|INTERVIEWING TIP OF THE MONTH
# 42 August 2003
Probing for the Possibility of Impulsive Suicide
TISA Description of the Problem: Impulsivity is always a concern with suicide. In many respects the patient's impulsivity makes it more difficult to predict impending actions, for, by definition, they are impulsive. Jim Stephens, MA, LPC, in the following tip, provides an interesting way of gauging the degree with which the client might foresee his or her own degree of impulsivity. At the very least the technique may lead to an interesting line of discussion. At its best, it might even help us with our abilities to weigh the risk of impending suicidal action.
Tip: I have found the following line of questioning to be of value in helping me to clarify the intent for self-harm versus the possibility of self-harm. It seems to be of use with both adults and adolescents:
"You've told me that you don't have any intention of hurting or killing yourself. At the same time, you've told me you're going through a very rough time and are becoming more and more desperate. My concern is that, in a moment of desperation, you might impulsively take pills (shoot yourself, crash your car, etc.) without much thought about the consequences. What do you think?"
TISA Follow-up: This tip is simple, easy to remember, easy to use, and addresses an area - impulsivity - that is traditionally tough to address.
Tip provided by:
Jim Stephens, MA, LPC
Holly Hill Hospital Emergency Services
Raleigh, North Carolina