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Presenting Problem
Joanne is a 45-year-old woman with a 13-year-old daughter. She has been divorced for
10 years and has not dated since. She got divorced due to her husband confessing that he is gay.
She works long hours at work, which is a high stress job which leads her to no time for
extracurricular activities. She had an affair with her sister’s husband for a year who is still
pursuing her. She ended that affair because of the guilt she felt and never told her sister about it.
She currently takes medication but has been non-compliant and attends monthly sessions
with a psychiatrist. She has a history of depression. She has slit her wrist and overdosed twice.
She has stopped by the outpatient clinic to inform the counselor of her appreciation of the
counselor and how important she is to her. She has informed the counselor that she has a gun and
is going for a drive. The counselor tries to get her to stay but she refuses.
Precipitating Event
Joanne had been divorced for 10 years, which had led her to being a single parent. Her
husband admitted that he is gay which led to the divorce. She works at a high stress job that takes
the majority of her time. Her affair with her sister’s husband has led to feelings of guilt. She is
still being pursued by her sister’s husband. She has a history of depression and suicide attempts.
She has cut her wrist and has had 2 overdoses. She is prescribed medication but is non-
compliant.
Risk Factors
History of depression- Women struggling with depression has a high incidence of
suicide attempts (Bommersbach et al., 2022).
Suicide attempts- Having an attempt of suicide is a “strong predictor of future
suicide” (Bommersbach et al., pg. 157, 2022)
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SUICIDE INTERVENTION PLAN
Divorced- After effects of a long-term situation may put Joanne at risk for suicide
attempt (Jackson-Cherry & Erford, 2018).
Stressful job- Joanne’s high stress job may be affecting her mood and causing
insomnia may be causing her depression (Holman & Williams, 2020).
Age- Joanne is 45 and individuals ages 45-54 is the fifth leading cause of suicide
death (Jackson-Cherry & Erford, 2018).
Alone and has a gun- Joanne has access to “lethal means” to potentially carry out
a suicide (Jackson-Cherry & Erford, pg. 160, 2018).
Unresolved guilt- Joanne has unresolved guilt due to her “poor decision-making
with respect to friends and partners” (Jackson-Cherry & Erford, pg. 160, 2018).
Resources and Protective Factors
There are various resources that can be used. One resource is her current
psychiatrist. She could also seek support from other family members or friends. The suicide
prevention line can be of assistance when having immediate needs (Jackson-Cherry and
Erford, 2018). Another protective factor could be her responsibility to her daughter. Joanne
could also lean on her religion or spiritual beliefs for support. She can also find community
group support. Having a sense of belonging will help as a protective factor.
Spirituality
Spirituality or religion can be of benefit to clients. According to Jackson-Cherry and
Erford (2018) “spirituality, religion and faith-based practices are also an important part of
a person’s coping strategies and help to give life meaning” (pg. 126). Joanne could
incorporate her beliefs into her life to help her with her struggles with suicidal ideations. It
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SUICIDE INTERVENTION PLAN
would be important to get an understanding of what Joannes beliefs are in order to help
her on a spiritual level.
Ethical Considerations
Certain considerations have to be acknowledged. Before implementing any spiritual
or religion concepts, counselors must first gain consent. The AACC states that counselors
“should obtain consent that honors client choice, receptivity to these practices” (AACC ES1-
330, 2014). According to ethics, counselors are to do no harm and not impose their values
on clients (ACA, A.4.a, 2014). Joanne beliefs could be different than the counselor. This
would lead the counselor to gain an understanding of Joanne’s spirituality especially when
they are inconsistent with the client (ACA, A.4.b, 2014). Counselors must also ensure that
they are competent in Christian counseling before implementing it with a client (AACC,
ES1-210, 2014).
Spiritual Considerations
Joanne could be struggling with her beliefs. Joanne has committed adultery which is
considered a sin in the bible. Joanne’s divorce could be impacting her spiritual beliefs
because her marriage did not last. As mentioned by Kim et. al (2020) religion could act as a
protective layer for women. Attending religious services can reduce suicidal ideations (Kim
et. al, 2020).
Intervention
Gather more information from the client.
Discuss a safety plan and removing items that could be used to self-harm.
Arrange client to be seen for further suicide assessment at a local hospital or crisis
facility.
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SUICIDE INTERVENTION PLAN
Treatment Plan: Goals and Intervention
Problem 1 (mental): Joanne has a history of struggling with depression.
Goal 1: Joanne will lower symptoms of depression.
Objective 1: Joanne will use positive thoughts in place of negative thoughts.
Intervention 1: Counselor will help Joanne identify positive thoughts
and phrases to utilize.
Problem 2 (physical): Joanne has a history of self-harm.
Goal 2: Joanne will reduce thoughts of self-harm.
Objective 2: Joanne will recognize patterns that lead to self-harm.
Intervention 2: The counselor will teach Joanne coping strategies
when suicidal ideation is present.
Problem 3 (emotional): Joanne had an affair and is struggling with guilt.
Goal 3: Joanne will recognize issues that contribute to her guilt.
Objective 3: Joanne will verbalize unresolved grief/guilt (Kolski et al., 2014).
Intervention 3: The counselor will explore and implement strategies
of grief/guilt.
Problem 4 (social): Joanne works 60-70 hours per week which leads to not being able to
socialize with others.
Goal 4: Joanne will set time aside to develop interpersonal relationships (Kolski et
al., 2014).
Objective 4: Joanne will have social interaction to prevent isolation (Kolski
et al., 2014).
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SUICIDE INTERVENTION PLAN
Intervention 4: The counselor will work with Joanne in arranging
opportunities to socialize with others.
Problem 5 (spiritual): Joanne may have spiritual beliefs.
Goal 5: Joanne will use her faith as support.
Objective 5: Joanne will recognize religious and spiritual support in her
community.
Intervention 5: The counselor will explore facilities in the
community that can support Joanne spiritual beliefs.
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References
AACC Code of Ethics. (2014). https://aacc.net/wp-content/uploads/2017/10/AACC-Code-of-
Ethics-Master-Document.pdf
ACA 2014 code of ethics - American Counseling Association. (2014).
https://www.counseling.org/resources/aca-code-of-ethics.pdf
Bommersbach, T. J., Rosenheck, R. A., Petrakis, I. L., & Rhee, T. G. (2022). Why are women
more likely to attempt suicide than men? analysis of lifetime suicide attempts among us
adults in a nationally representative sample. Journal of Affective Disorders, 311, 157–164.
https://doi.org/10.1016/j.jad.2022.05.096
Holman, M. S., & Williams, M. N. (2020). Suicide risk and protective factors: A network
approach. Archives of Suicide Research, 26(1), 137–154.
https://doi.org/10.1080/13811118.2020.1774454
Jackson-Cherry, L. R., & Erford, B. T. (2018). Crisis assessment, intervention, and prevention.
Pearson.
Kim, Y. J., Moon, S. S., Kim, Y. K., & Boyas, J. (2020). Protective factors of suicide:
Religiosity and parental monitoring. Children and Youth Services Review, 114, 105073.
https://doi.org/10.1016/j.childyouth.2020.105073
Kolski, T. D., Jongsma, A. E., & Myer, R. (2014). The crisis counseling and Traumatic Events
Treatment Planner, with DSM-5 updates. Wiley.
