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Suicide Prevention Plan
Author Note
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to.
Email:
Suicide Prevention Plan
Department of Counselor Education & Family Studies, Liberty University
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Suicide Prevention Plan
Suicide Prevention Plan
Presenting Problem
Joanne is a 45-year-old, heterosexual woman with a history of depression and multiple
suicide attempts. She is treated by both her counselor and by a psychiatrist, who has prescribed
medication for the client. Joanne surprises the counselor by coming to the office unannounced in
order to assure the counselor of her gratefulness for the counselor’s work and says that she wants
the counselor to know how much their relationship has meant to her. Upon further conversation,
the counselor discovers that Joanne has a gun in her vehicle and that she wants to, “go for a
drive.”
Precipitating Event
Joanne’s situation has multiple precipitating events that add tension to her presenting
problem. Joanne’s has a history of depression. Additionally, she has attempted suicide three times
with her methodology growing in aggressiveness: twice by overdosing and once by cutting her
wrists. Her psychiatrist, whom she sees monthly, has prescribed her a medication; however,
Joanne does not take this medication as directed. She takes pride in her very stressful job, at
which she works between sixty and seventy hours per week; however, she does not find
satisfaction in her life outside of her job. Her former husband left her and their now thirteen-
year-old daughter ten years ago, after admitting to her that he was a gay man. She has not dated
since the divorce; but she did participate in an affair with her sister’s husband, which the client
ended.
Risk Factors
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Suicide Prevention Plan
It is important for counselors to be able to recognize the risk factors for attempted suicide
in their clients. For Joanne, there are several factors that designate Joanne at a very high risk of
suicide, and they are as follows:
The client has multiple suicide attempts.
The client has a current psychological diagnosis of depression.
The client is not compliant with the use of prescribed medication.
The client has a high stress job.
The client is socially isolated.
The client was divorced under stressful circumstances.
The client is between the ages of 45 and 54.
The client has access to means.
The client has a plan to “go for a drive” with a weapon in her vehicle.
Resources and Protective Factors
Unfortunately, Joanne’s risk factors outweigh her resources and protective factors that
can be useful to reduce suicide risk. Stone and Crosby note that access to clinical, therapeutic
care can be an important factor to mitigate suicide risk (2018). Joanne is currently involved in
what can be assumed to be two healthy therapeutic relationships. Although she is not compliant
with her medication, she does make time to see her psychiatrist every month. Additionally,
Joanne also feels a level of connection with her counselor that she feels the need to come to the
office in order to thank them for the work that they have put into her life and to say goodbye.
Spirituality
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Stone and Crosby note that some level of spiritual connection can function as a protective
factor that serves as a buffer against suicidal ideation and behavior (2018). It is important to
note; however, that both the American Association of Christian Counselors (AACC) and the
American Counseling Association (ACA) hold to the ethical standard that a counselor is not to
impose their personal beliefs onto their clients (2014;2014).
Joanne’s religious preference does not appear in her presenting problem. However, based
on the level of therapeutic relationship that exists between Joanne and the counselor that she
feels the need to say goodbye to, it can be assumed that they have had conversations that
surround spirituality. Joanne is described as having no social outlets and only finding
satisfaction
in her high-stress job where she works many hours. ACA ethical guidelines, as well as AACC
ethical guidelines prohibit the imposition of personal spiritual beliefs. If conversations between
Joanne and her counselor have revealed that she is not religious, utilizing spirituality in
conversations surrounding her life and suicidality is not ethically viable (2014; 2014). If,
however, those conversations have revealed that Joanne is a spiritual person, then the use of
spiritual language and questioning prove useful.
Intervention
The first steps taken by a counselor with a client who is currently in a suicidal crisis are
incredibly important. Involving a case manager, reducing access to means of suicide, involving
other providers, and potentially increasing frequency of care at a day facility may be necessary
in
the Joanne’s case (SAMSA, 2013). The conversation between Joanne and her counselor should
include straightforward questions about her previous suicide attempts and her current plans for
the gun in her car. Once assessing Joanne’s suicidal intent, the counselor should include their
clinical supervisor in the conversation. Their clinical experience will be extraordinarily helpful in
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both helping the client in the moment and in creating a plan for Joanne’s gun. The firearm
presents a present danger to both her and potentially other individuals that may be harmed by the
shot or shots fired. It may also be useful to include the expertise of the psychiatrist that Joanne
sees monthly. Increasing her frequency of care somewhere such as a day facility may be
necessary as well.
Treatment Plan: Goals and Intervention
Problem 1: The client is severely depressed.
Goal 1: The client will gain tools to cope with her depressive tendencies. Over
the next three months, she will decrease her level of depression and score less
than a 6 on the Beck’s Depression Inventory (Current score is X)
Objective 1: Become compliant with her psychiatrist prescribed
medications.
Intervention 1: The counselor will educate the client on the
importance of her medication.
Intervention 2: The counselor will recommend a reminder system
for the client.
Objective 2: Verbalize remaining feelings of grief and betrayal that may
be contributing to current depression.
Intervention 1: The counselor will utilize Gestalt empty chair
technique, having the client communicate with her former spouse
in order to verbalize their hard feelings.
Goal 2: The client will incorporate self-care in their daily life in order to increase
self-confidence and to assist in dealing with grief and depression.
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Objective 2: Client will build relationships and utilize support systems
over a period of three months.
Intervention 1: The counselor will encourage the client to
establish continued communication and relationship with the
supportive people in the client’s life.
Goal 2: The client will find and devote more time to activities outside of work.
Objective 1: Regularly utilize three separate forms of self-care over the
next three months.
Intervention 1: The counselor will develop and reinforce a self-
care routine that is based around the client’s interests and healthy
coping strategies.
Problem 2: The client is socially isolated.
Goal 1: Over two weeks, the client will identify/create plan to gain a supportive
social structure.
Objective 1: Identify social structure that will offer daily relationship as
well as support during crisis.
Intervention 1: The counselor will have the client draw an eco-
map, giving the client an idea of the support that surrounds them.
Intervention 1: If ethically sound, i.e., the client has indicated that
they are religious, the counselor will advise the addition of a
religious service in order to connect the client to both a spiritual
power and a ready-made community.
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Objective 1: Client will taper back the excess of hours that she is working
at her job, spending no more than 50 hours per week after a period of 4
weeks.
Intervention 1: The counselor will assist the client in building a
schedule to pare down her work hours.
Intervention 2: The counselor will assist the client in
communicating with her superiors about her plan and reasonings.
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References
AACC. (2014). American Association of Christian Counselors. https://www.aacc.net/wp-
content/uploads/2020/06/AACC-Code-of-Ethics-Master-Document.pdf
ACA. (2014). ACA Code of Ethics. American Counseling Association | A professional home for
counselors. https://www.counseling.org/resources/aca-code-of-ethics.pdf
Jackson-Cherry, L. R., & Erford, B. T. (2017). Crisis assessment, intervention, and prevention.
Pearson.
SAMSA. (2013). Quick Guide For Clinicians Based on TIP 50 Addressing Suicidal Thoughts
and Behaviors in Substance Abuse Treatment. SAMHSA Publications and Digital
Products. https://store.samhsa.gov/sites/default/files/d7/priv/sma13-4793.pdf
Stone, D. M., & Crosby, A. E. (2018). Suicide prevention. PubMed Central
(PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112615/
