Legal and ethical challenges in counseling suicidal students - Special issue: legal and ethical issues in school counseling

Professional School Counseling, Oct, 2002 by David Capuzzi

A carefully prepared and well-presented classroom presentation made by a counselor or member of the school's crisis team is essential. Such a presentation should include both information on causes, myths, and symptoms as well as information about how to obtain help through the school. Under no circumstances should media be used in which adolescents are shown a suicide plan.

On the elementary level, school faculty should not present programs on the topic of suicide prevention. Their efforts are better focused on developmental counseling and classroom presentations directed at helping children develop resiliency and overcome traits (e.g., low self-esteem or poor communication skills) that may put them at risk for suicidal behavior at a later time. Although these efforts should be continued through secondary education, middle and high school students are better served through presentations that address adolescent suicide directly.

Crisis Management

School counselors often receive student referrals from other adults in the building when the student is thought to be experiencing a suicidal crisis. The principles delineated below are shared for the purpose of providing succinct guidelines for a suicide-risk assessment so that steps can be taken to prevent a possible attempt. Any assessment, phone call, or step taken in this context should be documented in case notes.

Remember the meaning of the term crisis management. When thinking of crisis management, it is important to understand the meaning of the word crisis as well as the word management. The word crisis means that the situation is not usual normal, or average; circumstances are such that a suicidal adolescent is highly stressed and in considerable emotional discomfort. The word management means that the professional involved must be prepared to apply skills that are different than those required for preventive or postvention counseling. An adolescent in crisis must be assessed, directed, monitored, and guided for the purpose of preventing an act of self-destruction.

Be calm and supportive. A calm, supportive manner on the part of the intervener conveys respect for the perceptions and internal pain of an adolescent preoccupied with suicidal thoughts. Remember that such an adolescent usually feels hopeless and highly stressed. The demeanor and attitude of the helping person are pivotal in the process of offering assistance.

Be nonjudgmental. Statements such as "You can't be thinking of suicide, it is against the teachings of your church," or "I had a similar problem when I was your age and I didn't consider suicide" are totally inappropriate during a crisis situation. An adolescent's perception of a situation is, at least temporarily, reality and that reality must be respected;

Encourage self-disclosure. The very act of talking about painful emotions and difficult circumstances is the first step in what can become a long-term healing process. A professional helper may be the first person with whom such a suicidal adolescent has shared and trusted in months or even years, and it may be difficult for the adolescent to confide simply because of lack of experience with communicating thoughts and feelings. It is important to support and encourage self-disclosure so that an assessment of lethality can be made early in the intervention process.