Suicide Assessment Role-Play - Ideation without Intent or Plan

This video features a counseling role-play session that demonstrates assessment of a client (played by an actress) expressing suicidal ideation without intent or plan.

[@isabel-sc1lb]

These role-play videos are good. Seeing how a therapist could possibly respond to a client in this scenario makes me feel better about discussing my passive thoughts with my therapist in the future.

[@jazzynovy5400]

I appreciate this video in distinguishing the difference between SI and w/o plan or intent. I have faced many counselors who cant distinguish this and think that a client who has thoughts still need to go inpatient even with no plan or intent. It comes to show that you need to ask direct questions regarding suicidality and not walk on eggshells on the subject. Patience is key and also confidence with talking about suicidality.

[@kelly4321]

With a tough topic such as this it is good to see how the counselor is open and relaxed with the client while also being forthcoming and upfront.

[@kimberlykelly386]

This video was really helpful. I liked how Dr. Grande asked the important clarifying questions without beating around the bush. I also liked that he asked her what's keeping her from acting on her suicidal ideations. It was great seeing how he evaluated and validated her alarming feelings and I found it really helpful to hear his immediate suggestions (stay with parents, contract for safety, etc.)

[@veronicabetz9452]

Great display of therapeutic alliance. The counselor's relaxed and nonjudgmental approach enabled the client to disclose very sensitive information.

[@barrymichlowitz1071]

Since when can you get appointments 2 consecutive days?

[@heather7927]

I think this was an important video to watch to know how to ask the hard questions and be properly prepared to intervene for a client who is suffering from suicidal thoughts. I liked how Dr. Grande asked the client what prevents the client from committing suicide and if she had a plan as well as how long the thoughts have been coming. Dr. Grande came off genuine, concerned, and compassionate towards his client while remaining nonjudgmental as well as supportive.

[@virginiamurrey9139]

Great example of how to conduct a session with suicidal ideation with no intent or plan!

[@monicaperry13]

I like how Dr. Grande was calm with the client despite her suicidal ideations being stronger than they have been in the past. He also let her know that her thoughts were common in people with depression. The client seemed willing to be up front and open with him due to him being nonjudgmental.

[@willischwabe703]

Thanks for so many years of and so much high quality content.

[@Pixieburglar]

I really liked this video. Suicide is a topic that gets overlooked so often because it is a difficult topic to talk about and many do not want to ask a client if they are having suicidal thoughts. Due to the trepidation, many clinicians are not properly trained in this area. It so do important for us to know how to handle this area with our clients.

[@kyarapanula1002]

I'm digging the addition of some psychoeducation around 4:50, in the mix of compassion and information gathering. It's evident the important task is to assess safety, and then get to the next 24 hours, before digging deeper into the etiology of the depression and consequent suicidal thoughts.

[@reginaames3038]

This was a great video it showed Dr. Grande separating the psychic pain from the self. She wants to get rid of the pain and does not really want to die. He also assessed her resources to make sure that she has a plan for the day and somewhere to go where she could be safe.

[@jazzynovy5400]

+Regina Ames I really liked this aspect of the session. Draw strengths and supports. And the fact that he created a safety plan and the client agreed to it.

[@thecorgisquad9861]

I thought it was helpful to see a client that had suicidal ideations without having a concrete plan or intent to carry out her suicide. I am excited to compare this video to the next two videos in the playlist and be able to contrast the differences. I am sure that many of us watching this can relate to what this client is experiencing and we will deal with it frequently with our own clients someday.

[@michellerobinson968]

+Jessica Muzzin I believe it is helpful to see videos of clients with different levels of suicidal thoughts. There is a difference between having suicidal thoughts, having a plan, having access to means and having intent.

[@katherinebeck593]

This video was a great example of the power of the client and how the counselor can bring that out in a client by being understanding and supportive.

