Abstract
This paper will explore the various theories and principles of counseling suicidal children and adolescents. It will provide a brief overview of the different theories and principles used to effectively counsel these clients, including cognitive-behavioral therapy, hopelessness theory, interpersonal psychological theory, family therapy, and related therapy principles for suicidal adolescents. Additionally, the paper will discuss one specific game, activity, or expressive technique used to help these clients. The paper will conclude by discussing the potential benefits of counseling and the challenges counselors face when working with these clients.
Keywords: cognitive-behavioral therapy, hopelessness theory, interpersonal psychological theory, family therapy, suicide
Suicide Among Adolescents: Theories, Principles and Counseling Techniques
Introduction
Suicide is an increasing problem among children and adolescents and is the third leading cause of death in these age groups in the United States (American Foundation for Suicide Prevention, 2019). Further, it is estimated that 1.5 million children and adolescents attempt suicide each year (CDC, 2020). Thus, suicide is a leading cause of death among children and adolescents in the United States. The tragedy of suicide is further underscored by the fact that it is often preventable with the appropriate counseling and treatment. Due to the complexity of the issue and the need for specialized care, counselors must have a strong understanding of the theories and principles used when counseling suicidal children and adolescents. Therefore, school counselors, mental health professionals, and other staff who work with children and adolescents must know the theories and principles of counseling suicidal children and adolescents. This paper seeks to provide an overview of fundamental theories and principles used in counseling suicidal children and adolescents, as well as a discussion of an activity or technique used with this population.
Theories and Approaches of Suicide Counseling Among Adolescents
Interpersonal Psychological Theory
The most widely accepted theory of suicide is the interpersonal psychological theory (IPT) developed by Joiner (2005). According to IPT, three key components must be present in order for an individual to be at risk for suicidal behavior: the feeling of not belonging or being accepted by others termed as perceived burdensomeness; the feeling that one is unable to cope with the stressors in their life referred to as thwarted belongingness; and the acquired capability to engage in suicidal behavior (Joiner, 2005).
Interpersonal psychological theory can be applied to counseling adolescents with the suicidal disorder in several ways. Firstly, it can help adolescents identify and understand their own emotions and the emotions of others in order to manage their own emotions and relationships better. Secondly, it can help the adolescent explore interpersonal patterns and dynamics to gain insight into the origins of their suicidal thoughts and feelings. Thirdly, it can be used to help the adolescent develop better coping skills for managing suicidal ideation and feelings. Finally, it can help the adolescent build a more positive self-image and sense of self-worth, which can be a powerful tool for preventing future suicidal thoughts and behaviors.
Cognitive-Behavioral Theory
In addition to IPT, the cognitive-behavioral theory (CBT) of suicide has been used to explain suicidal behavior in children and adolescents (Klonsky, 2007). CBT states that suicidal behavior results from faulty thinking patterns, or cognitive distortions, which lead to maladaptive behaviors and emotions. For example, an individual may engage in negative self-talk and rumination, which can lead to feelings of hopelessness and helplessness, leading to suicidal behavior. Cognitive-Behavioral Therapy (CBT) is an evidence-based approach to counseling adolescents with suicidal disorders. CBT focuses on changing the thoughts and behaviors associated with suicidal ideation, which can lead to improved functioning, decreased distress, and improved overall well-being.
In the context of suicidal disorder, CBT can help the adolescent identify, challenge, and replace distorted thinking patterns that can lead to suicidal behavior (Klonsky, 2007). For instance, the therapist can guide the adolescent to recognize and confront any distorted beliefs they may have regarding suicide, such as “I am worthless, and my life has no meaning,” and replace them with more helpful and realistic thoughts, such as “I have value, and my life has a purpose.” In addition, CBT can help adolescents develop healthy coping skills and problem-solving strategies to manage their suicidal thoughts and behaviors. The therapist can encourage the adolescent to engage in activities that reduce the likelihood of suicidal behavior, such as exercise, journaling, connecting with supportive people, or engaging in creative activities.
Most importantly, CBT can be used to help adolescents develop a safety plan for times when they are feeling suicidal (Klonsky, 2007). This plan typically outlines preventative steps the adolescent can take to avoid suicidal behavior and coping strategies for managing their suicidal thoughts. It also includes a list of people the adolescent can reach out to for help if necessary. Overall, CBT can be a powerful tool for helping adolescents with suicidal disorders manage their thoughts and behaviors healthily and effectively.
