Suicide Assessment of Client with Initially Subtle Warning Signs of Suicide

[@silaslizzie43]

You're not a therapist unless your hand is on your chin. Love the videos.

[@sarawilkinson6766]

This is why I feel like I want a beard.

[@kdelka81]

@@markdouglas1601 lol

[@matthewakian2]

@@kdelka81 It's a good Emmy award-winning performance.

[@flyby2300]

My impression is that he mumbles slightly, because he holds his hand on his chin consistently.

[@gyrgrls]

@@sarawilkinson6766 "Open the door, or I'll blow your house in..."

[@possessedslig]

She's a good actress, that felt very real

[@whitestguyuknow]

There's one on narcissism and it really became clear how severe of a mental disease it really is for someone who is just genuinely 100% a narcissist. Then I scrolled down and saw she was an actor.... I genuinely believed she was ill. These actresses are very convincing and good at their job

[@Caperhere]

@@matteframe LOL

[@MrCjchamp]

She gives a vibe of someone who has truly been in pain at some time in her life. She’s channeling that in this role play

[@robertdoss6152]

She is not a trained Method actor. No one responds with that kind of realism without the internal feelings of your own.

[@makinietherapy]

It's very rare to see examples of setbacks in role play. Thank you so much for showing the uncomfortable and sometimes painful side of therapy.

[@angelinastanton7996]

I also liked this video. I wonder what a counselor should do if a client becomes irate and violent, or unwilling to go to the hospital in this case. I would like to see a video like that, because in reality these situations can escalate.

[@littlelam3691]

Say, “you know,” one more time

[@icarus313]

I know these two are just acting ... but I swear I could believe every word of this! It looked absolutely real from start to finish. I don't think I've ever felt my heart beat so hard in my chest before, just from watching a video of two people sitting in chairs and talking in a quiet room for 22 minutes. Unbelievable. I was in full tears during the last few minutes. Credit to the actors for doing such a convincing job, and for showcasing the importance of suicide prevention. Outstanding video.

[@totalcontrol4205]

Agreed!

[@barbaramatthews4735]

Good acting skills

[@gwho]

this acting was better than my therapist's actual 4 sessions, that useless pos

[@creativesundries]

You can tell he is a great therapist.

[@brittanijohnson8661]

I wish he could be my therapist, for real! These videos are the second best option.

[@paper-chasepublications9433]

Her acting and responses were very realistic. Doctor Grande, your approach and bedside manner is so commendable! Much respect to you!

[@ckyung1312]

Counseling, when done well is a noble profession - thank you, Dr. Grande!

[@aliciazahn1718]

The signs of suicide could have easily been overlooked, particularly if Dr. Grande just focused on her alcohol use and not detected the implications of her current behavior. There were a lot of issues going on for this client but it does not necessarily mean the client is having suicidal thoughts or making plans to commit suicide. This video highlights the importance of probing for more information in situations of changed behavior and crisis.

[@reneemendez4287]

+Alicia Zahn They could have been overlooked which is the scary part of a suicide assessment. It is literally life and death. Dr. Grande did a good job understanding what was really going on with the client

[@stellaercolani3810]

Probing freaks me out

[@isabelamogosanu7777]

@@stellaercolani3810 its because they care though

[@HSMfanatic17]

Even if he focused on the alcohol use, that would still lead to the probing questions of why

[@jessicaristorucci232]

Yr to see gf yo G’s this May yes tye tye ur te free te gate try to get t

[@SilvaMorasten]

"Are you disappointed I'm trying to save your life?" excellent... these kind of videos are very good idea!

[@mikekinsella2822]

YES I am disappointed because your only saving my life temporaraly and refuse to fix whats the real problem which is giving me hope for the future so that I want to live.

[@mandabear52289]

I think this is the type of client that scares me the most. I subtle warning signs can so easily be missed. I also like how Dr. Grande sat in silence with her for a minute when she didn't answer a question that he asked. Then made a comment about an observed change in her behavior. That opened the door for more conversation.

[@CandyKaneLane]

+Mandy Moore I also have that fear of working with clients who present subtle warning signs of suicide because I want to make sure I am doing the right thing and not missing anything. Dr. Grande's video was very helpful for me.

[@sanya3398]

@@CandyKaneLane why not just sttraightforwardly ask? at a certain point this felt painfully tense and drawn out.... afaik stats show direct questions about thoughts of suicide are more helpful than harmful

[@YTStoleMyUsername]

​@@sanya3398Because earlier on, it is not always initially clear someone may have suicidal thoughts. As others have said, a therapist may have just focused on her drinking and why that was getting worse, etc. But he asked a lot of open ended questions to get to the root of the problem, and then when it became clear, he did straightforwardly ask at about 15:47. People with subtle suicidal warning signs (esp when they have had them a long time) get used to hiding them from others, even their therapist. They answer "no" to the pre-appointment questionnaires and know how to skirt the topic. A skilled therapist however, can use the right questions to determine if its a possibility based on your words and your body language. Then they will straight up ask. They aren't just going to ask each person who walks in "How are ya today? Thinking of offing yourself?" because you won't get a truthful answer.

