Preventing, Detecting, and Addressing Suicidality in Play Therapy Settings
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| LISA COWART, MA, LPC-S, RPT-S, NCC
children and adolescents who eventually die by suicide, suicidal thoughts are often not detected by health providers during the point of care (The using play therapy interventions to improve protective factors reduces suicide vulnerability.
Screening for Suicide Although national safety guidelines implore therapists to screen children health professionals are not screening for this critical risk (Goldstein Grumet et al., 2019). Part of the suicide screening process is reviewing client personal and medical history for suicide risk during the initial intake screening all clients for suicide in therapy settings using clinical judgment and a screening tool. One of many tools is the Columbia Suicide Severity Rating Scale (CSSRS). For younger children, suicide assessment includes giving caregiver questionnaires during the screening process. Symptom to screen directly for suicide throughout treatment. Therapists should review screening responses prior to session so any concerns can be assessed further and addressed immediately.
30 | PLAYTHERAPY | September 2021 |
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Children may not initiate conversations about suicide and sometimes may exhibit somatic complaints as a warning sign (e.g., headaches assessment is to ask about suicide. Asking directly does not increase an
Policy mental health settings have a policy in place concerning suicide. The policy may include when the play therapist plans to screen for suicide, such as during phone intake, initial contact, and in subsequent sessions. The policy also may include what tools a therapist will use to screen and what action steps a therapist plans to take if a child discloses suicidal thoughts or plans. Play therapists will also determine policy based on their scope of practice, their particular setting, and the resources available to them.
Risk Factors and Warning Signs Some populations at higher risk include younger children who have been without hyperactivity, adolescents diagnosed with depression (e.g., have recently disclosed sexual abuse or have an abuse history; who have a history of trauma or loss; who are survivors of a loved one who died by suicide; who have previously attempted suicide or have been previously admitted to inpatient care for mental health concerns; who
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