If, during a counselling session, a client stated, ‘I do notsee the point anymore,’ or ,’I want to kill myself,’ it is important that thecounsellor addresses these statements sensitively but directly. I would, as thecounsellor, ask the victim whether they had any thoughts of suicide and whetherthey were self-harming themselves or had had thoughts of doing so.
If the client replied that they occasionally/regularly hadthoughts of suicide but did not have any intention of carrying out thesethoughts, I would sensitively ask questions to clarify; how long the client hadhad these thoughts, how often these thoughts occur, did they occur around anyspecific date, was there a specific reason as to why these thoughts occur, hadthey thought of how they would do it and what was it that stopped them fromsuiciding. If, after speaking with the client, I believed that the client didnot have any intention of suicide, but felt that I would benefit from furtheradvice and reassurance, I would speak with my safeguarding officer orsupervisor.If the victim replied that they had recent thoughts ofsuicide and did intend carry out these thoughts, I would then ask the followingquestions:Have they made a plan of how they plan to suicide? If theysaid yes, I would then ask that they tell me about it. I would clarify whetherthey had a timeframe to carry out the suicide, what method they planned to use,for example, taking an excessive amount of medication.
I would then ask furtherquestions to establish what the medication was, where they were keeping it andif they had any of the medication on them at the moment. I would also ask whythey had not carried out the act yet and ask questions about what/who it wasthat was keeping them from doing so. For example, if they mentioned that theyhad a younger sister that they were close to, I would ask the client questionsabout that person to allow them to recognise potential reasons to keep themfrom suiciding.I would then speak with the client, reaffirming our contractand inform them that I would need to speak with my safe guarding officer aboutwhat we had discussed, ensuring that they were aware that this was aboutkeeping them safe, not that they had done anything wrong.
If I believe that a client is self-harming I would ask themdirectly about this. The client may admit that they are or they may deny it.However, it is important to recognise that the client may be using self-harm asa coping strategy and to ask them to stop doing this, may potentially be moreharmful to them. Therefore, I would ask the client questions such as; why theywere self-harming, what they were thinking when they did it, how did it makethem feel, did they feel better or worse than before they carried out theself-harm.
If for example, the client cut themselves, I would ask them whetherthey would consider trying something else,for example…….but I would not tell them that they need to stop, as thismay cause them to feel guilt and shame about their behaviour and that they arebeing judged may possibly stop them from attending further counselling sessions.