|INTERVIEWING TIP OF THE MONTH
# 26 April 2002
Assessing a Client's Suicidal Intent
TISA Description of the Problem: One of the most critical aspects of suicide assessment is the delicate process of uncovering valid data on the client's actual intent to proceed with actions towards self harm. In the following very useful tip from Ray Mercier, several valuable questions that can help with this task, are elucidated.
Tip: I have found the following three questions to be useful during my suicide assessments:
1) What do you find to be intolerable with your life at this time?
(This question helps the client to talk more freely about the most pressing problems, stressors, and pains that he or she is experiencing. In short, this often leads to a discussion of the client's "reasons for dying".)
2) How else can you handle this problem?
(This question often leads into a fruitful exploration of alternative ways of coping with the current stressors.)
3) What is keeping you alive? or What is there to live for?
(Either of these questions helps both the client and the clinician to uncover the client's "reasons for living".)
TISA Follow-up: The above questions can help clients to discuss openly the complex feelings surrounding their own ambivalence. In essence the clinician is granted a look at the intimate act of weighing the pros and cons of committing suicide that is occurring in the client's mind. If the reader is interested in learning more about the importance of this task, some exciting research is being done by David Jobes and Rachel Mann on this exact topic. ("Reasons for Living Versus Reasons for Dying: Examining the Internal Debate of Suicide. Suicide and Life Threatening Behavior, 29, #2, Summer 1999, 97-104.)
Tip provided by:
Ray Mercier, M.D., P.C.
Private Practice: Troy, Michigan
University of Michigan
(800) 332-7998, Ext. 6478