Treating Suicidal Clients


© Bronwen Schoombie
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When you hear the words, suicide, or attempted suicide, they often paralyse us, and we find ourselves unable to get along with the job at hand.

However, this is exactly what a good therapist should not allow to happen. Look at suicidal behavior as any other type of manipulation - or at least attention seeking behavior and work with what you have. Don't get side-tracked with the fact that your client may not be here tomorrow.

Of course, you cannot laugh off your responsibility either, and you need to put some checks and balances into place. If you are concerned about your client actually committing the act, then you might need to have her (him) admitted to a hospital, or you might arrange that a family member come and take care of him (her) at their home. You might have them call you frequently on your cell phone, and if you do not receive a message at the appointed time, you could have an agreement that you will call the police. Whatever unique solution fits with the client and his (her) situation is fine, so long as you have a pretty good idea that even if he (she) tries it, they won't get away with it.

This is a sad part of therapy, because so often depression is a state of feeling out of control, and the very act of placing all these checks and balances in place is sort of taking the ball out of the client's court. But then again; he or she has placed you in a difficult position (legally if one of your clients does commit suicide you can be in very deep water), and if he hadn't pushed it this far, you might have given him or her more leeway.

However, once contracts against re-attempting suicide are in place, do not allow yourself to be "sucked into" the tremendous manipulation that this is. You need, rather, to focus on the life of the client, what led her (him) to this drastic phase, what other courses of action might there be. Find out what the emotion behind the action is. Is it revenge, despair (which is probably the worst), a need to "show them"? Whatever it is, work with that.

Work with why the person feels the way they do, what led up to it, and how could they, perhaps, widen the lenses so as to see a bigger picture than the one they have before them. A man who has just lost his job sees himself as unemployed. However, widen the lense" and you may find he has excellent resources, be they family, education, a wealth of experience, capital, or whatever. So often, people "get stuck" with a thought, but if you gently help them, they might start to see that there are positives to their situation. However, one word of warning. They need to find the positives themselves. For you to start with clichés like "but, can't you see, you have so much to live for..... you are so pretty, rich, famous...." cannot and never will work. That type of statement is the quickest alienator of clients that I know.

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Here's the follow-up discussion on this article: View all related messages

3.   Mar 26, 2002 10:45 PM
In response to message posted by Victor01:

Thank you Victor. You're quite right I did have a wonderful therapist and ...


-- posted by Jennyag


2.   Mar 26, 2002 8:08 PM
In response to message posted by Jennyag:

Hello Jenny,

I wanted to thank you for writing this.

I believe you ...


-- posted by Victor01


1.   Mar 23, 2002 1:16 AM
Over the last 8 years having suffered with severe clinical depression with constant suicidal ideation and acute episodes, can I put some thoughts to you from the other side of the coin so to speak.
...

-- posted by Jennyag





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