[@brittanyvodzak9198]

This was a great video to watch to learn how to properly assess a client to see if they have suicidal ideation without plan or intent. It is important to be directed with the client so the counselor has all the correct information about the clients suicidal ideation.

[@vidaadansi5633]

I like how Dr. Grande was able to assess her to make sure she doesn't intent to harm herself. He also explore her support systems and was able to guide her away from the stressful environment to a more safer place. How sure does any counselor know that the client will hold his/ her part of the contract of safety? I feel a client can sign the contract without any commitment.. Good assessment.

[@mandabear52289]

I always enjoy watching these role-plays. I think that they are always helpful. Seeing it helps me very much! I love that he tells her to focus on the reasons she has for living (ex. her family etc.)

[@CandyKaneLane]

+Mandy Moore I also enjoy these real life situational role -plays. I think it is important to focus on positive aspects when a person is considering harming themselves to try and bring them out of that.

[@jacklinskibicki6098]

+Mandy Moore I also liked that part of the video. I thought it was helpful to watch Dr. Grande demonstrate how to approach this type of therapy session and client.

[@CandyKaneLane]

I like how straight forward Dr. Grande is, we have learned throughout the program that it is important to be direct and ask a client whether or not they have thought about suicide, thought about a plan, and have intent, without beating around the bush with other questions. I also like that Dr. Grande was able to get the client to expand more on her thoughts regarding this situation in order to assure that she did not have any intent nor a plan to go through with suicide.

[@aliciazahn1718]

+Candace Fernandez Agreed, the directness is something to definitely strive for and this video is a great example of how to do that without being "matter of factly" about the situation. I think he sounded concerned and genuine but not alarmed or passive with his assessment.

[@lizconnor1820]

Dr. Grande seemed very comfortable discussing the subject of suicidal ideation with this client and that was evident based on her ability to have an honest, authentic conversation with him. This video is a good example of the best way to speak to and handle a client with SI without intent or plan!

[@angelinastanton7996]

I also loved the way he was open to discussion with the client. Watching this video made me feel more comfortable in imagining myself approaching a suicidal client.

[@johnharrisjr2808]

I think this was a good video that demonstrates the assessment of a client expressing suicidal ideation without intent or plan. I like how Dr. Grande asked her what is preventing from "doing it" and she comes up with reasons why she doesn't want to "do it".

[@Mjthfdj]

Helpful video on suicidal ideations. I really learned from the client's demonstrations. Good work.

[@alexdeloach6472]

I really liked the incorporation of the safety contract in this video.

[@amandagerrick5004]

This video was helpful in demonstrating how to talk to a client and help them open up regarding suicide ideations.

[@loriwardwell2957]

Good use of the safety contract, I am glad to see that used in a way I can visualize.

[@bethanyelstrom3566]

I enjoyed this video. I can understand the direct approach of asking specific questions. This was a good exploration of the client's ideation or if there is a plan. The client's sense of urgency to see the counselor raises the flag of awareness. The client does not want to commit suicide, but needs a place to discuss her "stuck" issues and depression.

[@rachelfoster5463]

+Bethany Elstrom I also appreciate the direct line of question. When dealing with suicide, you have to be specific and clear. It is not a time to "beat around the bush and be unclear.

[@dawnb.9315]

Helpful to see how Dr. Grande evaluates the client's ideation and intent. Before learning about suicide assessment, I would have had no idea how to progress with a session like the one illustrated above. Helpful to see this acted out.

[@thecorgisquad9861]

+Dawn B. I was thankful to watch the progression of what a therapist is to do with this information and how they should move forward once they know their client is thinking about suicide. This absolutely terrifies me.

