower levels of depression and negative suicide ideation (i.e., reasons for dying) after treatment.
Download: Click here to download a copy of the report

2010

Title: Preparing a referral pathway: Establishing the safety of community based therapy in suicide intervention.
Reference: Surgenor, P.W.G. (2010). Preparing a referral pathway: Establishing the safety of community based therapy in suicide intervention.  Unpublished report for the Health Service Executive.
Summary: This small study was conducted in collaboration with the HSE to establish Pieta House as a secure and effective treatment environment. All (100%) of the clients who had completed treatment stated that they would use the services again and aside from the desire for a more extended service and better physical access, felt that nothing could be done to improve the quality of the service they had received.
Download: Click here to download a copy of the report