First Thoughts on Suicide

Mar 09, 2017

“Yet it is in our idleness, in our dreams, that the submerged truth sometimes comes to the top.”

Virginia Woolf

First Thoughts on Suicide

TISA Description of the Problem: By uncovering a client’s first thoughts on suicide, many windows into the soul may appear. Karen Orsulak, LCSW offers two concrete, and effective, questions that she asks adolescents when performing a suicide assessment.

Tip: The following two questions often open up a door to an animated exploration of what suicide means to an adolescent, and I ask them often:

“When was the first time you ever thought of killing yourself or wanting to die?”

“How old were you when you first started having these thoughts?”

I feel that clients who first had thoughts early on at young ages such as 7 and 8 may have increased risk.

TISA Follow-up: I’ve nothing to add to these two excellent questions, other than to endorse their use and to pass them on to our students when teaching clinical interviewing skills.

Tip provided by:

Karen Orsulak, LCSW
Teen Intensive Outpatient Program
Kaiser, Oakland