[@rachelfoster5463]

This video showed how subtle comments from clients can be an indication of deeper issues. If Dr. Grande had not asked specific questions and picked up on the client's subtle words, he may have let her leave the office that day. This video showed how important it is to be in tune with your client.

[@aliciazahn1718]

+Rachel Foster In some ways it's a bit scary, having that much responsibility to have such keen perception. This video seemed very real and is a strong example of how to be alert and aware as a counselor.

[@brittanyvodzak9198]

+Rachel Foster I liked learning what questions Dr. Grande asked when the client said subtle things. It is important to listen to the client very carefully so that you do not miss important cues.

[@janicedixon2051]

Absolutely. As a future helping professional it makes me nervous to think I will eventually be in the position to address client issues related to suicide. Dr Grande was very in tune with this client, tracked her statements and was able to pull out the differences in what she has stated in previous sessions.

[@anjiliveach3267]

Thanks for this video, Dr. G. It's really well done. I appreciate the way you led her through the conversation without putting words in her mouth, but rather gave her open-ended questions and mirrored her statements back to her. I know this was scripted, but it felt very emotional and genuine.

[@rejaneoliveira5019]

Through your other videos one can see the excellent educator that you are. Now, on this video we can actually see some of your counseling skills which are just as impressive. Best line - “I would care if you died.” Sounded really genuine. You both did a great job!

[@PreciousRegalos]

Dr. Grande has such a kind voice.

[@juanitawest976]

Dr. Grande: You really touched my heart when you said I'd care if you died. Thank you for this video.

[@Pixietoria]

It’s so interesting to see a session with someone (even though she’s acting) from the outside. It puts a lot of perspective on to my own counselling experience and assures me I am lucky to have found a counsellor who responds very similarly towards me. You seem like an excellent professional Dr Grande. Well done for putting up such helpful videos.

[@IlovetheBeach42]

I want this Drs demeanor, attitude, tone, pace everything. So effective at connecting with the patients in a nonjudgmental way.

[@alicat1564]

I went to a therapist once , I did not find she helped me at all, I always felt weird paying money to the receptionist at the end. She listened to me talk but I figured I can talk to a friend and vent for free.

[@alexandraschuster9700]

I used to think the same way, but a therapist as an outsider definitely helps

[@SmiteDoctor]

That may work for you, but having someone to talk to who isn't emotionally invested in your life and your story can be great for seeing new perspectives and also, not everyone has a single friend or family member that they can talk to

[@sugarbum99]

dunjica77 having to pull out your painful stories over again and getting nowhere if that therapist is not helping you is torturing so sometimes I think people go see no one, especially if they have tried. You’re completely right.

[@mariebernier3076]

@@dunjica77 It IS painful to pull out your story gain, it makes me angry and panicked because I don't believe anyone will help me. On my side, tho, I HAD to find someone to help me because things were starting to fall apart. I found a really talented psychiatrist who took me on for multi sessions per week. I resisted for about a year but I started to trust her last fall (all subconscious for me) and we're really getting somewhere on old, old crap that had me very hopeless that I'd ever feel better. I see a lot of change and I really feel like I was brought back from the brink. I'm very luck to have family help paying for her, even tho she cut her rate for me. I've seen other therapists for years...years...and felt like it didn't help. Keep looking, keep "shopping" until it does feel like someone works for you. NOT makes you comfortable, but gets to your underlying feelings. It sucks and is uncomfortable. That's how it should feel for a while if you're getting better.

[@crose7412]

@alicat1564 Did you subsequently "talk to a friend and vent for free"?

[@NixyRose72]

I wish I could find a doctor this caring. I'm not a drinker, but the other things, the feelings of complete worthlessness, uselessness, irredeemability.... Ppl don't always understand, rock bottom has a basement, a subbasement and a wine cellar. Plus, there's even tunnels under that. Where are the psychiatrists/psychologists/counselors who care this much? I could use one.

[@Cate7451]

You take care of yourself. Keep looking for help.

[@TheHomeExpert5]

"Come to me all you who are who are burdened and heavy laden and I will give you rest." Jesus said that. You need Jesus. We all do. Read the book of John in the New Testament.

[@giovanna8187]

Nix I had a terrific psychiatrist for about 5 months. Very kind, intuitive. Helped me a lot with self esteem thru cognitive therapy sessions. There are people out there who want to help those in need. Find one.

[@doctorofletters8412]

They are out there, trust yourself enough to take the responsibility to find them. You’re the only one who can love yourself enough to do that

[@dancingheart6224]

Those layers of hitting rock bottom are so important for therapists to detect. You explained it so well with that metaphor. It's exactly why therapists have to be able to detect it from the beginning stages before the client loses interest in life 100% and there's no turning back for them.

[@i.a.9744]

this made me sob, i see myself in her...and you look like a great professional. your work is amazing!❤

[@lilolmecj]

Dr. Grande this is your best video I have seen.

[@stringedassassin]

Honest question: no job, no insurance, losing our home... how are we even in therapy??

[@zengrenouille]

There are places that treat regardless of ability to pay, and Todd has said he's worked at a few of those places.

[@cosimavonliebenau8317]

It’s a role play session. The ‘client’ is acting. He makes that clear in the text before the video starts.

