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Teen Suicide: Practical Interventions for Adolescents in Crisis
10 CEUs Teen Suicide: Practical Interventions for Adolescents in Crisis

Section 7
Track #7 - Use of the 'Speaking Directly' Technique in Joint Sessions

CEU Question 7 | CEU Answer Booklet | Table of Contents | Crisis CEU Courses
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs


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On the last track, we discussed the four step Hook technique for helping a teen client deal with the anger component of his or her depression.  The four steps in the Hook technique are identify the hook, the hook book, identify the need, and fill the need.

On this track, we will discuss the first four myths the families of suicidal teen clients may have about suicide.  These four myths are teens who talk about suicide will not commit suicide, all suicidal people want to die, if you ask someone about suicide it might give them the idea, and suicide happens without warning.

4 Myths about Teen Suicide

Share on Facebook Myth #1 - Teens who Discuss Suicide will not Commit Suicide
A first myth that a teen client’s family might have is that teens who discuss suicide will not commit suicide.  Tom, 13, had been living with his father until his father accepted a position overseas.  When Tom went to live with his mother Valerie, the two fought frequently as Tom had difficulty adjusting to Valerie’s parenting style.  A week into living with his mother, Tom stated, “If you’re going to treat me like this, I might as well kill myself!” 

Valerie stated, “I felt relieved honestly, that Tom was getting it off his chest.  I felt like I didn’t have to worry anymore.”  However, two months later, Valerie returned home from work to find Tom attempting to hang himself.  Clearly, whenever a teen mentions attempting suicide, it should be taken as an indication that something is wrong, and the threat should be taken seriously.  I explained to Valerie, “Even if the teen making the threat isn’t acutely suicidal, there is certainly something very wrong that is making the teen upset and needs attention.”

Following Tom’s suicide attempt, I felt that joint counseling between Tom and Valerie was an important component of helping Tom overcome his crisis.  However, I found that initially these sessions took on a gossipy quality.  Either Tom or Valerie would speak directly to me, relating aspects of their personal views of the situation as if the other person were not in the room.  I decided to implement the Speaking Directly technique.  In the speaking directly technique, I ask family members to talk directly to each other. 

Family members obviously have to talk to each other when the counselor is not around, and clearly in Tom and Valerie’s case they had not found a workable way around their communication problems on their own.  As I coach families in speaking directly to each other, I find that family members often directly experience what is going wrong in their communication process, and may spontaneously evolve ways of doing something about it.  Clearly, if Tom states, ‘my mom never thinks I do anything right’ to me, he experiences something very different than if he stated directly to Valerie, “I feel as if I can never please you, mom.” 

I also find that by removing myself from a translation role in the conversation, I can better observe how the family relates outside of the therapy session.  Although I comment and coach when necessary, I find this position also shifts the sense of responsbvility for problem solving onto the clients, where by necessity it belongs.

Share on Facebook Speaking Directly Technique
I introduced  the Speaking Directly technique when Tom stated, “My mom never lets me stay out late with my friends like dad did!”  I stated, “Why don’t you say that to your Mom?”  Tom looked at his mother a little reluctantly and stated, “Mom, you never let me stay out late with my friends.  Dad always let me stay out much later.” 

I coached Tom by asking him to also tell his mother how he felt.  Tom stated, “Mom, I really feel frustrated when you don’t let me stay out late.  It’s not what I’m used to, and I also think it means you don’t trust me the same way dad does.”  Think of your Tom and Valerie.  Would trying the speaking directly technique be beneficial in your next joint session?

Share on Facebook Myth #2 - All Suicidal People want to Die
A second myth that a teen client’s family might have is that all suicidal people want to die.  As I mentioned on Track 1, there are degrees of intentionality.  Teens who chose a highly lethal method without communicating intent are far outnumbered by those who communicate a desperate cry for help and use a suicide gesture to manipulate others.  In my experience, the majority of suicidal teens are ambivalent.  Part of them wants to die, and part of them wants to live.  The suicidal teen may not be aware of her or his own ambivalence, or she or he may be in denial about the finality of death.

Share on Facebook Myth #3 - Parents Should Avoid Direct Questioning
In addition to the myths that teens who talk about suicide will not commit suicide, and that all suicidal people want to die, a third myth that a teen client’s family might have is that if the parent asks the teen if she or he wants to commit suicide, the parent might give her or him the idea.  Parents who believe this myth may feel that they should avoid any direct questioning about the idea of suicide. 

As you are well aware, for a parent to bring the topic of suicide into the open will not begin a suicidal thought process for someone who is not in a crisis.   I explain to parents that since suicide is so difficult to discuss, it is often the case that a teen who is thinking about suicide has no one to talk to about it.  If the parent has the courage to bring up the subject, it may be the beginning of relief from the tension and anxiety that accompany suicidal thoughts.

Share on Facebook Myth #4 - Suicide Happens without Warning
A fourth myth that a teen client’s family might have is that suicide happens without warning.  Research has shown that only 20 percent of suicidal people do not communicate their intent beforehand, and most of these individuals are likely to be middle aged or older.  A younger suicidal person is likely to try to let others know she or he is in pain or to manipulate or control others. 

This does not mean that teens are not serious about suicide, but it does mean that it is important for the families of teenagers to learn the warning signs and be vigilant.  I review the warning signs discussed on Track 2 with all the members of an at-risk teen’s social support network.  What warning signs do you review with a suicidal teen client’s loved ones?

On this track, we have discussed the first four myths the families of suicidal teen clients may have about suicide.  These four myths are teens who talk about suicide will not commit suicide, all suicidal people want to die, if you ask someone about suicide it might give them the idea, and suicide happens without warning.

On the next track, we will discuss myths five through eight that the families of suicidal teen clients may have about suicide.  These four myths are, once a person is suicidal he or she is suicidal forever, suicide is inherited, all suicidal people are mentally ill, and suicide occurs exclusively among the poor or the famous.

Online Continuing Education QUESTION 7
What are the first four myths the families of suicidal teen clients may have about suicide? To select and enter your answer go to CEU Answer Booklet.

 
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