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Suicidal client helped over the phone
Hi Everyone,
Peggy Olson shares with us this experience with a suicidal client. Please note that this work was done over the phone. The client was suicidal at the moment and thus waiting for a future appointment may have been too late. I know some practitioners hesitate to use EFT over the phone because it is "more appropriate" to do this in an in-person office environment. However, in this case, a decision to wait could have been a fatal one. Just something to think about.
Hugs, Gary
Hi Gary,
Yesterday I used EFT successfully with a very suicidal client. This was a new client referred to me that I have not seen yet in person. I phoned her to make an appointment and she stated she was feeling very suicidal and was going upstairs to take some pills to depart from this life. We talked about why she had phoned me and then I asked her if she would be willing to try a method to reduce her suicidal feelings. She hesitantly said ok. I had to say the affirmation for her for the first couple of times and then we went through the routine over the phone telling her where to tap and tapping on myself at the same time. After the first round, she stated she felt better. We did the routine three times and she said now she did not feel suicidal anymore, just really sad. We brainstormed what she could do to take care of herself and how she would spend the rest of the day, but she assured me she was now ok and would not hurt herself.
I called the next day to do a routine check in and she said that she was so appreciative for the time spent teaching her how to eliminate those suicidal feelings and that she felt a light had been turned on for her that gave her hope for the future. She has not had the suicidal feelings return and is looking forward to our meeting in person next week.
Thank heavens for these new therapies that allow us to help people help themselves quickly. Peggy Olson, LPC
[Richard Costa responds to Peggy Olson]. You know, I hope that before doing telephone treatment that there is a good solid assessment, backup plan, no suicide contract and all the other stuff.
Sheesh. This makes me nervous!! You are fortunate that this was a good outcome but how can you intervene with someone that you do not even know yet??? Lets be careful out there with our enthusiasm.
Richard M. Costa, L.C.S.W.
[Harry Corsover responds to Richard Costa]. While these are valid points, how can you not intervene if you find yourself on the phone with someone who says he is about to go and take his life? Just how do you suggest doing a solid assessment, etc. at that moment?
I think most of us, if faced with such a situation, would use whatever skills or tools we have available. In the past, that was limited to cognitive interventions, persuasion, looking for some therapeutic leverage, looking for something that we might be able to use to get the person to stay alive long enough to either get into our office or for emergency services to arrive. None of those approaches have any greater guarantee of success than tapping (and perhaps a lot worse, if there is no established therapeutic relationship).
I really don't understand what you would suggest doing instead.
Respectfully, Harry Corsover
Hi Everyone,
I want to thank Richard Costa for his cautionary comments on Peg Olson's post about dealing with a suicidal client over the phone. Suicide, of course, is a bit different than fingernail biting and professionals need to weigh these things. Also, Peg did not go very deep into the details of this case. Thus cautionary flags might naturally go up.
Richard's comments sparked some spirited messages which, to date, have taken the other side of this subject. Differences of opinion are healthy indeed. This is how we learn. This is how we make progress. I am also very pleased at the professional manner (and language) in which this debate has been conducted. Points have been made without making personal comments. That speaks to the quality of this forum. Thank you all.
Below is Peg Olson's response.
Hugs to all, Gary
Hi Gary,
Just read Richard Costa's email and response from Harry Corsover and I agree wholeheartedly with Harry. How, when I have never met this person, am I going to get a solid assessment? And so should I just ignore the fact that this person is actively suicidal and because I haven't seen her just refer her to the crisis line? I did ask for a no suicide contract with her and also asked if she would be willing to get someone to come and stay with her. She refused my suggestion to ask anyone to come and stay with her. And so if I have some skill or treatment I feel has any chance of helping her, why would I withhold that intervention or treatment?
What does that say about me as a licensed professional counselor and a human being if I do not use all the skills I have to attempt to help this person? What she gains is some time connecting to another human being in a moment of feeling out of sync with the whole world. I am very grateful I was willing to use this method with this woman as it renewed a spark of life in her that wasn't there when I phoned. I told her at the end of the phone call that I would be phoning her for a check-in call the next day and to please call if she had a return of the suicidal feelings. I asked her to make plans to be with a friend and to find some activity in which she could use to help her over this hump in the road and to visit a friend and perhaps stay the night at a friend's house. I asked her if she felt she could keep her no suicide contract with me until she had her appointment and she said I had to trust her to do that. Being very intuitive I have to go with my intuition and I believed this woman. Talking to her the next day was like talking to another person-her voice was cheerful and she thanked me for calling and said she was looking forward to our appointment.
Interestingly enough, I also brought this case up in supervision at my state agency today. (This case is in my private practice, but I work as a contract therapist for half the week at a state wide agency and just wanted some feedback on this case.) All the therapists agreed with the way I handled the case.
I would like to know what you think could have been handled differently. I am satisfied with the choice I picked.
Thanks, Harry, for mirroring my own thoughts on this subject.
Best Regards, Peggy Olson, LPC
[Don Elium responds on this topic]. With EFT, I have found that going for the heart of the suicidal pain--gently, lovingly, and firmly--as soon as I can gives the client enough relief to come out of the "suicidal zone" (usually called a 10) where suicide is the only logical option. Once down to even a 7 or 8, the thoughts change from, I am going to and I know how to and I want to but I won't right now. At this point, I can get the contract with them to call me if they feel or think they will. That is, if time is short on the phone, etc. Before I was afraid to address the PR of "Even though I have a plan to kill myself and end this meaningless suffering, I totally love, accept, and forgive myself for" because I thought it would make it worse. Now, I say it for them if they can't.
Also, I am all for backup plans, solid assessments and avoiding cavalier attitudes. However, I am truly amazed, astonished, and very thankful, that the EFT does what it does in these situations. EFT has cut down the "Suicidal Crisis Return Client Phone Call" time from hours, to minutes. I think that is a blessing for the client, and me. Don Elium, MA MFCC
