Essential professional development and CEU training for mental health clinicians, supervisors, and graduate students

In an era where 16.9 million Americans reported serious thoughts of suicide in 2024, mental health professionals need evidence-based tools that actually work. In a recent conversation on The Self-Carepist Therapist Podcast, Dr. David Jobes shared insights from his 40+ years researching suicide prevention and developing the Collaborative Assessment and Management of Suicidality (CAMS). This proven framework reduces suicidal ideation, keeps clients out of hospitals, and transforms how we approach this critical clinical challenge.

Sobering Reality: Less than 23% of mental health graduate programs provide even one hour of training on suicide assessment and treatment. Yet suicide remains a leading cause of death, with nearly 49,000 lives lost annually in the United States alone.

What Is CAMS? Understanding the Framework

The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based therapeutic framework developed by Dr. David Jobes, a professor of psychology at the Catholic University of America who has dedicated over 40 years to suicide prevention research.

Unlike traditional approaches that focus on symptoms or diagnoses, CAMS centers on the suicidal experience itself. This framework can be integrated into any therapeutic orientation, whether you practice CBT, DBT, psychodynamic therapy, or humanistic approaches. It’s not a new therapy to learn but rather a structured way to engage with suicidal clients that dramatically improves outcomes.

Why Traditional Approaches Often Fail

For decades, the mental health field has operated under a medical model that treats suicide as a symptom of depression or other mental illness. The conventional wisdom suggests that if we treat the underlying diagnosis, suicidal thoughts will disappear. Research tells a different story.

Dr. Jobes explains that targeting treatment directly on suicidal ideation and behavior is where the real progress happens, independent of diagnosis. Yet many clinicians still default to what he calls a “medieval mindset” that relies on hospitalization, medication, and control rather than collaboration and empowerment.

The Problem with Hospitalization: While well-intentioned, short hospital stays (three to five days) often leave patients at higher risk upon discharge. Recent research, including a scoping review from Australia, shows that involuntary commitment can actually increase suicide risk rather than reduce it. Patients receive minimal therapeutic intervention beyond medication and group sessions that research shows they don’t find helpful.

How CAMS Works: A Session-by-Session Breakdown

The First Session: Therapeutic Assessment

CAMS begins with what Dr. Jobes calls a “therapeutic assessment.” With the client’s permission, the clinician literally or figuratively sits beside them (not across from them) to collaboratively complete the Suicide Status Form (SSF).

Here’s what makes this first session transformative:

The client completes the assessment. Rather than the therapist asking questions and filling out forms, the client rates their own pain, stress, hopelessness, and other variables while the clinician helps. This shift in power dynamics is profound.

Clients feel understood. After 20 to 25 minutes of this collaborative process, clients consistently report feeling better because the assessment truly captures what it means to be suicidal. The therapist demonstrates deep understanding, sometimes even finishing the client’s sentences because the tool is so well-designed.

Identifying “drivers” instead of diagnoses. The revolutionary question at the heart of CAMS is simple: “What makes you suicidal?” Not what’s your diagnosis, but what specific problems in your life drive these thoughts?

The vast majority of drivers fall into three categories:

Relational issues: “My kids don’t talk to me,” “My girlfriend dumped me,” “I’m being bullied online.”

Vocational struggles: “I hate my job,” “I can’t find work,” “I’m losing my house.”

Issues of self: “I hate myself,” “I can’t look in the mirror without feeling disgusted,” “I have PTSD from combat and can’t move forward.”

Once drivers are identified, the clinician and client develop a stabilization plan (similar to a safety plan) and create a treatment plan specifically targeting those drivers. The goal is explicitly stated: to keep you out of the hospital.

Interim Sessions: Targeted Treatment

Subsequent CAMS sessions, called “interim sessions,” follow a consistent structure. The clinician and client quickly check in on core assessment variables, then spend the majority of the session working on the identified drivers using whatever therapeutic interventions the clinician knows best.

This might include couples therapy for relational issues, cognitive therapy for self-hate, behavioral activation for depression, or referrals to group therapy or job counseling. The flexibility of CAMS means it works across theoretical orientations and treatment settings.

Resolution: Building a Life Worth Living

According to clinical trial data, CAMS typically requires six to eight sessions to reach resolution. Resolution doesn’t mean every trace of suicidal thinking disappears. Instead, it means the client has achieved stability and can manage suicidal thoughts and feelings when they arise.

