SUICIDE INTERVENTION PLAN 1
Suicide Intervention Plan Assignment
Alysha Nashert
School of Behavioral Sciences, Liberty University
Presenting Problem
Karen is a 46-year-old divorcee with a history of depression and prior history of multiple
attempted suicides. One of the attempts involved cutting her wrists, while the other two were
attempted overdoses. She unexpectedly comes to the office unannounced to see her counselor
to express appreciation and gratitude. She mentions she has a gun in the car and plans on going
for a drive but does not want to stick around to talk. Although the client sees a psychiatrist, she
is noncompliant with her medication and has very little social support. All these factors
collectively confirm that Karen is high-risk for suicide.
Precipitating Event
There are multiple precipitating events in this scenario. First, the client has a history of
chronic depression that is uncontrolled due to lack of medication compliance. She went through
a divorce about 9 years ago and her only relationship involved an affair with her brother-in-law
Page 1 of 11
SUICIDE INTERVENTION PLAN 2
about 6 years ago. There is ongoing pursuit, but she continues to live in secrecy about the affair
causing chronic feelings of guilt. Additionally, the client has a high-stress job and spends 60-70
hours of her week at work, and she has no other hobbies or social life noted.
Risk Factors
•Personal history of depression (Substance Abuse and Mental Health Services
Administration, 2013)
•Divorcee/loss of marital relationship (Substance Abuse and Mental Health Services
Administration, 2013)
•Prior history of suicide attempts (Substance Abuse and Mental Health Services
Administration, 2013)
•Relationship difficulties/infidelity (Substance Abuse and Mental Health Services
Administration, 2013)
•Chronic psychological distress (guilt) from affair (Substance Abuse and Mental Health
Services Administration, 2013)
•High stress job ((Substance Abuse and Mental Health Services Administration, 2013)
•Possession of a weapon (Substance Abuse and Mental Health Services Administration,
2013)
•Minimal social support (Substance Abuse and Mental Health Services Administration,
2013)
•Unscheduled visit to counselor (Substance Abuse and Mental Health Services
Administration, 2013)
•Medication noncompliance (DiMatteo et al., 2000)
•Minimal social life/lack of social support/poor socialization (Substance Abuse and
Page 2 of 11
SUICIDE INTERVENTION PLAN 3
Mental Health Services Administration, 2013)
•Single parent (Kareem et al., 2024)
Resources and Protective Factors
The client has protective factors and resources available to her to assist and offer aid in
times of crisis. Material resources would include a steady job, although it is high stress. Having a
job and steady income can reinforce positive mental health, but due to the high number of
working hours, it also may contribute to more depression as well. Personally, she has a strong
therapeutic alliance with her counselor and engagement with a psychiatrist who both have
identified a willingness to help. The reality that Karen felt comfortable and safe enough to stop
unannounced at her counselor’s office means that there is a high level of trust and connection
in that relationship. A challenge she may encounter is similar support from her psychiatrist as
she has been noncompliant with treatment. Additionally, she has a 14-year-old son, which also
serves as a protective factor. She has responsibility outside of herself and someone who is
dependent on her, which may offer some reduction in suicide risk (Dehara et al., 2020;
Substance Abuse and Mental Health Services Administration, 2013). Socially, as mentioned
previously, she has a relatively strong therapeutic alliance, but she also has familial connection
and support through at least her sister (Substance Abuse and Mental Health Services
Administration, 2013). This may be limited due to secrecy of the affair. There may also be social
connections within her job that offer a layer of meaning, resources, and connections. For
immediate need, the client has the ability to contact by calling or texting 988 the Oklahoma
Comprehensive Crisis Response
Team during her mental health crisis (Oklahoma Department of Mental Health and Substance
Abuse Services, n.d.). At the community level, CREOKS is a local organization that offers
Page 3 of 11
SUICIDE INTERVENTION PLAN 4
outpatient services to individuals with behavioral health (CREOKS, 2025). At the national level,
National Alliance on Mental Illness (NAMI) offers support to individuals struggling with mental
illness (National Alliance on Mental Illness [NAMI], n.d.). In addition to offering these resources,
I would also recommend referring the client to her psychiatrist or outpatient therapy for
medication management.
Spirituality
Ethical Considerations
While the client’s spirituality may not be known, it is critical for the counselor to act in
accordance with the ACA and AACC codes of ethics. According to the ACA Code of Ethics, the
counselor is required to practice with nonmaleficence, avoiding anything that may cause harm,
or causing harm to their clients, intentionally or unintentionally (2014, Preamble and Section
A.4.a). The welfare of the client is the counselor’s primary responsibility, which includes
alerting the appropriate authorities if the client expresses suicidal intent (ACA Code of Ethics,
2014, Section A.1). The counselor has a duty to protect, have the right resources, appropriate
planning, documentation, and resources to ensure safety of the client.
