|INTERVIEWING TIP OF THE MONTH
# 71 January 2006
"Side Doors Into the Elicitation of Suicidal Ideation"
TISA Description of the Problem: Sometimes it is very easy to raise the topic of suicidal ideation, and, indeed, at times it is the client who spontaneously raises the issue. At other times, perhaps because of the client's fears of stigmatization or because of a client's wariness or ambivalence, it is more difficult to raise the topic without risking some disengagement from the client. In such instances it may be useful to approach the topic particularly gently. Raymond Potter, M.D., Ph.D. of San Antonio has several nice ways of accomplishing this task.
Tip: I have found two methods of raising suicidal ideation in an indirect fashion, that have worked effectively for me with guarded patients, helping me to ensure a sound engagement while uncovering suicidal ideation.
1) The "third person" approach: "Has anyone told you that they are thinking of suicide?"
2) The "family member" approach: "Has anyone in your family talked about suicide?"
After I approach the potentially taboo topic of suicide with one of these questions, I then proceed to ask clients directly about their own suicidal ideation.
TISA Follow-up: These indirect approaches are both clever and graceful. They can play an important role in the elicitation of suicidal ideation with patients hesitant to share or plagued by stigmatization.
Tip provided by:
Raymond D. Potter, M.D., Ph.D.
San Antonio, Texas