The final phase of CAMS shifts focus from suicide prevention to life worth living. What gives this person purpose and meaning? How can they build the life they actually want? This existential component, drawing on values clarification from Acceptance and Commitment Therapy (ACT) and logotherapy, helps clients move from merely surviving to truly living.

The Evidence Base: Why CAMS Works

Unlike many interventions that lack rigorous research, CAMS has been extensively studied with impressive results:

Seven randomized controlled trials demonstrating effectiveness in reducing suicidal ideation

Fourteen open trials across diverse populations and settings

Over 1,400 patients treated in clinical trials over 20 years, with only five completed suicides among the highest-risk populations (people recently hospitalized or who had just made attempts)

Significant cost savings by averting expensive emergency department visits and inpatient stays

High patient satisfaction because clients feel understood, empowered, and hopeful after the first session

What About Suicide Attempts? While CAMS excels at reducing suicidal ideation, critics have noted it doesn’t necessarily reduce attempt behaviors as effectively as DBT. However, recent data from clinical trials, including studies with college students and a German inpatient trial, are showing significant reductions in attempt behaviors as well. For attempt behavior specifically, combining CAMS with DBT skills training shows tremendous promise.

CAMS Training: Professional Development and CEU Opportunities for Therapists

Given that most graduate programs provide minimal training in suicide assessment and treatment, professional development in this area is essential. CAMS training offers multiple pathways depending on learning style, clinical setting, and career stage.

Self-Directed Learning

Experienced psychotherapists can start with the source text, Managing Suicidal Risk: A Collaborative Approach (Third Edition) published by Guilford Press. The book provides comprehensive information about the model, case examples, and fillable PDFs of the Suicide Status Form.

Some clinicians with strong clinical judgment and experience working with suicidal clients can implement CAMS by reading the book and practicing with the forms. However, most professionals benefit from more structured training.

Integrated CAMS Training Model

The most robust training pathway comes through CAMS Care, the training company developed to bring this intervention to scale. The integrated model includes:

Online video training: Watch Dr. Jobes demonstrate the intervention with realistic, unscripted patient scenarios

Role-play training: Conducted monthly either online or in person, participants practice the first session with partners and receive real-time coaching

Consultation calls: Monthly consultation with CAMS experts provides ongoing support as you implement the model with actual clients

This integrated approach addresses a crucial ethical and clinical requirement that busy therapists often overlook: consultation. When working with suicidal clients, consultation isn’t optional. It’s essential for ethical practice, risk management, and clinical effectiveness.

CAMS Certification

For clinicians who complete training and want to demonstrate competency, CAMS Care offers certification. To become CAMS certified, practitioners meet with an expert consultant, role-play the intervention, and demonstrate their mastery of the approach.

Special Training Opportunities

Graduate students and training programs: CAMS Care offers significant discounts for directors of training, clinical internship programs, and graduate student placements. Training the next generation of clinicians before they develop bad habits or debilitating fear around suicide is a priority.

Educational systems: Schools, universities, and educational institutions receive discounted rates to make training accessible.

Clinical teams and systems: Organizations can arrange group training with negotiated rates, making it feasible to implement CAMS across an entire clinic, hospital unit, or agency.

Continuing Education Credits

Mental health professionals seeking CEUs in suicide prevention can access CAMS training through various formats. Additionally, eight states now require suicide-specific training for license renewal, making CAMS an ideal choice for fulfilling these requirements while gaining genuinely useful clinical skills.

CAMS in Different Settings: Adaptations for Various Clinical Contexts

CAMS Brief Intervention (CAMS-BI)

For emergency departments, crisis centers, and other short-term settings, CAMS-BI distills the framework into a one-session intervention. This version has shown remarkable effectiveness in reducing distress and increasing motivation to live.

A published study from LSU Baton Rouge demonstrated that CAMS-BI, delivered by graduate students (100% of providers were students in training), significantly reduced patient distress in a single session. Patients walked out with a stabilization plan and clarity about the two problems they needed to address to save their lives.

Empath Units: The Future of Crisis Care

Empath units represent an innovative alternative to traditional emergency departments for behavioral health crises. These specialized spaces feature comfortable seating, reduced environmental stimuli, and staff trained in trauma-informed, non-coercive approaches.

