Two Questions for Indirectly Gaining Some Insight on a Client’s Suicidal Intent

Mar 09, 2017

“All things have their unique place in the universe.
They fulfill their roles simply by being what they are.”

Lieh Tzu
Taoist sage

Two Questions for Indirectly Gaining Some Insight on a Client’s Suicidal Intent

TISA Description of the Problem: We are always trying to improve our ability to uncover suicidal intent. If you are unfamiliar with our interviewing strategy for uncovering suicidal ideation, planning, behavior, and intent called the Chronological Assessment of Suicide Events (CASE Approach), you might enjoy the free Two-part Article on Uncovering Suicidal Intent and the CASE Approach on our homepage in the far right sidebar entitled “Enjoy Tisa Resources”. Uncovering indirect evidence of suicidal intent is one of the cornerstone principles of the CASE Approach. Such indirect evidence of suicidal intent can be very useful as illustrated by the following excellent clinical interviewing questions from Pam Carter, CSAC.

Tip: I find that getting a read on how alone a client was when contemplating suicide (or when actually making an attempt) can provide valuable information on their actual intent to die. I find the following two questions to be useful in this regard:

1) “Were you alone in the house?”
2) Where were your family members at the time?”

TISA Follow-up: Both of these questions from Pam may nicely uncover information that may reflect actual intent, for they provide information on how likely the client may have been hoping to be found before death might occur during the attempt. In short, from the client’s perspective, what was the likelihood of “rescue”? A similar example of how indirect questions may uncover information that reflects the seriousness of the client’s intent to die is illustrated by the following question, “How many pills were left in the bottle, after you overdosed?” or “How many pills did you think it would actually take to kill you?”

Tip provided by:

Pam Carter, CSAC
Middlebury Counseling Service
Middlebury, Vermont