[@stringedassassin]

@@cosimavonliebenau8317 That part I get... and I understand Jaime's comment above, I just wasn't thinking that many places offer care for free.

[@ShipsKat]

@@stringedassassin Outside of the USA, it's not uncommon.

[@stringedassassin]

@@ShipsKat In the US it's pretty much "pay up or suffer and die" in my experience. Or sometimes "Suffer and die then pay up".. .it varies slightly.

[@cindyrhodes]

Thank you so much for this. As an artist, art student, and art teacher, I have a lot of experience with... art students, of course, and because emotion/spirituality is a key component of most artists, I have seen and experienced my share of depression and suicidal thoughts. While all I could do was to suggest that the people go to a counselor, I am thankful that there are wonderful counselors like Dr. Grande to help people with this. Both Dr. Grande and the actress do a great job in this video!!

[@jpincinjr]

The questioning was great in this example. Her subtle hints at suicidal thoughts were not overlooked, which was great.

[@Jsmith-xi8ft]

"What happened to your goals?" "I drank them away." Word. I so relate.

[@DaisyLee1963]

"I would care if you died." I never thought of this before but I bet it would devastate a therapist for their client to commit suicide. I can't believe I've never thought of this before. Thanks for the great video and for the insight it offered me.

[@kaecaeru]

I have a really poor self image and use humour to cope.. so I just imagine a therapist with a their list of clients names and they cross off mine and say 'whoops, better luck next time' lmao

[@daisyleigh777]

Hey Miss Daisy, Seems we have the same username (slightly different spelling, of course). And my mother's birth year is 1963.

[@Gwen13061]

Crying. I really wish someone cared this much about me

[@JustJesstheMess]

Me too. Technically he doesn't really care though, he's literally being paid to care so it doesn't really count as much.

[@Cate7451]

Jess C. But we all need real people in our life too care. We all have to work on that.

[@totalcontrol4205]

@@JustJesstheMess It is possible to care and get paid. Maybe, you're confusing caring and loving. Maybe you feel that not loving you is the same as not caring for you.

[@jujujewel2172]

@@JustJesstheMess I do get what you mean, it is their job, but also, as a professional they learn boundaries so it won't affect them, they can probably care without being emotionally involved, even though it is a very emotional subject, and so it would seem, to others, & the rest of us "normals" (non freaks, from an episode on Murdoch Mysteries about the circus) hard not to allow it to be become personal... I suppose, if they were as moved to tears as we all were they would be too soft, and possibly their empathy might end up being absorbed and turn inward ? That's just my guess. I think they learn and maintain strong boundaries and strategies for resilience to deal with people so that their own sanity stays in tact, and/or they are just mentally tougher, so they remain an observer and never get drawn in too much; like he said, "cant fully understand/comprehend," but "does care" so has not been there himself, never personally felt or experienced (such dispair) first hand, most likely, but is "obligated and wants to help," in a way since that is part of their job, but has to delegate (outsource) that job of "stabilizing" elsewhere, in their "duty of care" required of them... Because they chose this job and dedicated time and money and effort, to this career of "helping people" so by default, they have to have had some interest in helping people, at some point, even idealistically, you would think... Well it's only a select few who seem to be genuine wanting to see this through, unless they've always only ever saw it as a means to easy money, (like if buLLshytting and pandering to people with mental health issues and disorders seemed like something easy to do for a living, without actually giving a rats ass about humans. I suppose that is possible... I can't personally fathom it, as I think you would have to be a narcissist - a psychopath could imitate human emotion, maybe if they were like Ted Bundy, but I think they would not be able to maintain the fascade all the time, because they really aren't capable of caring, they just don't have the capacity - narcissists "care," but only about themselves, but I can imagine, it is possible there would be some of them floating around, feeding off other people's misery... ? ((This could actually explain some in the mental health profession well, though, talking government workers, in my experience, here in Australia at least))

[@giovanna8187]

@@totalcontrol4205 Exactly. It isn't love, but it's care. If you're injured, a nurse will care for you, comfort you, make sure you get everything you need, but she doesn't love you! And, of course, that doesn't matter. Same thing here.

[@lilolmecj]

It is so profoundly sad to feel hopeless for the future. In my experience, hope is essential above every other thing, it drives our ability to strategize.

[@ss454girl]

You forgot the part where she completely loses it when you tell her she's going to be hospitalized, you end up writing an affidavit to make her involuntarily committed, and you have to call the police after she attacks you, to restrain her while she's transported to the inpatient hospital.

[@kinkyqu33n94]

Ah yes and while in the hospital they corner her and forcibly remove her clothing because she doesnt understand why she has to take her clothes off for a psychological evaluation and then they leave her strapped to a gourney crying for hours wishing she would have never let anyone know she was in any kind of distress because they just use the opportunity to make it that much worse..

[@stza16]

I was thinking about that.

[@jalasword]

@@kinkyqu33n94 exactly why I would NEVER tell anyone what is on my mind. But, nearly every day for years, I make the decision to not end it today. One day, I'm sure I will be to exhausted from pushing through.