[@reneemendez4287]

Suicide is one of the most difficult subjects, to me, to talk about during a session because everyone has those times where they think "I don't want to deal with the pain/stress anymore" which can be an indicator of suicidal intention but everything relies in the client's details. Like this video showed the client having ideation but did not have a plan or intent and even stated "I don't think I could do it; I'm scared to die"

[@timmartin6091]

Some years ago, I almost took my own life. I was abused when I was a kid, broken, depressed, anorexic, bulimic, self-harming. suicidal. My biological father choked me and chased me with the lawnmower as if her was gonna run me over, I went in & out of psychiatric units like it was a game of Chess. Suicide watch. I was on enough Antidepressants to kill a horse since i was 12. I hated myself. I wanted out. I wanted the pain to stop. The abuse to end I wanted power. I got into witchcraft. I thought it would give me the identity i wanted, to be set apart from people who hurt me. It only made me sicker. Sicker. Thats what it did to me. The doctors said i’d never get well. That i would suffer severe Chronic Manic depression, and never be well, that id be stuck on antidepressants all of my life. I would plot suicide on a daily basis, binging and purging my food as often as opening and closing a door. The pain was too real. People choked me. Assaulted me. Told me i was ugly, told me to apologize to him for every year i was alive. i felt worthless. Nothing ever got better. Then my mother died. The (1) & only soul who ever loved /emotionally supported me was removed from the earth. I was stuck living with people who broke me, ruined my identity, thus causing me to hate God. I thought God hated me, that he was just like the ones who tortured me, a family of abusers, who cover up all their actions with the mask of religion. I didnt know that God is on my side. I didnt know that Jesus would Love and Defend me, and fight for me and that He later would heal me, rescue me from Family. The ones who caused me pain. The ones who choked me for wearing a pagan necklace. I moved out after family threatened to throw all my belongings on the front yard, and have me permanently institutionalized in an insane asylum, when they were the ones who caused my mental illness via abuse. They blamed me for the abuse they did to me. To take my life in a psychiatric unit aka insane asylum when they were the ones who made me suicidal. Next morning i moved in with my dead mom’s parents. I stayed on the antidepressants, prescribed. But they only made me sicker. I got deeper and deeper into witchcraft, thinking it was a solution. But it made me even more suicidal. Self hatred was inescapable. All my cards have fallen down. I have nothing left. But out. I wanted out. I decided i was going to kill myself. I was going to take all my pills. But then Jesus stepped in. I didnt die. I surrendered my life to Jesus to make me well and heal me. The deity i blamed for me being abused wanted to heal me. He Was fighting for me and Loved me all along. He wanted to love me. He wanted to give me a new heart. His Heart. Jesus miraculously healed me - i am off all the drugs and dont need them and i dont have any mental illnesses. I am totally healed , full of joy. I’m now a born again Christian. I want ALL y’all to know that JESUS IS ON YOUR SIDE HE’s FIGHTING FOR you. Don’t believe me? Just WATCH WHAT HE WILL DO FOR YOU NEXT

[@catherines_castle]

Antidepressants shouldn’t be used for bipolar disorder, they can trigger mania

[@michellerobinson968]

This video is beneficial in understanding a client with suicidal ideation. Whether the client is having fleeting, passive, or active recurrent thoughts should be determined. The directness and questioning is appreciated as this is needed to obtain the information needed to ensure the client's safety. Understanding if the client is future oriented and goal focused is crucial when determining a disposition as well.

[@bethanyelstrom3566]

+Michelle Robinson I like the directness of questioning the client in this situation. I appreciate how the counselor asks what her plans are for the remainder of the day. and seeing if anyone else would be able to spend time with her.

[@sherrietilghman2745]

I agree with you, the question is scary. I like the next question, "what stops you from doing it

[@jpincinjr]

This was a great and authentic example. Looking forward to seeing the progressive in the subsequent videos to show a way of addressing this.

[@sherrietilghman2745]

Sometimes we can be apprehensive about asking the suicide question, but Dr. Grande goes right to the question.

[@runner000777]

+Sherrie Tilghman Agreed!

[@runner000777]

Great video! This conveyed ideation without intent or plan very nicely. This was very helpful.

