1. Move painful to present. It can be scary as a therapist when we have a client talking about suicide. Our mind might skip ahead to the worse-case scenario; death. Instead, staying present in the pain can alleviate some of the intensity in a client feeling they have safety and permission to talk about it.
2. Remember, curiosity doesn’t kill this cat. Remaining curious and open to a client sharing their experience can help you identify the risks and your next steps rather than escalating things. Adrenaline might be flowing but as an empathetic listener, you can identify the snippets of their suicide story that elevate risk and come up with a plan.
3. Avoid band-aids for bullet holes. Your own fear or inexperience may drive your desire to place your client in a hospital level of care but slow down! Many clients are reluctant to share their suicide story due to fear that you will hospitalize them so opening up takes work and trust. Identify when hospitalization is necessary versus the hotline, safety planning, or other life-saving resources.
4. Support safety planning out of a sinkhole. Engaging your client in safety planning can support awareness of wellness, warning signs, and triggers for decline while supporting practice of positive coping skills. It can also help you have some peace of mind by knowing how they can support themselves between sessions by utilizing other resources that could prevent burnout for you in this challenging work.
5. Accept chronic thoughts as comfort objects. You might not find comfort in the nonchalant disclosure of a client with chronic suicidal thoughts but they do! Alleviate the awkwardness by focusing on relationships, coping skills practice, and ongoing follow up of their suicidal thoughts to ensure nothing critical changes.
6. Know this isn’t one and done. You have the tools and the training to understand the complex relationship between dozens of risk factors. Tracking mental health, increased symptoms, and/or new or growing stressors that would put your client at greater risk for suicide can help you determine next steps.
7. Focus on quantity over quality. Client protective factors are identified as things internal or external that keep them alive in the face of suicide. Helping your client to build a longer list of protective factors can support them in finding hope and support outside of your therapeutic sessions.