Risk Assessment

Beyond Magic: How Do We Detect Suicidal Thoughts?

Beyond Magic: How Do We Detect Suicidal Thoughts?

No objective test exists for suicidal thoughts – no X-ray to detect broken hope, no CAT scan to reveal intolerable emotional pain, no blood test to expose toxic intentions. This reality is disappointing, even devastating. People understandably want professionals to predict and prevent suicide. For example, in the aftermath of the pilot Andreas Lubitz intentionally […]

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Documentation: Do it Well, for the Client’s Sake and Yours

Documentation: Do it Well, for the Client’s Sake and Yours

  “Client denied suicidal ideation.” “Client reports suicidal ideation but lacks plan or intent.” “Client reported only mild suicidal thoughts.” Many clinicians use these phrases in their clinical notes – and then say nothing else about suicide risk. Such minimalism is not good practice, for either the clinician or the client. Good documentation enables the […]

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Involuntary Hospitalization: From Ally to Adversary?

Involuntary Hospitalization: From Ally to Adversary?

You are listening to a client describe very specific plans to attempt suicide by overdosing. She has 94 pills of a potentially lethal medication at home. She knows the number because she has counted, again and again, in a sort of ritual to prepare herself for the act. A familiar unease settles in you. You ask […]

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Uncovering Suicidal Thoughts

Uncovering Suicidal Thoughts

To help a person deal with suicidal thoughts, you first need to know they have them. The challenge here is that many people who seriously consider suicide do not tell their therapist, at least not fully.  What To Do? Shawn Shea, M.D., a psychiatrist and expert on suicide risk assessment, has described excellent techniques for […]

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