Client suicidal behaviour: Impact, interventions, and implications for psychologists

Abstract

Members of the Australian Psychological Society's Colleges of Clinical and Counselling Psychologists were surveyed to ascertain the incidence and impact on them of client suicidal behaviour. Also sought were their opinions about preferred interventions in managing high-risk clients, and coping strategies in the event of a client suicide. Four hundred and thirty-seven responded, a return rate of 29%. Just over half (n = 244) were members of the College of Clinical Psychology, 187 were members of the College of Counselling Psychologists and 5 were members of both colleges. More than one third (n = 170) had experienced one or more completed client suicide, 332 had experienced attempted suicide, 377 noted threats or suicidal gestures, and 396 suicide ideation. Clinical psychologists rated hospitalisation, referral to a GP or psychiatrist, and restricting access to means of suicide as more effective interventions than counselling psychologists, who rated verbal “no suicide” contracts as the more effective intervention. Psychologists who had experienced a client suicide ranked recognising that they were not responsible, talking with their colleagues, an increased acceptance of suicide as a possible outcome, and talking with their supervisors as the most helpful strategies following the event. Less than half could recall any aspect of pre-registration training in dealing with suicidal clients, although most had undertaken some professional development since. The authors conclude that further research is needed to determine the effective intervention strategies for working with suicidal clients.