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On the last track, we discussed two focus areas for family change following a teen client’s suicide attempt. These two focus areas are what to say about the attempt and realistic expectations.
On this track, we will discuss four brief techniques to help suicidal teen clients cope with negative self-thoughts. These techniques are, the self-observation technique, partner monitoring, what am I thinking?, and the choice points technique.
Sara, 16, was a high-performing A student. Sara’s parents were very strict, and insisted on grades no lower than an A- average. Sara was not allowed to participate in any extracurricular activities, and she was under constant pressure for high academic achievement. During the fall of her junior year, Sara began struggling in her pre-calculus course. Sara was too ashamed to ask for help, and consequently failed her midterm.
Sara’s parents were furious, and Sara was made to feel that she had not applied herself. Sara’s parents announced that she would not be allowed to participate in social activities until her grades improved. One week later, Sara attempted suicide by slashing her wrists. Fortunately the injuries were superficial, and Sara was willing to enter therapy and sign a Behavioral Contract agreeing to keep herself safe in between sessions.
Sara stated, “I just feel like the biggest loser on the planet. I’ve never failed anything before! No matter what I did, I couldn’t get away from the horrible feeling that I was worthless. I just had to do something to get away from those feelings!”
Four Concepts for Coping with Negative Self-Thoughts
Concept #1 - Negative Thinking is a Bad Habit
Technique: Partner Monitoring
I stated to Sara, “Tell Nancy you don’t want her to let you say anything negative or self-defeating. Although sometimes it’s perfectly okay to complain or say negative things, for these two days ask Nancy to interrupt you without exception. By having Nancy interrupt you, you can start practicing stopping your negative thinking in its tracks, by consciously identifying and ignoring the negative thoughts.”
Technique: What am I thinking?
I stated to Sara, “I’d like you to try and carry this card with you everywhere for a month. Keep it in a pocket, or somewhere where you will notice it frequently. As often as possible, look at the card and notice what you are thinking. If you are thinking negative thoughts, practice ignoring the thought by consciously thinking about something else, even if you just sing a favorite song in your mind. With practice, you will be able to start ignoring these negative thoughts without looking at the card.”
Concept #3 - Choice Points Technique
Sara stated, “Well, the other day my dad made a comment about my pre-calculus grade, and at first I got mad that he would bring it up. Then I started telling myself I deserved it, and I started feeling like a loser again.”
I stated to Sara, “When your father says something to you wish he hadn’t, concentrate on recognizing that moment as a choice point. You have the power to choose negative thinking, or to choose to let negative thoughts pass by and replace them with positive thoughts. If you feel you might have trouble thinking of a positive thought, you might try making a list of favorite images or memories, and keep the list with you throughout the day.”
I also helped Sara practice active and passive relaxation techniques focused on letting her negative thoughts pass by. Think of your Sara. Would the choice points technique be helpful to him or her?
On this track, we have discussed four brief techniques to help suicidal teen clients cope with negative self-thoughts. These four techniques are, the self-observation technique, partner monitoring, what am I thinking?, and the choice points technique.
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