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

Members of the Australian Psychological Society's Colleges of Clinical and Counselling Psychologists were surveyed to ascertain the incidence and impa ct on them of client suicidal behaviour. Also sought were their opinions ab out preferred interventions in managing high-risk clients, and coping strat egies in the event of a client suicide. Four hundred and thirty-seven respo nded, a return rate of 29%. Just over half (n = 244) were members of the Co llege of Clinical Psychology, 187 were members of the College of Counsellin g Psychologists and 5 were members of both colleges. More than one third (n = 170) had experienced one or more completed client suicide, 332 had exper ienced attempted suicide, 377 noted threats or suicidal gestures, and 396 s uicide ideation. Clinical psychologists rated hospitalisation, referral to a GP or psychiatrist, and restricting access to means of suicide as more ef fective interventions than counselling psychologists, who rated verbal "no suicide" contracts as the more effective intervention. Psychologists who ha d experienced a client suicide ranked recognising that they were not respon sible, 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 h ad undertaken some professional development since. The authors conclude tha t further research is needed to determine the effective intervention strate gies for working with suicidal clients.