Patients spend a day or two in this supportive environment and typically improve without the chaos and trauma of traditional ER boarding. Pairing Empath units with CAMS-BI creates a powerful combination that addresses the immediate crisis while setting up longer-term treatment success.

Inpatient Psychiatry

While CAMS was originally designed for outpatient care, inpatient versions exist with a focus on disposition planning and discharge. The goal is to conduct the therapeutic assessment, identify drivers, and create a clear outpatient treatment plan so patients leave the hospital with direction rather than just stabilization on medication.

College Counseling Centers

NIMH-funded multi-site trials have studied CAMS specifically with college students, comparing it to DBT and treatment as usual. College counseling centers have been early adopters because the approach works well with young adults navigating identity, relationships, and existential questions about purpose and meaning.

Telehealth and Online Delivery

Research demonstrates that CAMS can be delivered effectively via telehealth without losing the collaborative, empathic spirit. Using fillable PDFs of the Suicide Status Form, clinicians share their screen and complete the assessment together with clients. Patients can then correct the clinician when they get something wrong (which patients love to do), maintaining the collaborative dynamic even through a screen.

Clinical Supervision and CAMS: Training the Next Generation

One of the most exciting developments in CAMS implementation involves training graduate students and early-career professionals. Dr. Jobes notes that students often make the best CAMS clinicians because they:

Don’t have counterproductive habits to unlearn. They haven’t been conditioned by years of no-harm contracting or reflexive hospitalization.

Care about evidence. Students want to practice interventions that actually work and are hungry for effective tools.

Are enthusiastic about challenging cases. Rather than fearing suicidal clients, trained students become excited to use their new skills and genuinely help people in crisis.

Expand the workforce responsibly. With proper training and supervision, second and third-year master’s and doctoral students can deliver CAMS with excellent outcomes, addressing the workforce shortage in mental health.

For Clinical Supervisors: CAMS provides a structured framework that makes supervision of suicidal cases clearer and less anxiety-provoking for both supervisor and supervisee. The Suicide Status Form documents the collaborative process, making it easier to review clinical decisions and ensure quality care. The emphasis on consultation also models best practices for trainees early in their careers.

Success Stories from Training Programs

At Eastern Kentucky University, Melinda Moore runs a PsyD program where second and third-year students become expert CAMS clinicians. These students actively seek out opportunities to work with suicidal clients and carry their expertise into the field when they graduate, spreading evidence-based practice throughout their careers.

Multiple clinical trials now use students in training as primary providers (with appropriate supervision), demonstrating that expertise in suicide intervention doesn’t require decades of experience. It requires good training, ongoing consultation, and a framework that works.

Combining CAMS with Other Evidence-Based Approaches

CAMS and DBT: A Powerful Partnership

Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan (who served as a research mentor to Dr. Jobes), remains the gold standard for reducing self-harm and suicide attempt behaviors. CAMS excels at reducing ideation. Together, they create a comprehensive approach.

Several clinics now implement a model where all clients begin with CAMS. Those who are dysregulated and engaging in self-harm also receive DBT skills groups. This combination addresses both the cognitive/emotional drivers of suicidality and the behavioral dysregulation that leads to attempts.

The Hope Institute and various CAMS clinics around the country have pioneered this integrated approach, demonstrating that intensive outpatient models using both frameworks can avert expensive hospitalizations while providing superior care.

CAMS and Cognitive Therapy for Suicide Prevention

Brief Cognitive Behavioral Therapy (BCBT) and Cognitive Therapy for Suicide Prevention (CT-SP) have strong evidence for reducing attempt behaviors. These can be used as driver-specific interventions within the CAMS framework when cognitive distortions or hopelessness are identified as primary drivers.

Values Clarification and Existential Approaches

Dr. Jobes emphasizes that CAMS increasingly incorporates values clarification from ACT and existential/logotherapy approaches. This is particularly relevant given the rise in existential distress among adolescents and young adults who cite concerns about climate change, political toxicity, and societal collapse as drivers of their suicidality.

Even a “grumpy 17-year-old teenage boy who just grunts” can articulate values when given the opportunity. Treatment that embraces and operationalizes those values creates hope and forward movement.

Special Considerations: Working with Adolescents

Three ongoing clinical trials focus specifically on adolescents and older teens, and the findings are reshaping how CAMS approaches younger clients.