Hopelessness Theory
Another critical theory of suicide is the hopelessness theory (HT), developed by Beck (1974). According to HT, a person’s sense of hopelessness is the primary factor that leads to suicidal thoughts and behaviors. HT states that a person’s hopelessness results from negative cognitions about the future, such as a feeling of helplessness, a belief that one’s goals are unattainable, and a lack of perceived control over one’s life. Hopelessness theory can be applied in counseling adolescents with suicidal thoughts to help them recognize and manage their feelings of hopelessness. The idea behind the theory is that feelings of hopelessness can lead to suicidal ideation and behavior. By understanding the underlying causes and triggers of these feelings, adolescents can learn to recognize, manage, and ultimately reduce their feelings of hopelessness.
The counselor can help adolescents identify their negative beliefs and thoughts about themselves, their future, and the world around them. They can then explore alternative perspectives and ways of thinking that could help reduce hopelessness. Through this process, the counselor can help the adolescent to gain insight into the causes of their suicidal thoughts and feelings, as well as develop coping strategies to manage them. This process aims for adolescents to gain a more balanced, optimistic perspective of themselves and the world around them, thus reducing the risk of suicide.
Family Therapy
Family therapy is another approach to helping suicidal children and adolescents (Rutledge, 2016). Family therapy focuses on helping the family work together to create a supportive and safe environment for the client. It can also help to identify and address family dynamics contributing to the client’s suicidal ideation. Family therapy is an effective form of therapy for adolescents suffering from a suicidal disorder. The approach taken in family therapy can be tailored to meet the individual needs of the adolescent and the family.
In family therapy, the therapist works with the adolescent and the family to identify the underlying issues contributing to the adolescent’s suicidal thoughts and behaviors. This can include exploring family dynamics, communication styles, and coping strategies (Rutledge, 2016). Through this exploration, the therapist can help the family to identify areas where they can provide more support and understanding to the adolescent. The therapist can also work with the family to identify more effective ways of communicating with the adolescent and help them to develop better problem-solving skills. This can include teaching them to identify and constructively express their feelings. The therapist may also provide guidance on how to structure interactions with the adolescent to reduce conflict and encourage cooperation. In addition, the therapist can help the family develop a plan to best support the adolescent, including how to recognize warning signs of suicidal thoughts or behavior and how to provide appropriate help.
Further, family therapy can also provide a safe and supportive space for adolescent to express their thoughts and feelings and to make sense of their suicidal thoughts and behaviors. This can be an essential part of helping the adolescent to build resilience and self-esteem. Overall, family therapy can be a practical approach to counseling adolescents with suicidal disorders. It allows the family to understand the adolescent’s experience and develop more effective ways of supporting them.
Principles of Suicide Counselling Among Adolescents
In addition to these theories, several principles have been identified as essential in working with suicidal children and adolescents (Hersh, 2018). Principles of suicide counseling among adolescents are vital because they provide a framework for understanding the complex issues contributing to a young person’s suicidal thoughts and behaviors. They also help counselors to provide more effective and compassionate care to those in need. By understanding adolescents’ unique risks and needs, counselors can better create a safe and supportive environment in which adolescents can explore and process their thoughts and feelings. Ultimately, these principles help to reduce the rate of suicide among adolescents and provide them with the necessary tools to live healthier and more fulfilling life. In this section, three principles of counseling suicidal adolescents will be discussed: understanding their risk factors, utilizing a strengths-based approach, and creating a safe environment.
Understanding Risk Factors
The first principle of counseling suicidal adolescents is to understand the risk factors for suicide. Risk factors include mental illness, substance abuse, access to lethal means, family history of suicide, violence, bullying, and a lack of social support (Centers for Disease Control and Prevention, 2021). It is essential to understand the risk factors so that the counselor can better assess the risk of suicide and provide appropriate treatment.
Therefore, understanding risk factors in suicide counseling among adolescents is critical in identifying potential warning signs of suicidal behavior and helping prevent it from occurring. By understanding these risk factors, counselors can evaluate the individual’s risk for suicide, provide appropriate interventions, and create a safety plan. Additionally, understanding risk factors can help counselors provide better support to adolescents during difficult times, such as during times of transition, loss, or grief. Counselors can also use risk factors to help identify additional resources and services that may benefit the individual.
