Suicidal prevention from a solution focused approach

GUEST BLOG by JOHN HENDEN BA(Hons) RMN Dip Couns(Univ of Bristol) MBACP FRSAI have been teaching the solution focused approach to suicide prevention since 1996. The tools and techniques were developed out of working in a crisis slot at a community mental health centre, where there was not a single suicide in 3 years. Colleagues and I, in focusing at the time on ‘what works’, discovered that there were 10 key points we covered in the first session; which not only encouraged clients to choose life over death, but also inspired them to live fuller lives, once their suicidal thinking was past. Showing deep empathy, being sincere and genuine as they were relating their pain and not showing fear of the ‘worst case scenario’, were just three of these 10 key points.Many practitioners can miss the subtleties in communication when dealing with people who might be considering the suicide option as a solution to their difficulties. The statistics are alarming: around 65% of people who complete suicide, have seen a practitioner within the previous four weeks. It is important, therefore, to equip practitioners well, in this vital area of work with suicidal people.On my 2-day intensive Suicide Prevention workshops, I provide a list of about a dozen questions to choose from which are designed to elicit suicidal ideation, if indeed, it is there. Variously, these have been described as ‘fishing questions’ and are quite tentative in nature. One is: “With all this going on for you, how much more can you cope with?” It is important for practioners to be made aware of both the words use in reply, and any non-verbal communication that may be saying something else.Within this list, there is one direct question which asks about their preferred method of suicide, should they be thinking seriously about it. If a positive answer is given to this, practitioners are urged to move into the second battery of questions, which have been refined and developed over several years. The list is called, ‘Sample questions for the suicidal person, once suicidal ideation has been established’. These cover the basic SF techniques: scaling, exceptions and attempted solutions, etc; and, the specialist SF techniques of graveside scenario, miracle question(adapted), deathbed scenario(adapted) and others.Participants on the 2-day workshops are encouraged to list the numerous non-verbal communications which could indicate suicidal intent. On some workshops, as many as 40 have been listed.  Workshops allow much practice on the various techniques used, in the safety of the classroom. Invariably, confidence in working with the suicidal can increase by about 2 points on the 1-10 scale, at the end of the 2 days.My book entitled, ‘preventing Suicide: the solution focused approach’ has now gone for its 4th printing, and I am delighted that it will be published in Japanese by the end of 2014. Negotiations are underway currently, for a Polish and Finnish translation.John Henden