[@kinkyqu33n94]

@@jalasword I feel the same way but I cant explain it to any therapists or psychs without triggering their paranoia when they have the ability to imprison me and have me violated in a mental ward. Of course I know they do it because their protocols state they have to keep us safe but I know from experience hospitals aren't safe. I want to keep myself safe too and staying isolated from people is the only way I can do it because when it comes down to it I'd much rather hurt myself than allow someone else the opportunity to hurt me. It's a sick world we live in and I dont really think the vast amounts of misery are worth the miniscule amounts of pleasure it brings to many people..

[@silverbullett6684]

Sounds like you've had a bad experience

[@angelinastanton7996]

This was another helpful video explaining to a client ethical obligations and protocols to take when having a suicidal client in session. The client in this video seemed a bit more difficult and the counselor seemed to experience difficulty getting exact answers from the client. I like that the counselor asked the client if she did intend to end her life in order to get a more direct response. I would like to see a video where a client is unwilling to go to the hospital or possibly becomes violent, however.

[@bethanyelstrom3566]

This assessment was difficult. She presents with drinking, loss of job, going to lose her house, anger, frustration, and negative. I like how the counselor kept being persistent and asking about taking a turn for the worse. Counselor does a good job of reflecting her feelings. She seems at a loss and can't seem to find a way back. The warning signs of worthlessness and hopelessness start to wear on her through out the session. She keeps giving a little more information with each question that is asked. It almost feels like she is dropping breadcrumbs of clues up to the point where he asks about ending her life. This showed a great deal of attention to detail and concern for the client.

[@sabbapixie]

I realize this video was put out 5 years ago and there is little point commenting. But, I've been there. Except for the inpatient thing, thankfully that has never happened (due to no insurance) and will never happen (I won't put myself in a position for it to). Although this was excellently done, it is painful to see that ending. I realize I am thinking of this from a point of no insurance and, other factors. Rant over. Thank you for doing what you do.

[@haeleighmoore7822]

I cried so much with this video,, I've felt this hopeless twice before, I've had these thoughts twice before, I fear this is coming onto me soon. Emotional, well played scenario.

[@billjon3483]

Haeleigh Moore good luck

[@uptown3636]

Haeleigh, I hope all is well with you now.

[@marygibbons2263]

Haeleigh Moore, I was like this most of my life until I found an excellent counselor and he helped me get the treatment I needed. Treatment helped, and they got me started in a 12 step program, which has given me a whole new life. I used to wish I were dead, but now 8 have a life worth living! PLEASE don't give up. There is help available

[@2010kgurl]

Dr. Grande, this was tender to watch because it reminded me deeply of the time my psychiatrist was almost too late in saving me, years back. I wouldn't be starting my MSN to be a psych NP without just someone like you. Thank you for all the videos and tough work you do behind the scenes.

[@enatp6448]

I think that the suicide assessment conversation can't be led with the liability issues. It has to led with compassion, curiosity, and sincere concern.

[@MarksTournaments]

Sadly they just look out for themselves

[@katherinebeck593]

This wasn't something that I initially thought about in the beginning of the semester, my thinking was a little more cut and dry. Im glad that I saw this video and explored the subtle signs.

[@kelseyjean4042]

I'm sure this wasn't your intent, but I used this video to cope ahead to talk to my provider regarding SI. It helped. We have a good plan. Thank you.

[@sherrietilghman2745]

I like how Dr. Grande compared the way the client felt about drinking before to how she feels now. She doesn't seem to care about anything and it seems to be hard for the client to want to see any hope.

[@kelly4321]

This was a good role play to see, especially with how the client was getting increasingly more angry and frustrated about the situation. The counselor does a good job of being neutral and allowing her to feel what she is while asking questions to get more information about the situation and how she is feeling about it. This is a good reminder to not allow yourself to get frustrated as the counselor by feeding off of the clients frustration. Having the clients energy affect a counselor could happen so it would be imperative to keep that in mind, especially when first starting out. It is a balance of being there for the client but not letting it affect the counselor.

[@ProgrammedForDamage]

This felt so real it gave me chills. I've had these *exact* back and forths with people before. Thankfully they're all still here. This video is as accurate as they come.

[@wherethereslifethereshope9858]

Thank you Todd. I can so relate to this young ladies situation and feelings of hopelessness...and learnt a new word...negativistic.

[@cellison9414]

Excellent video. Both of you did a great job. Such a important topic,too.

[@pakistanihumanist4584]

I am gonna do everything to prevent that Though they are both acting, but golden words.

[@TheoWren]

this made me emotional in a way i wasn’t totally prepared for. i’ve been there, for different reasons.

[@barbaramatthews4735]

I felt that way once after losing a job. Only I wasn't drinking. I was sober but in a pit of dispair and hopelessness. To me, my job was part of who I was as a person. I felt severe loss. I had what I later learned was catastrophic thinking. I believed that I was losing my house, then my dogs would starve, my mom would be homeless, I'd never find a new job, that I didn't deserve a job because I was a failure. I felt unloveable and damaged. I could only see the negative. I felt like nobody understood me. Depression is a liar and a thief. It makes you believe that you're worthless. It robs you of your ambition and worth. This video really expresses some of the things that suicidal thinking makes someone believe. It is irrational. When I was contaplating suicide I was having many irrational thoughts that seemed real even though I knew they were untrue. It's confusing to know something is wrong and believe it anyway.