Unique Drivers in Youth

For the first time in Dr. Jobes’ research career, social determinants and global concerns are appearing as drivers of suicidality. A 10-year-old recently cited “the brain rot of my generation” as a driver. Teens mention climate anxiety, political division, and fears about the future with striking frequency.

While clinicians can’t solve climate change or fix society, they can work with young people on their relationship to these concerns, their sense of agency, and their ability to find meaning despite uncertainty.

The Stabilization Support Plan for Parents

The third edition of the CAMS manual includes a new tool: the Stabilization Support Plan. This provides clear guidance for parents on securing lethal means in the home and supporting their child’s treatment without undermining the therapeutic work.

When this works well, it’s transformative. Parents know exactly what they need to do without being drawn into backdoor conversations or attempts to control their child in ways that increase risk.

Adolescent Autonomy and CAMS

Teenagers are developmentally primed to assert expertise, especially about themselves. CAMS works beautifully with this developmental stage because it positions the teen as the expert on their own experience.

Dr. Jobes shared an example of telling a 10-year-old client, “I don’t know what’s best for you. Your parents don’t know what’s best for you.” Instead, he offered a range of interventions for the identified drivers and asked the child to choose. This approach instills agency and investment in treatment rather than the typical power struggle.

Critical Insight: NIMH-funded research with adolescents intentionally avoids backdoor conversations with parents. Lethal means discussions happen in front of the child whenever possible. This transparency respects the young person’s autonomy while ensuring safety. The treatment is fundamentally child-focused, only bringing parents in when relational dynamics are identified as drivers.

Common Concerns and Misconceptions About CAMS

“Won’t Avoiding Hospitalization Put Clients at Risk?”

This is the most common concern, and it stems from decades of conditioning that hospitalization equals safety. The evidence tells a different story. Patients are actually at higher risk immediately following discharge, and involuntary commitment can increase rather than decrease suicide risk.

CAMS doesn’t mean never hospitalizing anyone. It means using hospitalization as a last resort when outpatient stabilization truly isn’t safe or possible, rather than as a reflexive first response to suicidal ideation.

“I’m Not Trained in Suicide-Specific Interventions for Different Drivers”

You don’t need to be. CAMS is flexible and works with whatever therapeutic approaches you already know. If a client identifies relationship problems as a driver and you know couples therapy or interpersonal therapy, use that. If you know CBT, use it for cognitive drivers. The framework helps you organize and target your existing skills, not learn entirely new interventions.

“What If I Can’t Make Progress on the Drivers?”

You don’t have to completely resolve a driver for the client to improve. Making a meaningful dent in three or four sessions often leads to resolution because the client feels more stable, can manage suicidal thoughts and feelings, and has hope that change is possible.

“Isn’t This Too Complicated for Crisis Settings?”

CAMS-BI (the brief intervention version) is specifically designed for crisis settings and takes one session. Research shows it’s effective even when delivered by graduate students with appropriate supervision.

The Research-to-Practice Gap: Why Aren’t More Clinicians Using CAMS?

Despite strong evidence, there’s what Dr. Jobes calls a “chasm” between research and practice in suicide prevention. Several factors contribute:

Lack of training: Most graduate programs provide virtually no education about suicide assessment and treatment.

Institutional inertia: Hospitals and agencies continue using approaches they’ve always used, even when evidence doesn’t support them.

Fear and liability concerns: Clinicians worry about malpractice and believe (incorrectly) that hospitalization is the safest legal position.

Reimbursement structures: Insurance companies and systems haven’t always supported intensive outpatient alternatives to hospitalization.

Marketing challenges: Mental health has historically been reluctant to “sell” treatments, even evidence-based ones. DBT succeeded partly because Dr. Linehan created a business infrastructure to train clinicians. CAMS has followed suit with CAMS Care, but awareness still lags.

The Future of Suicide Prevention: Care Transition and Aversion Models

Much of Dr. Jobes’ current work focuses on care transition aversion: keeping people out of emergency departments and hospitals entirely by providing effective outpatient intervention when they’re in crisis.

This model makes sense from every angle. It’s better for patients (less stigma, maintained functioning in work/school/family life), more cost-effective for systems (avoiding expensive ED visits and inpatient stays), and more effective clinically (continuity of care with the same provider rather than handoffs between settings).

As healthcare systems face budget constraints and workforce shortages, evidence-based outpatient models like CAMS become not just clinically preferable but economically necessary.

