In Response to- "trying" to do

David,

This is a very heavy responsibility and one that I am familiar with in my role

at the adolescent residential treatment center. You don't want to make even
one mistake.

True, one mistake = a death that should not have happened.

Is the person upset because the person is alive? If the person is
really upset because she is alive, this would suggest that the person
still wants to die. This would not be a good person to clear.

I went on a call involving a 31 yr old white male Dx with AIDS
The Dx was made on 6-6-96 he thought it was a sign he was going to hell. When
he woke up in the ER he was not upset -- he was PISSED OFF.

This was not be a good person to clear.

The interviewer could present the client with an imaginary situation >in which

someone offered the client several means of killing himself >just prior to the
self-injury incident: (a) a loaded gun, (b) some >pills, (c) a knife. Which
one would the person have chosen instead >of the one the person actually used?
If the person's discussion of >this imaginary situation indicates that the
person would have chosen >a more lethal means, this is not a good person to
clear.

I (Mark) would never give this situation, It would be like telling them next
time try a more effective way or at the very least you may be suggesting
something they did not think of. Some Client's my even get more depressed.
Example "Gosh, my life sucks so bad I can't even kill myself right!"

I liken it to a little bit like a sale, NEVER bring up an objection the
customer did not think of, because you will never close the deal.

In slang, don't suggest something crazy to a crazy person they may try it.!!

You can test for the controlled variable in a not so direct way.
1) does the Client have any future plans (purpose).
2) does the Client express remorse (are they reorganizing).
3) does the Client list any reasons for living.
4) does the Client reference any Values Ethics or Morals for living.
5) does the Client refer to intrapersonal to interpersonal issues.

These are a few different way to test if the is likely to commit suicide.
After all suicide is the worst form of self criticism.

M. Lazare

DTSDTO@AOL.com

Mark didn't like my hypothetical situation of testing for the variable:
Is the person still suicidal? It is a good clinical practice to start
off with more general, less directive questioning. So, I agree with
Mark.

Asking the person: if you were going to replay the scene of last night,
what would you do differently to make things come out better? would be
less suggestive, less directive. If the person repeated her action,
or came up with a more effective means, this would not be a good person
to clear.

The major reason for having someone in Mark's role is to save time and
money which would be involved in keeping a person in the hospital a bit
longer. This is what he is being paid for. This puts him in a bind.
If he decides to keep all suicide attempters in the hospital, there is
no need for his position. If he attempts to clear as many people as
possible, he runs the risk of a person killing himself sooner or later.
Not an easy position to occupy.

ยทยทยท

From: David Goldstein
Subject: Re: In Response to "trying" to do
Date: 12/13/97