[@rochelleshon306]

Barbara Matthews Well said. Thank you. Your words really hit home. I’m totally struggling with no way out.

[@barbaramatthews4735]

@@rochelleshon306 I know it sounds cliche by hang in there. Recovery is a process. There is no magical "cure." There is no "quick fix", but it really does get better. Don't try to fix it. You're not a car needing new breaks. It's not that simple. Allow yourself to be not OK. Give yourself permission to be flawed. You really are OK just as you are. If you believe in a higher power then seek help with what you believe to be God. If you are more secular then find what you find comfort in. If you haven't already talk with your doctor about some of your symptoms. Feeling depressed does not make you crazy. Needing help does not make you weak. Actually, sometimes having a medical condition, such as thyroid problems can cause symptoms of depression. It's a good idea to just get a physical exam to see if anything is going on. I could give all kinda of text advise but it really isn't worth much. You have to do what is best for you. Just know that you don't have to suffer and help is available. Be good to yourself and know these things have a way of working out. I still struggle sometimes. I have more coping tools now than I did before and I'm on medication that helps.

[@happysloth3208]

I have this too though nothing really bad has happened in my life. For me it comes in cycles and I’ve never wanted to end my life but I remember once I got so depressed it caused me to not eat and I started to lose weight once, I got a little underweight I started to eat because I was scared of my health. I went to a therapist and it helped it was mainly anxiety and my constant struggle with ADHD. Right now I’m ok though I’m doing better in school.

[@foreverwander0320]

“It’s confusing to know something is wrong and believe it anyway.” You explained that feeling very well. I hope you’re doing well these days. ❤️

[@CandyKaneLane]

I like these types of role-plays because I think it helps to prepare us for when we get out there and start counseling clients. I have never had to work with clients before and having a client with suicidal warning signs whether subtle or not, makes me nervous because I want to make sure I am keeping my client safe and alive. This video gave me a sense of what I might look for in clients who present subtle warning signs and how to remain professionally intact with my client.

[@jacklinskibicki6098]

+Candace Fernandez Agreed. This area of counseling also makes me nervous and I think having the opportunity to watch Dr. Grande demonstrate the appropriate course of treatment with a variety of client situations is helpful.

[@totalcontrol4205]

Candace Fernandez Not sure why it makes you feel nervous. People are going to make their own decisions no matter what you do to help. They aren't family or friends and if you are too attached to your client, then you will lose control of yourself in the relationship.

[@dr.kelseavisalli8998]

@@totalcontrol4205 I find it very typical that many new counselors have a feeling of nervousness around potentially losing a client or not doing everything they could have done to help support them. I think maybe that fear of self blame or even imposter syndrome flows in. Just my thoughts!

[@kayfreeman2011]

so many people are missing that this is for educational purposes for those who are currently on the road to becoming psychologist and counselors. Issa role play. Of course it won’t be down to the T. GREAT JOB the both of you!!!

[@alicea153]

Loss is something many cannot handle if it's too much loss...I was this woman in 2008 and I was a very successful counselor for over 25 years with a Ph.D. It's 2020 and I'm just coming out of the emotional pain of losing everything in my life, everything that made me who I was, using wine to numb my feelings...and yes many suicide attempts and hospitalizations along the way. Today I can't imagine suicide, nor who was that person who tried so many times...thankfully I survived but I'm not the same person...the happy woman, mother, daughter, friend, and colleague...very sad for many.

[@Conradvspro]

I started crying when he said “i would care if you died” that hits sooo hard🥺 Srry im late to this...and this entire video hits hard😔 Keep up the amazing work btw!

[@mariebernier3076]

Yes. Yes.

[@rochelleshon306]

Same here, good grief, me too.

[@mikekinsella2822]

I would say If you really cared yoy fix the root of the problem not just talk about it

[@brittanyvodzak9198]

I liked how Dr. Grande was able to pick on up on how the behavior of this client was changing. He was able about to pick up on subtle comments that the client was making. It is important to listen to the client very carefully and learn the types of questions the counselor should be asking.

[@Dylvente]

Such a sensitive and skillful therapist!

[@jessicaborn8195]

Dang, where do you find these actors that play clients? They are all so awesome it's like they're speaking straight from the heart.

[@michellerobinson968]

I liked how this video shows the significance of probing and asking questions. I appreciate how Dr Grande called the client out in her change in behavior like drinking on the day of their session. Asking questions and obtaining specific answers to ensure client's safety is critical. Clients tend to throw out hints and are not usually direct and/or open with suicidal thoughts.

[@bethanyelstrom3566]

+Michelle Robinson Dr. Grande does a great job of listening and probing for as much detail as possible. The client talks all around the issue of suicidal thoughts until asked specifically about the subject. I do like that he did not just jump straight to suicidal questions and gained as much information about the whole situation.

[@reginaames3038]

+Bethany Elstrom I agree the listening and probing by Dr. Grande is great and didn't jump right into suicidal thoughts.

[@Pixieburglar]

Again, I appreciate the variety of role plays on the topic of suicide. This role play was very helpful for me because it pointed out how subtle the signs of suicidal ideation can be. I can see as a counselor, how important it would be to probe a client for me information in order to make sure of the safety of the client.