Getting Started: Next Steps for Clinicians and Supervisors

For Individual Therapists

If you’re ready to expand your competence in working with suicidal clients, start by visiting the CAMS Care website to explore training options. Consider beginning with the book Managing Suicidal Risk to understand the framework, then pursue role-play training and consultation to implement it effectively.

Remember that consultation is not optional when working with suicidal clients. CAMS training builds this in from the start, modeling ethical practice and reducing the isolation that can lead to clinician burnout.

For Clinical Supervisors and Training Directors

If you oversee a training program, practicum site, or internship, consider making CAMS training part of your curriculum. The discounts available for educational settings make this feasible, and training students before they develop counterproductive habits pays dividends throughout their careers.

Building supervision around a structured framework like CAMS also reduces anxiety for new supervisors and provides clear documentation of the clinical process.

For Organizations and Systems

Agencies, clinics, hospitals, and healthcare systems can contact CAMS Care to discuss implementation across teams. Creating a “CAMS clinic” or integrating CAMS into existing services requires planning, but the investment pays off in improved outcomes, reduced hospitalizations, and enhanced staff morale.

Some organizations have developed internal trainers who work under the CAMS Care umbrella, ensuring quality assurance while building sustainable capacity.

Free Resources to Get Started

CAMS Care offers free quarterly webinars featuring leading experts in suicide prevention. These online sessions provide valuable continuing education and introduce clinicians to the CAMS approach at no cost. Visit the CAMS Care website to register for upcoming webinars and access additional free resources.

Self-Care for Clinicians Working with Suicidal Clients

Working with people in suicidal crisis takes a toll. Dr. Jobes, after 43 years in the field, emphasizes several self-care strategies:

Personal therapy: He completed five years of therapy during graduate school and believes deeply that clinicians should practice what they preach.

Strong relationships: He spends significant time with his wife, who he describes as his best friend. Regular connection and mutual support are essential.

Consultation with trusted colleagues: Even as a world expert on suicide, Dr. Jobes never works as a “lone ranger.” He consults with colleagues who know him and can provide perspective on challenging cases.

Using effective interventions: There’s a morale boost that comes from doing work that actually helps. When clinicians use evidence-based approaches and see clients improve, it prevents burnout and creates a positive cycle.

The Hope Institute Effect: Clinics that implement CAMS consistently report something unexpected. They worry staff will burn out working primarily with suicidal clients. Instead, the opposite happens. The culture becomes one of hope, excitement, and “we’ve got this” rather than fear and avoidance. When therapists have tools that work, the work becomes energizing rather than depleting.

How CAMS training could be integrated for most mental health professionals

Nearly 17 million Americans experienced serious suicidal thoughts in 2024. Suicide is the 11th leading cause of death in the United States. Yet fewer than one in four mental health professionals receives any training in suicide-specific assessment and treatment during their graduate education.

This gap leaves clinicians unprepared, anxious, and likely to default to approaches that aren’t evidence-based. It leaves clients feeling misunderstood, controlled, and hopeless. And it perpetuates a system where expensive interventions (hospitalization) with limited evidence continue while effective outpatient approaches struggle for adoption.

CAMS offers a different path. With seven randomized controlled trials, over 1,400 patients treated successfully in research studies, and growing implementation worldwide, it represents one of the most thoroughly evidenced approaches to suicide intervention available.

More importantly, it transforms the therapeutic relationship. Instead of the clinician as expert trying to control the patient, CAMS creates a genuine collaboration. Instead of focusing on diagnosis and medication, it identifies and treats the actual problems driving someone’s wish to die. Instead of invalidating and hospitalizing, it empowers and stabilizes.

For graduate students, CAMS provides early mastery of a skill that will serve their entire career. For experienced clinicians, it offers a structured framework that reduces anxiety and increases effectiveness with the most challenging cases. For clinical supervisors, it creates clarity and documentation in an area fraught with liability concerns. For organizations, it saves money while improving outcomes.

But perhaps most importantly, CAMS gives hope. In that first session, when a clinician tells a suicidal person, “I have four or five different interventions for the self-hate that makes you want to kill yourself,” something shifts. Dr. Jobes describes seeing “this little flicker” in clients’ eyes that looks a lot like hope.

That flicker can become a flame. That flame can become a life worth living. And that’s why CAMS training matters for every mental health professional committed to making a real difference in the lives of people who are suffering.