working with suicidal clients. Informed consent with a suicidal client can help to provide structure to treatment, disclose risk appropriately, and inform the client of ground rules such as the limits and boundaries of confidentiality. This is a necessity when considering the issues of duty to warn and involuntary hospitalization that go along with suicide risk. A multicultural factor to consider while developing this informed consent was different cultures and religions and the individuals and families who are parts of these groups have different attitudes, values and beliefs regarding suicide. These values may pose challenges for counselors with these groups. Negative attitudes may promote shame for families who have experienced suicide death. In some cultures, suicide is regarded as an honorable choice. The knowledge and understanding of specific cultural beliefs may assist in identifying and determining risk for suicide. A strategy that could be utilized with the clients permission, is involving family in the informed consent process or in a discussion of risks and benefits of treatment can offer multiple potential benefits including educating them about warning signs and emergency resources. If the clients decide to include their family the counselor can work engaging them to support the therapeutic goals and process. This will in turn strengthening the safety net available for this individual and could minimize the potential for lawsuits in the event of a suicide attempt or death.
Collaborating with colleagues and supervisors and asking for their views regarding the client’s condition could be beneficial.
This collaboration could potentially be critical in understanding the level of risk. If I have any doubts about the level of my competency I would consider a professional collaboration over a referral. A client may need to be referred to a physician for a medication evaluation in some cases, and collaboration as well as a referral may become necessary. This can be addressed if a client denies suicidal intent, yet shows evidence of serious depression, as a counselor I would ask further questions possibly make a referral for further evaluation. A counselor can participate in and contribute to decisions that affect the well-being of clients by drawing on the perspectives, values, and experiences of the counseling profession and those of
colleagues. A risk management strategy that could be used with a suicidal client is developing a safety plan with the client. I could also consult with an attorney to make sure I am attending to the legal aspects involved in this case, which can be considered a risk-management intervention as well. I will also be sure to become aware of local and state laws that pertain to my specific practice, as well as the policies of any agency for whom you work. By keep up to date with legal and ethical changes, becoming involved in professional organizations and attending risk management workshops I can work to ensure ethical practice. This informed consent fits into my personal model for ethical practice. It is clear and concise. This informed consent reflects legal mandates into an ethical perspective. I will feel compelled to apply these principles to practice with all clients. This process will be easily facilitated when there is congruence between personal and professional values. I intend on practicing and living the ethical standards of the profession.