[@jacklinskibicki6098]

This video is helpful in learning how to draw additional information from a client who does not initially appear to be potentially suicidal. This is useful to watch, as many clients will remain hesitant to disclose their thoughts of suicide. This video offers a guide for how one may approach this situation during a session.

[@kimberlykelly386]

+Jacklin Skibicki I agree, Jackie! I could see me potentially exploring her feelings of frustration and anger and how to get through that and may have missed these underlying, subtle warning signs that need attention. It may take a little probing but this made me realize just how important it is so rule out potential harm to self before doing anything else.

[@Youwinmeta]

You are such a compassionate man 🙏🏻

[@gothicfeline]

Wow this gave me a lot of feelings. Sadly, it also got into why I will never ever tell a therapist if I'm suicidal. I've been involuntarily hospitalized in psychiatric facilities three times in me life, and they tended to make me worse (but much better at hiding what was going on). I am quite determined to NEVER go back to one, ever again. If it means lying to my therapist, then I'll lie.

[@cherihausmann]

It would be important to find a therapist that would have a specialty in suicidal ideation.

[@monicaperry13]

This was a powerful video and definitely showed the importance of digging deeper especially with a familiar client who you know is acting differently from past sessions. Her plan to commit suicide could have easily been missed had her therapist focused only on her drinking issue.

[@lizconnor1820]

I agree Monica. He could have very easily been lead to focus on her drinking issue rather than assessing her intent to commit suicide because her signs were so subtle. Instead, like you said, he dug deeper and really showed that he cared for her and her life. Very moving

[@alexdeloach6472]

I agree. It would’ve been easy to continue talking about her drinking and miss the subtle signs of suicide.

[@johnharrisjr2808]

Great Video! I like the way that Dr.Grande gave her space to process what she was going to do about her drinking, losing her job, and getting ready to lose her house. Dr. Grande allowed silence in the room and didn't fill it giving her solutions but allowed her to admit that she didn't know what she was going to do. I also like how Dr.Grande pointed out the clients strengths at the end of the session

[@af398]

Oh my goodness, I answered her questions with the same answers before she even responded! This girl (even though it's role play) was me 12 years ago! Thank goodness I'm sober! What a sad sad state. If you're reading this and struggling to get sober, I encourage you to seek help and stay with it! I'm proof sobriety is better and possible. I believe you can get through this!

[@WhisperofaGhost]

Yes! This was like reliving a session from 10 years ago...my therapist was so similar and the conversation was like a mirror. I'm so relieved to not be drinking anymore, back then I couldn't even fathom it.

[@cherylcaardillo1702]

@@WhisperofaGhost praise God 😇❤😇

[@JustJesstheMess]

Aaah. So THIS is how a good psychologist runs a session! Never seen it done. I've said SO many of these exact same things to psychologists and psychiatrists before and they're just busy typing away or writing going "mhmmmm, yeah. Right. Mhmmmm." Lol. I'm like "did u hear what I just said? Wasn't that considered to be an alarming statement to you people?" But no. Most of them just watch the clock until the session runs out and I'm convinced that they're not taking notes at all, they're just doodling on their little note pads. It's probably just drawings of aliens and big boobs and Led Zeppelin logos or some shit.

[@mariebernier3076]

Sorry, your comment is serious and important, but I couldn't help smiling at the hilarious things you imagined the educated, sombre professional was drawing. BIG BOOBS!!! So funny.

[@stevepowsinger733]

You can see patient notes if you request in the U.S. You may not like what you see though. And sometimes it’s filled with medical jargon.

[@Crazyjn]

Wow! I really believed this was a real session! Great work!

[@tiiaj7589]

I've basically said, very clearly I want to die, and they smile me out of the room.

[@danir6054]

Tiia J wow, I've also had this occur.

[@JustJesstheMess]

Same here. And they just go "well we're out of time for today. See you next week!"

[@bluelakes_]

Same wow

[@pony_OwO]

Mental health "professionals" are all con artists

[@MathildaFlow]

Me too.

[@reneemendez4287]

Its the subtle warning signs of suicide that makes me scared about accidentally overlooking something that may seem small, but in reality is literally life or death important. It was good seeing how Dr. Grande navigated though the uncertianty.

[@mandabear52289]

+Renee Mendez I agree! It scares me how subtle the warning signs can be! I think this video just goes to show how important a through suicide assessment is. He did a great job navigating the clients attitude and the uncertainty.

[@gregrice1354]

Wow. Serious drama, too common in the hurt and sense of despair, but also so powerfully moving in seemingly plain talking, listening, compassion. This is unlike theatrical drama, as it is not intended, structured, staged, lit, focused to convey an author's unique view, or mood, or philosophy. This is created to show how to give care at one of the moments in many people's lives, as adults, when the sense of power or control or of effects in one's life have been overwhelmed and blockaded by seeming unending blocking of the stream of thoughts, ideas, feelings, shifts in mood, that combine every other day to make us function, survive, and just be. Thanks for creating this 19 minute video, Dr. Grande. This scene, in conjunction with the video you made on the signs of a deficient therapist convey a lot about the field of therapy as a system of practicing care, hope using some the world's best education, knowledge, and so much of that is to affirm life, to care for our neighbor. Indirect reference about these deep truths, regarding Harm Reduction - your book - could be better with couple portions of the 2 scenes noted, this intervention and the one about what a "bad" therapy session might be. Can you tell us if the woman in this intervention scene is an actress or just a fellow therapist? Thanks. 1-11-2022

[@reginaames3038]

Great video, shows comorbidity of depression and alcohol use and how it can lead to suicidal thoughts. This demonstration reminds me of the risk factor acronym, "IS PATH WARM", that Flanagan talked about.

