1st Edition

Helping the Suicidal Person Tips and Techniques for Professionals

By Stacey Freedenthal Copyright 2018
    288 Pages
    by Routledge

    288 Pages
    by Routledge

    Helping the Suicidal Person provides a highly practical toolbox for mental health professionals. The book first covers the need for professionals to examine their own personal experiences and fears around suicide, moves into essential areas of risk assessment, safety planning, and treatment planning, and then provides a rich assortment of tips for reducing the person’s suicidal danger and rebuilding the wish to live. The techniques described in the book can be interspersed into any type of therapy, no matter what the professional’s theoretical orientation is and no matter whether it’s the client’s first, tenth, or one-hundredth session. Clinicians don’t need to read this book in any particular order, or even read all of it. Open the book to any page, and find a useful tip or technique that can be applied immediately.

    I. Understanding Suicide and You  Tip 1: Reflect on Your Biases about Suicide  Tip 2: Take Stock of Your Experiences with Suicide (or Lack Thereof)  Tip 3: Confront "Suicide Anxiety"  Tip 4: Be Alert to Negative Feelings Toward the Suicidal Person  Tip 5: Reject the Savior Role  Tip 6: Maintain Hope  II. Overcoming the Taboo  Tip 7: Face Your Fears  Tip 8: Directly Ask about Suicidal Thoughts  Tip 9: Turn to Techniques for Eliciting Sensitive Information  Tip 10: Embrace a Narrative Approach: "Suicidal Storytelling"  Tip 11: Ask about Suicidal Imagery, Too  Tip 12: Uncover Fears of Hospitalization and Other Obstacles to Disclosure  III. Joining with the Suicidal Person  Tip 13: Recognize that, for Some People, You are an Enemy  Tip 14: Avoid Coercion and Control Whenever Possible  Tip 15: Resist the Urge to Persuade or Offer Advice  Tip 16: Understand the Person’s Reasons for Dying  Tip 17: Validate the Wish to Die  Tip 18: Acknowledge that Suicide is an Option  IV. Assessing Danger  Tip 19: Gather Remaining Essentials about Suicidal Thoughts and Behavior  Tip 20: Learn About Prior Suicidal Crises: The CASE Approach  Tip 21: Cautiously Use Standardized Questionnaires  Tip 22: Privilege Warning Signs Over Risk Factors  Tip 23: Screen for Access to Firearms  Tip 24: Inquire about Internet Use  Tip 25: Probe for Homicidal Ideation  Tip 26: Collect Information from Family, Professionals, and Others  V. Assessing Protective & Cultural Factors  Tip 27: Examine Reasons for Living  Tip 28: Identify Other Protective Factors  Tip 29: Pay Attention to Culture  Tip 30: Investigate Religious and Spiritual Views of Suicide VI. Putting It All Together: Estimating Risk  Tip 31: Solicit the Person’s Own Assessment of Suicide Risk  Tip 32: Estimate Acute Risk for Suicide  Tip 33: Estimate Chronic Risk for Suicide  Tip 34: Document Generously VII. Attending to Immediate Safety  Tip 35: Know When and Why to Pursue Hospitalization  Tip 36: Know When and Why Not to Pursue Hospitalization  Tip 37: Do Not Use a No-Suicide Contract  Tip 38: Collaboratively Develop a Safety Plan  Tip 39: Encourage Delay  Tip 40: Problem-Solve around Access to Firearms  Tip 41: Discuss Access to Other Means for Suicide, Too  Tip 42: In Case of Terminal Illness, Proceed Differently (Perhaps)  Tip 43: Seek Consultation VIII. Planning for Treatment  Tip 44: Make Suicidality the Focus  Tip 45: As Needed, Increase Frequency of Contact  Tip 46: Treat Chronic Suicidality Differently  Tip 47: Involve Loved Ones  Tip 48: Suggest a Physical Exam  Tip 49: Recommend an Evaluation for Medication  Tip 50: Continue to Monitor Suicidal Ideation  IX. Alleviating Psychological Pain  Tip 51: After Safety, Address Suffering  Tip 52: Look for Unmet Needs  Tip 53: Target Social Isolation  Tip 54: Use Grounding Exercises X. Exploring Motivations and Misgivings  Tip 55: Assume Nothing: Does the Person Want to Give Up Suicide?  Tip 56: Tap Into Ambivalence  Tip 57: Compare Reasons for Living and Dying  Tip 58: Invite the Person to Look for the "Catch"  Tip 59: Search for Exceptions  XI. Inspiring Hope  Tip 60: Frame Suicide as a Problem-Solving Behavior  Tip 61: Help Brainstorm an "Options List"  Tip 62: Teach the Problem-Solving Method  Tip 63: Nourish Future Plans and Goals  Tip 64: Incorporate a Hope Kit  Tip 65: Highlight Strengths  XII. Drawing from Cognitive Behavior Strategies  Tip 66: Connect Suicidal Thoughts to Other Thinking  Tip 67: Educate about Cognitive Distortions  Tip 68: Help Challenge Negative Thoughts  Tip 69: Elicit Coping Statements  Tip 70: Rescript Suicidal Imagery  Tip 71: Discourage Thought Suppression  Tip 72: Foster Acceptance of Suicidal Thoughts  XIII. Improving Quality of Life  Tip 73: Enhance Coping Skills  Tip 74: Cultivate Mindfulness  Tip 75: "Broaden and Build" Positive Emotions  Tip 76: Pair Behavioral Activation with Values  XIV. Moving Forward After a Suicide Attempt  Tip 77: Differentiate Between Suicidal and Non-Suicidal Self-Injury  Tip 78: Determine the Person’s Reaction to Having Survived  Tip 79: Conduct a Chain Analysis  Tip 80: Evaluate Where the Safety Plan Fell Short  Tip 81: Take Advantage of the "Teachable Moment"  Tip 82: Attend to the Therapeutic Relationship  Tip 83: Address the Trauma of the Suicide Attempt  Tip 84: Explore Shame and Stigma XV. Building Resilience  Tip 85: Warn about the Possibility of Relapse  Tip 86: Review Lessons Learned  Tip 87: Complete a Relapse Prevention Protocol  Tip 88: Propose a Letter to the Suicidal Self  Tip 89: Follow Up


