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In the last section, we discussed guidelines for parents regarding intervention during a teen’s suicidal crisis in four situations. These four situations are, an emergency life threatening attempt, a non-emergency life-threatening attempt, possible suicide, and a low-risk situation.
In this section, we will discuss two focus areas for family change following a teen client’s suicide attempt. These two focus areas are what to say about the attempt and realistic expectations.
In the months leading up to his suicide attempt, Danny, 14, had become increasingly truant from school. He had also begun having disruptive outbursts at home and at school which included swearing, punching, physical harassment of friends, and punching walls. Danny father Bob, a strict disciplinarian, had never tolerated deviation from his rules, and responded by grounding Danny for weeks at a time.
Danny’s mother Mary was also strict, but tended to treat Danny like a young child. Mary still chose Danny’s school clothes, and laid them out for him in the evenings. Mary’s response to Danny’s disruptive behavior was to screen all Danny’s phone calls and search his room on a daily basis. Recently, Danny had attempted suicide by hanging.
During my initial crisis intervention with Danny, he stated, "No matter how hard I try, I’m not good enough, so why try any more? Even when I do try, the rules are always changing! Mom and Dad say if I mow the lawn, I can go out Friday. But I mow the lawn, then find out I can’t go out after all because I didn’t clean my room last Tuesday! I’m not allowed to do anything on my own, I’m not allowed to do anything that could prove I can be responsible, and if I try talking about it, they just don’t understand me! No matter what I try, I lose."
Since family issues clearly played a role in the crisis that led to Danny’s suicide attempt, I asked Bob and Mary to meet with me to discuss strategies for reducing Danny’s future risk.
Mary and Bob were eager to whatever it took to help Danny, but also exhibited defensive behavior regarding being asked to meet with me. I stated to Bob and Mary, "I don’t mean to imply that you are the cause of Danny’s suicide attempt. Teenagers’ lives are very much influences by parents, and this is why I try to involve parents in the therapeutic process for teens who have attempted suicide. A suicide attempt is often a signal that something within the family is not providing the teenager with the support he or she needs, and I’d like for us to work together to see if there are any areas for change which could help Danny in his recovery."
2 Focus Areas
♦ Area #1 - What to say about the Attempt
Try to let Danny do most of the talking, and listen to what he has to say. You might feel an urge to defend your actions to Danny. I strongly suggest you keep a journal where you can write down these defensive reactions, and we can talk about them in our sessions together."
Five Communication Guidelines
I stated to Mary and Bob, "Keeping calm can be very difficult, but it is vitally important during this early recovery that you try to keep an even temper. Feeling anger and other strong emotions is natural. If you feel strong anger, or other feelings, towards Danny, you might try writing a letter to express your feelings, which you do not show to Danny at any point. You might burn or shred the letter once you finish. Or, you could bring the letters in to one of our sessions so that we can discuss them."
♦ Area #2 - Realistic Expectations
Technique: Realistic Assessment
Think of your Bob and Mary. Would the Realistic Expectations technique help them develop a healthy starting point for addressing the needs of a son or daughter who has recently attempted suicide?
In this section, we have discussed two focus areas for family change following a teen client’s suicide attempt. These two focus areas are what to say about the attempt and realistic expectations.
In the next section, we will discuss four brief techniques to help suicidal teen clients cope with negative self-thoughts. These techniques are, the self-observation technique, partner monitoring, what am I thinking?, and the choice points technique.