[@aileenbordelon7884]

I thought this was real at first and I was like “ Is this even allowed” 😂

[@alexeysamokhin9629]

Why it shouldn’t be allowed?

[@alexalcan]

@@alexeysamokhin9629 I think she meant posting it online. It isn't allowed to post real therapy sessions with real patients publicly.

[@recoveryjournal6420]

6:14 and onwards - oh no that's so relatable it teared me up. The same words I've told my therapist recently, it was like hearing myself.

[@llchapman1234]

This session really highlighted how difficult it is for patients to really articulate feelings and thoughts. Great job on follow up questions to get more information and clarify her meaning on her statements. Just the fact that she came to the session indicated that she was looking for help, even if she was feeling hopeless and thinking about suicide. This was pretty good acting for an educational video. I'm impressed.

[@HumanimalChannel]

Great choice of subject matter Dr Grande. Really important stuff 💜

[@laurawatters914]

This is a good way to show the signs, people will relate to it more like role models, good video!

[@Mjthfdj]

I liked the review of hopelessness and helplessness. The text touched on this briefly but this video really allowed me to differentiate between the two.

[@Lauracharland]

Every video of yours I watch about suicide assessment always makes me feel unheard. Every single time I talk to my therapist about my suicidal thoughts (my plan and my intent), they rarely ever call the police. I’ve only been admitted 3 times in the span of a month because of suicide attempts but they let me out of the hospital after a couple of days. Now, when I tell her that I’m determined to do it, she ends the session by wishing me a great week and having me promise to still be alive for next week’s session... It only makes me want to do it even more because I feel like they’re not taking me seriously. It sucks being diagnosed with BPD because they rarely take you seriously when it matters the most. Anyway, thank you for your videos, helps me out a lot

[@rpj396]

Laura, how are you doing now?

[@Cate7451]

robyn watt yes Laura, how is it going?

[@perryloggins9868]

Laura, are you ok? Praying.

[@doctorofletters8412]

Have you spoken to your therapist about your feelings of being unheard? I don’t wish to trivialise your comment, but I know that having BPD can magnify those feelings of being unheard and abandoned . You’ve said you were ‘only’ admitted three times in a month. That sounds like a lot. That sounds like a lot of people heard what you said / didn’t say and were very concerned.

[@buttercatpaws9674]

My heart swelled up in my chest, the client's expression of hopelessness. Bravo Zulu Doctor for your excellent self-control and demeanor, not to mention that this young woman is special and important to others... thanks for your interventions, life is precious at every level🐈🐾♥️

Watching this was almost verbatim the situation I was in only a couple months ago. My therapist had said to me "I would care if you died" and then "I know you don't have a lot of hope for the future right now. But I'm going to hope for the both of us".

[@ReubenAStern]

Is it bad that this sounds like a normal conversation to me? It's crazy how many people are depressed these days.

[@subhasharma4425]

The script is so well written, wow

[@neverandre8191]

Wondering what happens at the point where the doc says that he is going to stop her, if she had a different reaction to the one shown...angry and refused to go, or took back her threats of suicide?

[@Liciablyth]

Beautiful session. Well done to the actress and Dr Grande for your compassion and skill. I am sure this is a very healing video for many people.

[@ciaraquinn2010]

This is one perception of a suicidal person. My experiences are different, elated almost euphoric individuals who seem to have made peace. So much though infact that their loved ones let their guard down thinking they have got well and their mental health is improving. They may buy presents or give away items. They may visit people they haven't in a long time. This is so things are in order before they commit to the act. Suicidal folk may be very aware of how much their loved ones will miss them but feel "they will get over it" This is a brilliant role play though.

[@da3musceteers]

Lol thats me rn. If you seek care, you're not actually THAT suicidal. Theyre just faking it for attentjon

[@ThaTruFily]

Really appreciate there was a continuation of this one. I was just thinking some videos earlier why not make like a little story of progression and regression between sessions in these and welp another great video.

[@carolkirby9558]

Dr. Grande patiently stays with the client even when she is less than patient and he pursues her indifference about drinking when he knows there has been a change in her status on the topic of drinking. I like how he pursued a specific understanding of what she feels and why.

[@bernitacenteno1326]

I felt the authenticity of the situation and was on pins and needles wondering if she was going to shake her head no and say " I don't really want your help or any help, I've made up my mind. I'm going to do it ." I felt relief when she agreed with Dr. Grande. I breathed an emotional /physical sigh of relief too. Thankyou. I felt it was real, but it wasn't. I really have to give you credit Dr. Grande. Nothing seemed as if you were unable to help her, but her words.. That's why it was a nail biter, because she was suffering despondency so deeply that she agreed to be hospital..

