One should be aware that suicidality is a complex issue, which requires an in-depth analysis and comprehension of the major underlying factors. It is easy for a professional to misunderstand the history of the client, which can translate into an ineffective treatment and intervention process. The reading offers two major takeaways, which are focused on client misunderstanding and ambivalence of patient in regards to suicide.
The first takeaway is rooted in the fact that previous suicide attempts should be carefully and properly comprehended. It is stated that “a history of one or more prior suicide attempts and a current suicide plan—are often misunderstood” (Yeager & Roberts, 2015, p. 49). In other words, previous suicide attempts should not be treated as a reliable predictor of future outcomes since the lack of attempts might not mean that a client will not commit suicide from the first attempt. The second takeaway is based on the notion of an ambivalent relationship between a patient and counselor. It is stated that “some patients may well be ambivalent about suicide, untrusting of the clinician or psychiatric screener, ashamed, or guarded and unwilling to share suicidal thoughts with a stranger” (Yeager & Roberts, 2015, p. 50). In other words, assessments need to account for the level of trust between a patient and professional since it also is predictive of lethal outcomes. The case of Harvey has low suicidality, whereas Maryann has medium suicidality, and Jet’s case has high suicidality. The main reason is the fact that Maryann has additional trauma due to the loss of her father, and Jet was initially resistant to treatment and re-traumatized, but Harvey recovered after the intervention.
In conclusion, the degree of reliability of patient history and his or her ambivalence of trust are important to consider during the assessment.
Yeager, K. R., & Roberts, A. R. (2015). Crisis intervention handbook: Assessment, treatment, and research (4th ed.). Oxford University Press.