From the AACC Code of Ethics perspective, the approach is similar. The American
Association of Christian Counselors calls counselors competency and confidentiality, but they
are also called to protect individuals from harm and to take appropriate steps to ensure safety
(American Association of Christian Counselors, 2014, Section 1-430-a). These codes require
counselors to take action to protect life, which could incorporate hospitalization, further
consultation, or other referrals (American Association of Christian Counselors, 2014, Section
Page 4 of 11
SUICIDE INTERVENTION PLAN 5
1430-b). Both sets of codes highlight the importance of life preservation and client safety over
remaining confidential.
Spiritual Considerations
Spirituality is complex and multidimensional, and it encompasses personal beliefs,
values, and liturgies. These elements that can either serve to protect individuals from suicidal
risk or push them towards, depending on their personal experience (Sommers-Flannagan &
Sommers-Flannagan, 2021). Therefore, integrating spirituality into treatment for clients
experiencing suicidal ideation produces mixed results (Sommers-Flannagan &
SommersFlannagan, 2021). Suicide is a complicated topic when it comes to faith and religion
and often controversial (Sommers-Flannagan & Sommers-Flannagan, 2021). Often for clients
who are connected to a spiritual or faith community find additional support from supportive,
but some may need to disconnect from spirituality and religion as well (Sommers-Flannagan &
SommersFlannagan, 2021). Meaninglessness can increase the client’s vulnerability to suicide,
being grounded in faith or spirituality may reduce suicidal attempts (Sommers-Flannagan &
SommersFlannagan, 2021). It is important to remain unbiased and open to each individuals’
beliefs not only because of sensitivity with clients with suicidal ideations, but also because of
the requirements of the ACA Code of Ethics (Sommers-Flannagan & Sommers-Flannagan, 2021;
ACA Code of Ethics, 2014).
Interventions
•Encourage the client to stay and talk through current situation. Explore the client’s
current state of suicidal ideation/urges. Assess suicide potential, and if needed call crisis
intervention program. If client decides to leave, contacting police for a wellness check.
Page 5 of 11
SUICIDE INTERVENTION PLAN 6
•With the client’s prior history of attempted suicide, ask the client about current suicidal
thoughts and her plan/intent with the gun
•It is crucial to secure the firearm in the client’s vehicle. I would secure the firearm as
soon as possible and later have the client contact any social support to come pick up the
firearm from the premise
•Talk with client about treatment options, coping mechanisms that have been previously
successful, and arrange for psychiatric hospitalization if necessary
•Contact psychiatrist to gather additional information and schedule follow-up for
symptom and medication management
•Document assessment, action steps, treatment, and responses
•For the future, create a safety card with the client for prevention in the event of a future
crisis
Treatment Plan: Goals and Interventions
Problem 1 (mental): Karen has been experiencing chronic depression leading to periodic
suicidal ideations.
Goal 1: Karen will reduce the overall severity, frequency, and intensity of daily
depression so that functioning is no longer impaired by the end of week 6.
Objective 1: Karen will learn and practice two evidence-based coping
skills daily and track thoughts and overall mood in journal at least 4 days per
week with a goal of decreasing depression symptoms by 50%.
Intervention 1: Teach the client Cognitive Behavioral Therapy
(CBT) techniques, such as cognitive restructuring, relaxation techniques, or
Page 6 of 11
SUICIDE INTERVENTION PLAN 7
journaling, and review the logs and progress weekly with the client in a
collaborative manner (Gautam et al., 2020). The PHQ-9 Depression screening will
be administered before every session.
Problem 2 (physical): Karen is on medication for depression but is non-complaint leading to
uncontrolled depressive symptoms and poor self-care.
Goal 1: By week 6, Karen will take the prescribed medication 50% of the time.
By week 9, the goal is 75% and by week 12, she will find benefit to the
medication and take it as prescribed 100% of the time.
Additionally, she will incorporate one type of self-care weekly.
Objective 1: Karen will take her prescribed medication at least 21 days
out of the first 6 weeks and gradually increase the frequency and
consistency as the weeks go on. She will keep a simple log of days successfully taking the
medication, and how she feels on the medication versus when she does not take it.
She will also engage in self-care weekly, such as walking, yoga, massage, or spa
appointment with the goal of establishing better habits to improve overall functioning
and mental health
(Gavurova et al., 2022).
Intervention 1: Counselor and client will collaboratively come up
with ways to ensure medication compliance and brainstorm self-care
activities and review weekly. The client will set a daily reminder to take medication at the
same time every day so help with consistency.
Problem 3 (emotional): Karen does not have the skills to emotionally self-regulate, leading
to increased symptoms of depression such as suicidal ideation.
Page 7 of 11
SUICIDE INTERVENTION PLAN 8
Goal 1: By week 4, Karen will have used 1 self-regulating/coping technique at
least 3 times per week and add a new technique every 4 weeks until week
12 (3 total techniques).
