Guidelines for Suicide Intervention
Play therapists support children experiencing suicidal ideation beyond the initial crisis assessment. To help prevent suicide, play therapists provide suicide intervention by addressing mental health concerns, increasing coping strategies, and fostering resiliency. Play therapists can use the following guidelines for suicide intervention.
Teach New Coping Skills statements in subsequent sessions. Play therapists use developmentally appropriate questioning to follow up on suicidal ideation, such as “Last week you told me wanted to die with a knife. Have you been thinking about this again since you saw me last week?” Additionally, monitoring can occur through observation of play behaviors and themes, such as instability, anxiety, or hopelessness. Ray (2011) suggested the play theme of hopelessness can convey the internal message, “I have given up. suicidal ideation, play therapists focus on teaching new coping skills so that suicide is no longer the solution for problems.
As play therapists learn about children’s experiences through play,
they provide hope in the face of despair through relationship, presence, and bearing witness to emotional pain.
Suicidality is connected to emotional distress, and children in crisis may experience feelings of anger, depression, anxiety, sadness, and inpatient facility for suicidality, children who attempted suicide had with emotion regulation skills than children with suicidal ideation but no help children experiencing suicidal ideation develop emotional regulation skills (i.e., stress management, expressing and communicating feelings, understanding the feelings of others, adapting to change) through nondirective or directive approaches. For example, play therapists may facilitate emotional expression through sandtray prompts, such as “Create a scene about your anger” or through games like emotional charades.
Coping skills that help children communicate feelings may be especially needed for children who say, “I wish I was dead,” but screen at low risk for suicide. As a school counselor, I frequently worked with children who made such statements. I remained open and curious when screening for suicide, and I was able to teach them new skills for expressing their emotional pain. In such cases, I reminded them of my role: “When you say, “I wish I was dead”, I will always stop and ask you what you mean by that because I want to help make sure you stay alive.” I helped children
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gain perspective by reframing their statements: “You’re saying, ‘I wish I was dead’, but it seems you don’t really want to die forever. Instead, I think you’re trying to say that you’re so angry and sad right now. Is that right?” I used puppets and role play to introduce new skills: “I think there are other ways you could let your teachers, parents, and me know how angry and sad you’re feeling. Let’s practice some of those.” I always reminded children of the importance of letting adults know about suicidal thoughts that occur again.
Collaborate With Parents Parents and caregivers are vital partners for preventing childhood suicide. Parents should be provided with resources from suicide prevention organizations to better recognize warning signs and risk factors. Play suicidal ideation. This is important, because parents may feel scared, shocked, or confused when they hear suicidal statements and respond with statements, such as, “Don’t think about it,” or “You’ll feel better soon.” Filial therapy can help parents increase empathy and understanding of children’s emotional pain and reduce parental stress (Landreth & Bratton, 2019). Skills, such as reflective responding, may help parents respond to suicidal ideation in ways that encourage open communication, such as, “You’re worried right now. How can I help?” Filial therapy’s emphasis on the parent-child relationship and connection can help parents better attune to their children and enjoy special time together. Parents can learn skills for setting limits around issues of safety: “You’re feeling so upset, but hurting yourself isn’t safe. You can choose to do one of the ideas from your safety plan, like talking to me or coloring. I love you, and I’m worried about you.” Filial therapy principles can help parents learn to regulate their response, extend patience to themselves, and develop stronger resources for supporting the serious needs of their children in crisis.
Parents are partners throughout the process of treatment. Play
therapists offer hope to parents of children experiencing suicidal ideation that children can learn new solutions for their problems and live. One way to offer hope for parents is to share the therapeutic powers of play and help parents understand that play therapy can increase resilience and resources as children better communicate, gain emotional wellness, experience
social relationships,
Play therapists in school or community settings may encounter procedures given the seriousness of suicidality. As mandated reporters, play therapists adhere to ethical codes and legal mandates as well as workplace guidelines designed to ensure safety and communication with various stakeholders.
School-based play therapists can facilitate home-school communication about a child’s suicidality and progress through consistent contact with caregivers. School-based play therapists should detail how the child will navigate through the school building to ensure safety and supervision. For example, a child may need to be accompanied at all times if there is a
and increase personal strengths
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