[@ukcheesexlovepotion]

Thank you for all of the invaluable work and education that you provide.

[@skullslace2426]

I was there. Circumstances very different, but I understand that level of hopelessness. I was fortunate enough to have a partner and an excellent counselor who picked all that little pieces of me and helped me get my emotions back in check. It took work, it wasn't easy, and there were several blowbacks on the way. But having a counselor who truly cares is so incredibly important. During my first couple of sessions we went through a year's worth of tissues. How she dealt with me sitting there for 60+min straight, barely able to even communicate, I still don't understand. I appreciate this educational video so much. Thank you, and thank you, all counselors, who help others to see even the tiniest shimmers of hope.

[@natashavernon9828]

Oh my gosh what an awesome roleplay session. Always wished i could get therapy from Dr.Grande!

[@silaslizzie43]

You think you're in the hole now, no job, losing your house. Just wait until you spend 5-10 days in the hospital.

[@lmoa69]

You have no job and no insurance, but we're gonna put you in the hospital for about 10 days. Hopefully, when you get out of the hospital, you'll have no home to return to and a $25,000 hospital bill. Oh, and since you have no insurance... we're gonna need you to pay the receptionist before the cops take you away, thanks.

[@giovanna8187]

@@lmoa69 What else to do? She doesn't seem to have anyone in her life to help her. On the subject of hospital bills, mental health counselling should be free ! It is in my country, Canada, thank god.

[@lisahope6876]

Jeez I'm glad I dont live where ever you live.

[@CB-hk7hy]

Great video. The only thing I wish Dr. Grande had told Erin, once he realized she was at a point of planning to commit suicide, was to acknowledge that she was looking for a way for the unbearable pain inside to end. He needed to acknowledge her pain and help her talk through it. But what do I know, I'm not a doctor so.......

[@kjsch4739]

Why did I all of a sudden get scared and want to run away once he said "i want to try and interfere with your plan"

[@dannandaeterra]

I felt that way when he said "I'm gonna stop you".

[@totalcontrol4205]

I was like that when I first saw it. This video is kind of measure of where I am at at different times. If I'm here, I am depressed and heading towards another suicidal episode. This time, I don't feel anything about the video or his remark. I guess, I have grown weary of this, all of it, life, trying, this video, etc.

[@PreciousRegalos]

This part made me cry...

[@Schiffon]

@@totalcontrol4205 I feel your pain

[@Gramsci89]

Great video, really interesting thank you. though is that the dads Chair from Frasier?

[@rosenars6665]

having my second session with my therapist today and have an appt with my psychiatrist right after. It’s overwhelming but I know it’s all to help me live a better and happier life.

[@christinadeshaies4465]

Hope you found some tools to feel better🙂

[@rosenars6665]

@@christinadeshaies4465 I have! Thank you 😊

[@SHurd-rc2go]

Totally believable. This woman is so good.

[@ariannesaden729]

This was so well done. Thank you.

[@kalnedlewil2897]

Great acting!! I’ve seen people do these before and it’s always obviously fake but these 2 r great ! I hope she is using her talent in this way still !!!

[@kallie9229]

This seems very apt to the current quarantine life we're living. I know many are struggling (more) being home all day. I can't wait until I have finished school and can hopefully help someone find their light again.

[@joshuaneace6597]

I am watching this for HMS 212 Crisis Intervention and this is good acting and great at seeing warning signs on both substance use disorder and suicidal ideation.

[@heather7927]

This was a great video to watch. It was interesting how the client would drop hints and Dr, Grande was able to catch the hint and probe for further information. The client mentioned her job loss, drinking more, being unable to pay her bills, and how even though she is seeking treatment things have gotten worse not better. I thought it was interesting how Dr. Grande asked her what solutions she sees and if she was looking for a job. I liked how Dr. Grande broached the topic and came right out and said she was considering suicide and how she wouldn’t feel this way in a few weeks as well as that it seems like the only option but it’s not.

[@Phantom_Kero]

Wow this felt so real. Incredible acting!

[@aaron6841]

Dr grande how is she? Your right about not feeling this way forever! Thank you for your wonderful work.

[@healedkyber]

They are acting, she's probably doing fine!!

[@barbaraolsem8377]

She's a darn good actress. This is making me tear up because there's been times in my life when I felt exactly like the client. I made it without therapy I couldn't explain how I did it though.

[@happysappygirl101]

I wish I had someone like you as my counsellor. Hope I can find a video like this on your channel involving chronic suicidality... Anyway, thank you for this content! I'm not a mental health professional, but I appreciate this type of content immensely. Makes me feel like I could maybe open up to a counsellor about my actual thoughts without fearing some intense, negative reaction like I've gotten in the past from mental health professionals. I've been afraid to express the most pervasive and recurring suicidal and self harming thoughts, as I don't want to get institutionalized, especially since family members have used that as a threat in the past when I was still a minor.

[@eileeneamon9070]

A great therapist, not only in my opinion but the general opinion in the community, once said to me that you can delay a suicide with therapy and hospitalization and sadly, if someone is intent on ending their life , you will not stop them. Which is extremely sad.