Objective 1: The client will practice deep breathing, mindfulness,
gratitude, or self-compassion exercises 3 times per week and increase
number of techniques by week 8 and 12, and she will report the results in
weekly meetings (Koniver, 2024).
Intervention 1: Counselor will introduce coping mechanisms and
emotional regulation exercises every 4 weeks and allow the client to
practice during sessions to where the client feels equipped. Guide conversations and
weekly check-ins.
Problem 4 (social): Karen is isolated and lacks social support beyond minimal support
through family and work.
Goal 1: By week 12, Karen will have attended/engaged a weekly social event
through other organizations, social clubs, churches, etc. that are not
work-
related.
weekly.
In addition, she will reconnect with a family member/friend
Objective 1: Karen will research and plan to attend one event (same or
different) every week and spend at least 45 minutes connecting with her
son per week. She will document positive and negative mood changes with
the events with the goal that increasing socialization improves overall mood
(Dehara et al., 2020).
Intervention 1: Collaboratively create a list of 12 different events,
Page 8 of 11
SUICIDE INTERVENTION PLAN 9
social clubs, religious organizations, etc., and 12 ideas to spend time with her son
that she is interested in.
Problem 5 (spiritual): Karen lacks meaning outside of her career and working 60-70 hours
per week, which contributes to feeling depressed and hopeless.
Goal 1: By week 12, Karen will identify values and 3 different sources of meaning
outside of work.
Objective 1: Karen will create a list of values by the end of week 6, and
she will have the list completed and discuss the other sources of meaning
by week 12, with the goal of reducing suicidal ideation and depressive
symptoms
(Sommers-Flannagan & Sommers-Flannagan, 2021).
Intervention 1: Facilitate weekly conversations around values,
meaning making, and other spiritual practices (Sommers-Flannagan &
Sommers Flannagan, 2021).
Page 9 of 11
SUICIDE INTERVENTION PLAN 10
References
American Association of Christian Counselors. (2014). AACC code of ethics (Y-2014 ed.).
https://www.aacc.net/wp-content/uploads/2020/06/AACC-Code-of-Ethics-Master-
Document.pdf
American Counseling Association. (2014). 2014 ACA code of ethics.
https://www.counseling.org/docs/default-source/default-document-library/ethics/
2014-aca-code-of-ethics.pdf
Comprehensive crisis response. Oklahoma Department of Mental Health and Substance Abuse
Services. (n.d.). https://oklahoma.gov/odmhsas/treatment/comprehensive-
crisisresponse.html
Dehara, M., Wells, M. B., Sjöqvist, H., Kosidou, K., Dalman, C., & Sörberg Wallin, A. (2020).
Parenthood is associated with Lower Suicide Risk: A register based cohort study of 1.5 ‐
million Swedes. Acta Psychiatrica Scandinavica, 143(3), 206–215.
https://doi.org/10.1111/acps.13240
DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for
noncompliance with medical treatment. Archives of Internal Medicine, 160(14), 2101.
https://doi.org/10.1001/archinte.160.14.2101
Gautam, M., Tripathi, A., Deshmukh, D., & Gaur, M. (2020). Cognitive behavioral therapy for
Depression. Indian Journal of Psychiatry, 62(8), 223.
https://doi.org/10.4103/psychiatry.indianjpsychiatry_772_19
10 of 11
SUICIDE INTERVENTION PLAN 11
Page
Gavurova, B., Popesko, B., Ivankova, V., & Rigelsky, M. (2022). The role of self-care activities
(SASS-14) in depression (PHQ-9): Evidence from Slovakia during the COVID-19 pandemic.
Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.803815
Home. CREOKS. (2025, June 24). https://creoks.org/
Homepage. National Alliance on Mental Illness (NAMI). (n.d.). https://www.nami.org/
Kareem, O. M., Oduoye, M. O., Bhattacharjee, P., Kumar, D., Zuhair, V., Dave, T., Irfan, H.,
Taraphdar, S., Ali, S., & Orbih, O. M. (2024). Single parenthood and depression: A
thorough review of current understanding. Health Science Reports, 7(7).
https://doi.org/10.1002/hsr2.2235
Koniver, L. (2024). Grounding to treat anxiety. Medical Research Archives, 12(12).
https://doi.org/10.18103/mra.v12i12.6024
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2021). Suicide assessment and treatment
planning: A strengths-based approach. American Counseling Association.
Substance Abuse and Mental Health Services Administration. (2013). Quick Guide for
Clinicians: Based on TIP #50: Addressing Suicidal Thoughts and Behaviors in Substance
Abuse Treatment (Treatment Improvement Protocol (TIP) Series, No. 50, HHS Publication
No. SMA 13-4793).
11 of 11