Utilizing a Strengths-Based Approach
The second principle of counseling suicidal adolescents is to utilize a strengths-based approach. This means that the counselor should focus on the individual’s strengths and resilience rather than their weaknesses (Adeigbe, 2021). This approach can help adolescents build their self-esteem and self-efficacy, which can help them cope with suicidal thoughts.
A strengths-based approach to suicide counseling among adolescents can be incredibly beneficial in helping them to find the hope and resources they need to make positive changes in their lives. This approach focuses on the positive aspects of a person’s life, such as their unique talents and abilities, and helps them build on these strengths to create positive change (Adeigbe, 2021). This approach also encourages adolescents to find individual solutions and develop their coping strategies to deal with difficult situations. This can help them to develop more resilience and to build a stronger sense of self-efficacy. Additionally, it allows the counselor to offer more individualized and tailored support, as they can identify the specific strengths that the adolescent has and can use them to create and implement a tailored plan of action. Finally, this approach also encourages adolescents to be open and honest with their counselors, as they can trust that their strengths will be recognized and utilized in a meaningful way.
Creating a Safe Environment
The third principle of counseling suicidal adolescents is to create a safe and supportive environment. Thus, the counselor should ensure that adolescents feel safe to talk about their thoughts and feelings without fear of judgment or repercussions (King, Arango, & Foster, 2018). It is also essential to ensure that the adolescent has access to resources and supports if needed.
The role of a suicide counselor in creating a safe environment for adolescents is crucial. A suicide counselor should provide a safe, non-judgmental, and supportive environment for adolescents struggling with suicidal thoughts. The counselor should also create a safe environment for open discussion of suicidal ideation and provide resources to help adolescents find healthier coping skills (King, Arango, & Foster, 2018). Furthermore, a suicide counselor should be able to recognize the signs and symptoms of suicide, ensure that the adolescent is in a safe environment and create a plan of action to reduce the risk of suicide. The counselor should also be able to provide crisis intervention and suicide prevention services, such as providing information on how to access mental health services and resources. Finally, the counselor should be able to support the adolescent’s family and friends and refer them to appropriate services and resources.
Game, Activity, or Expressive Technique
One game, activity, or expressive technique used with suicidal children and adolescents is the “Suicide Safety Plan” game (Robinson, 2018). This game is designed to help children and adolescents identify coping strategies and develop a plan for staying safe during distress. The game involves creating a “safety plan” with the child or adolescent, which includes identifying potential triggers, warning signs, and safe people to talk to. The child or adolescent is then encouraged to develop creative and positive coping strategies that can be used when feeling overwhelmed or suicidal. This game can help the child or adolescent develop a sense of control and hope in managing their suicidal thoughts and behaviors.
The game also includes videos and activities to help teens understand the risks and resources available for suicide prevention. Through the game, adolescents are encouraged to build resilience, communication, and problem-solving skills and to practice self-care. The game also encourages adolescents to seek help and support from those around them. The “Suicide Safety Plan” game can be used in suicide counseling to engage adolescents in a meaningful and productive discussion about suicide. The game can help adolescents identify warning signs and create a safety plan. It can also encourage adolescents to seek help and recognize the importance of self-care and communication.
Conclusion
Suicide is a serious issue among children and adolescents. School counselors, mental health professionals, and others who work with this population must know critical theories and principles for counseling suicidal children and adolescents. This paper has provided an overview of the interpersonal psychological theory, cognitive-behavioral theory, and hopelessness theory of suicide and discussed the importance of building a trusting relationship, focusing on safety, understanding the context of the suicidal thoughts, helping the individual to identify and cope with their emotions, teaching problem-solving skills, and providing hope and support. Additionally, an activity or technique used with suicidal children and adolescents, the “Suicide Safety Plan” game, was discussed. It is projected that this paper will provide a better understanding of the theories and principles of counseling suicidal children and adolescents.
References
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Robinson, S. (2018). Working with suicidal clients: Activities to help build safety plans. Retrieved from https://www.goodtherapy.org/blog/working-with-suicidal-clients-activities-to-help-build-safety-plans-0926178.
Rutledge, J. (2016). Family therapy for suicidal children and adolescents. Journal of Clinical Psychology, 72(7), 843–855.
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