Sample Suicide Intervention Script (High Risk Student)

Sample Suicide Intervention Script (High Risk Student) I am counseling a 16-year-old boy, Chris, whose girlfriend killed herself after they broke-up. Chris cut school yesterday, and I know that he has been drinking heavily since his girlfriend’s funeral. This morning he is at school and is sober. I have called Chris into my office. Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Engage with the Person At-Risk of Suicide Hello Chris. I want you to know how sorry I am for your loss. How are you doing? OK, I guess. I just can’t seem to stop thinking about Susan killing herself. I understand it must be real painful to lose someone you care about. Can you tell me some more about your feelings? I just can’t help thinking that if it wasn’t for me, Susan will still be alive right now. I just can’t live with the guilt. So not only are you dealing with the sudden death of Susan, but you are also feeling real guilty? Yes (Chris begins to cry). Identify Suicidal Ideation You know Chris, sometimes when people have experienced a sudden lose and feel as you do, they think of suicide. Is this something you have thought about? (Chris stops crying, pauses, and tentatively says). Yes. Inquire About the Reasons for Suicidal Thinking I think I understand, but can you tell me some more about what it is that has lead you to think about suicide? I just can’t live with this guilt. Everyone is looking at me. They know that I had broken up with Susan. No one, except you, will talk to me. I’m sure everyone hates me and wishes I were dead. I might as well do them a favor. So then you are really feeling alone right now. You are thinking that you are being blamed for Susan’s death. You got that right (Chris’ tears have now turned to some anger). I’ll show them. What do you mean “I’ll show them”? If I kill my self they will not have me to kick around any more! [I have identified that Chris is feeling very guilty about Susan’s death, and feels isolated and alone. He is also feeling that everyone is blaming him for Susan’s death (which may or may not be true). I know that he has thoughts of suicide, but need to assess his risk of engaging in such behavior.] Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Sch Psy: Chris: Assess the Degree of Suicide Risk Chris, you mentioned that you think suicide is a way to cope with the feelings and problem generated by Susan’s death. Do you have a plan? How would you go about killing yourself? Yes, I could do it with my car Have you thought about when you would do it? Yes, I was planning to get drunk and drive off the bridge tonight. So the pain feels so intense you are thinking of crashing your car off the bridge tonight. Yes, Have you ever tried to talk to anyone about this pain before? I was thinking about going to my old therapist, but I don’t even know if she is still around. It has been over a year since I last saw her. What were you seeing the therapist for? Depression. Chris, have you ever tried anything like this before? No Is their any one you can talk to about this. Anyone who you think could help you solve these problems. No (Chris slums into his chair, the anger has dissolved, and he again begins to sob). [Chris has a plan, he has the means to carry it out, and he has a pretty immediate time frame for engaging in suicidal behavior. He is in intense emotional pain and feeling extreme guilt. While he has no prior suicidal behavior himself, the fact that Susan has modeled such as a problem solving strategy places him at increased risk. Finally, I have learned Chris is unable to identify any resources that can move him from a suicide orientation and that he has a history of depression. I determine his risk for suicide is High.] Sch Psy: Take Action to Reduce the Suicide Risk Chris, I know it hurts a lot right now and it seems like there is no way out, but I believe that I can help you, if you let me. Chris: What can you do (a hint of anger returns to Chris’ voice)? I’m ready to leave now. [Chris gets up and leaves the office. After giving the secretary a signal that I need assistance, I follow Chris to the parking lot.] Sch Psy: Chris: Sch Psy: Chris, we need to get some help right now. How would you like to proceed? I’m done with all of this? OK, Chris I understand. You see no hope. But I do. You need to come with me right now (my voice is compassionate, but firm). [This intervention will need to be very directive. The secretary has alerted the principal of my need for assistance. He is standing by on the edge of the parking lot. If need be he could immediately contact the police for assistance. As it turned out Chris responded to my very direct and firm approach. He cooperated with me and his parents who took him to the crisis intervention clinic at the local mental health facility].