[@jacklinskibicki6098]

This video is a helpful demonstration of how to appropriately react to and carry out a therapy session with a client expressing suicidal ideation without intent or a plan. I also thought it was useful to watch Dr. Grande identify the client's strengths toward the end of the session and ask her what she had planned for the rest of the day.

[@brittanyvodzak9198]

+Jacklin Skibicki I also liked being able to see how Dr. Grande reacted to the things that the client was telling him. I also thought it was important that Dr. Grande identified the strengths the client had to give them hope.

[@cindyrhodes]

Thank you so so much for this. This can certainly help someone who is considering getting counseling.

[@getmeouttahere3595]

Oh wow. This is so similar to what my therapist and I discussed in the initial consult..

[@aliciazahn1718]

The client's answer to her plans for the rest of the day were a bit alarming to me. It was good that Dr.Grande asked if anyone would be home with her and the client offers up the chance to go to her parent's house. A contract is a great idea in this situation, especially with a client who doesn't have a plan, seems not to want to commit suicide but is having some truly difficult thoughts and stronger than usual depressive symptoms. This was a great example.

[@mandabear52289]

+Alicia Zahn I agree with everything you said. I think the contract and the plan to stay at her parents house for the night was great. Especially since she had no plan or intent to commit suicide.

[@niktucker5812]

I think it is important for the counselor to ask the client what they think is causing their symptoms, are there thoughts of suicide, and what is preventing them from committing suicide. Often time, clients will not come out and tell the counselor about their thoughts of suicide. I think the counselor must take the initiative to ask.

[@rachelfoster5463]

Suicidal ideation is scary to me. The idea of suicide is present, but there is no definite plan in place. Dr. Grande did a great job assessing for safety and diving into where the ideation was stemming from. I think I feel unsettled about suicidal ideation because the client can still walk out of the door and not be concerned with the contract for safety and commit suicide, despite what they may tell the counselor.

[@kimberlykelly386]

+Rachel Foster I agree... having to evaluate these serious feelings is quite a responsibility. I really appreciated Dr. Grande's ability to be direct and to the point, and also setting a plan in place (staying with family) until they next see each other.

[@totalcontrol4205]

Why does it bug me so much that he always sits in front of the door?

[@mommabear5059]

Total Control maybe that’s a closet?

[@willischwabe703]

Dr. Grande actually ... ... is Gandalf "YOU SHALL NOT PAAAAAASS!!! (until our session is done, please). I hope this explaination is sufficient.

[@jimfitzpatrick9188]

Me too!

[@angelinastanton7996]

I like how Dr. Grande handled the situation in dealing with a possible suicidal client. I noticed that he did not have the client sign his no harm contract, and I was wondering if it is okay to just have the client verbally promise not to harm herself.

[@janicedixon2051]

Dr Grande reflected well and asked open ended questions that pulled out some important information. After this assessment would you have reported this? Or the contract was good enough?

[@heidihenkel7680]

I would not overdo reporting. It can discourage the client from ever being honest about this issue again, with you or with anyone else. They may also advise their friends to never talk about it if they ever feel suicidal. I think what happened in the role play was adequate. Reporting is for when it's necessary in order to keep the suicidal person safe- when there's no other way to accomplish that.

[@evidenceroom]

What if your not depressed but still have ideation?

[@1947stephanie]

Seems to me that the parents should be alerted to her thought pattern even though she has contracted with the doctor.

[@HansSilver]

Im suicidal i suffer bipolar since 2004

[@bethanyelstrom3566]

I enjoyed this video. I can understand the direct approach of asking specific questions. This was a good exploration of the client's ideation or if there is a plan. The client's sense of urgency to see the counselor raises the flag of awareness. The client does not want to commit suicide, but needs a place to discuss her "stuck" issues and depression.

[@reneemendez4287]

+Bethany Elstrom I really liked this video because it showed key questions to ask to determine the level of risk with the client