    Stacey Freedenthal, PhD, LCSW, is an associate professor at the University of Denver Graduate School of Social Work. Her psychotherapy and consulting practice focuses on suicide assessment and intervention.

    "This book is an extraordinary contribution to clinical suicide prevention—there is nothing like it. Dr. Freedenthal has created a treasure trove of ideas and techniques for any clinician who works with a suicidal person. Well informed by science, superb therapeutic wisdom, and clinical savvy, this readable and practical book is peppered with interesting case examples and suggestions for how to say difficult things. Providers need to keep this book close by to help ensure sound judgement and clinical competency when they care for those who struggle on the edge of life. By uniquely enhancing clinical care, this book is going to help save lives."

    David A. Jobes, PhD, ABPP, professor of psychology and associate director of clinical training, Catholic University of America

    "This book is essential reading for professionals working with suicidal individuals. It reflects the latest in suicide prevention research and theory and represents the cutting edge of therapeutic intervention, but it is organized for the clinician.  Helping the Suicidal Person will be my recommended text for all my trainings and I would strongly recommend it for any training program, community agency, or private practice clinician who wants to be more effective and more confident helping suicidal individuals survive and thrive."

    Kate Comtois, PhD, MPH, professor, Department of Psychiatry and Behavioral Sciences, University of Washington

    "This jewel of a book belongs on the shelf of every mental health clinician who is weary of books that never quite get around to ‘what to do’ for suicidal individuals. Dr. Freedenthal has assembled an invaluable set of guidelines that are expressed with compassion and in plain English, yet richly informed by scientific research on why people become suicidal and how best to help them. This book fills an important void in the clinical literature; it is a splendid resource for the serious clinician, whether beginner or veteran."

    Thomas E. Ellis, PsyD, ABPP, professor of psychiatry and behavioral sciences, Baylor College of Medicine, and senior psychologist, The Menninger Clinic

    "An excellent book for both the novice looking to learn how to best assess and treat suicide risk and the experienced clinician wanting quick, research-based tips to enhance their work with suicidal people. This book condenses all the latest suicide theory and research alongside vignettes into brief chapters that can be easily accessed by the busy clinician."

    Julie Cerel, PhD, licensed psychologist and professor, University of Kentucky College of Social Work, and president of the American Association for Suicidology