TABLE OF CONTENTS
I. Understanding Suicide and You
Tip 1: Reflect on Your Biases about Suicide. Tip 2: Take Stock of Your Experiences with Suicide (or Lack Thereof). Tip 3: Confront “Suicide Anxiety.” Tip 4: Be Alert to Negative Feelings Toward the Suicidal Person. Tip 5: Reject the Savior Role. Tip 6: Maintain Hope.
II. Overcoming the Taboo
Tip 7: Face Your Fears. Tip 8: Directly Ask about Suicidal Thoughts. Tip 9: Turn to Techniques for Eliciting Sensitive Information. Tip 10: Embrace a Narrative Approach: “Suicidal Storytelling.” Tip 11: Ask about Suicidal Imagery, Too. Tip 12: Uncover Fears of Hospitalization and Other Obstacles to Disclosure.
III. Joining with the Suicidal Person
Tip 13: Recognize that, for Some People, You are an Enemy. Tip 14: Avoid Coercion and Control Whenever Possible. Tip 15: Resist the Urge to Persuade or Offer Advice. Tip 16: Understand the Person’s Reasons for Dying. Tip 17: Validate the Wish to Die. Tip 18: Acknowledge that Suicide is an Option.
IV. Assessing Danger
Tip 19: Gather Remaining Essentials about Suicidal Thoughts and Behavior. Tip 20: Learn About Prior Suicidal Crises: The CASE Approach. Tip 21: Cautiously Use Standardized Questionnaires. Tip 22: Privilege Warning Signs Over Risk Factors. Tip 23: Screen for Access to Firearms. Tip 24: Inquire about Internet Use. Tip 25: Probe for Homicidal Ideation. Tip 26: Collect Information from Family, Professionals, and Others.
V. Assessing Protective & Cultural Factors
Tip 27: Examine Reasons for Living. Tip 28: Identify Other Protective Factors. Tip 29: Pay Attention to Culture. Tip 30: Investigate Religious and Spiritual Views of Suicide.
VI. Putting It All Together: Estimating Risk
Tip 31: Solicit the Person’s Own Assessment of Suicide Risk. Tip 32: Estimate Acute Risk for Suicide. Tip 33: Estimate Chronic Risk for Suicide. Tip 34: Document Generously.
VII. Attending to Immediate Safety
Tip 35: Know When and Why to Pursue Hospitalization. Tip 36: Know When and Why Not to Pursue Hospitalization. Tip 37: Do Not Use a No-Suicide Contract. Tip 38: Collaboratively Develop a Safety Plan. Tip 39: Encourage Delay. Tip 40: Problem-Solve around Access to Firearms. Tip 41: Discuss Access to Other Means for Suicide, Too. Tip 42: In Case of Terminal Illness, Proceed Differently (Perhaps). Tip 43: Seek Consultation.
VIII. Planning for Treatment
Tip 44: Make Suicidality the Focus. Tip 45: As Needed, Increase Frequency of Contact. Tip 46: Treat Chronic Suicidality Differently. Tip 47: Involve Loved Ones. Tip 48: Suggest a Physical Exam. Tip 49: Recommend an Evaluation for Medication. Tip 50: Continue to Monitor Suicidal Ideation.
IX. Alleviating Psychological Pain
Tip 51: After Safety, Address Suffering. Tip 52: Look for Unmet Needs. Tip 53: Target Social Isolation. Tip 54: Use Grounding Exercises.
X. Exploring Motivations and Misgivings
Tip 55: Assume Nothing: Does the Person Want to Give Up Suicide? Tip 56: Tap Into Ambivalence. Tip 57: Compare Reasons for Living and Dying. Tip 58: Invite the Person to Look for the “Catch.” Tip 59: Search for Exceptions.
XI. Inspiring Hope
Tip 60: Frame Suicide as a Problem-Solving Behavior. Tip 61: Help Brainstorm an “Options List.” Tip 62: Teach the Problem-Solving Method. Tip 63: Nourish Future Plans and Goals. Tip 64: Incorporate a Hope Kit. Tip 65: Highlight Strengths.
XII. Drawing from Cognitive Behavior Strategies
Tip 66: Connect Suicidal Thoughts to Other Thinking. Tip 67: Educate about Cognitive Distortions. Tip 68: Help Challenge Negative Thoughts. Tip 69: Elicit Coping Statements. Tip 70: Rescript Suicidal Imagery. Tip 71: Discourage Thought Suppression. Tip 72: Foster Acceptance of Suicidal Thoughts.
XIII. Improving Quality of Life
Tip 73: Enhance Coping Skills. Tip 74: Cultivate Mindfulness. Tip 75: “Broaden and Build” Positive Emotions. Tip 76: Pair Behavioral Activation with Values.
XIV. Moving Forward After a Suicide Attempt
Tip 77: Differentiate Between Suicidal and Non-Suicidal Self-Injury. Tip 78: Determine the Person’s Reaction to Having Survived. Tip 79: Conduct a Chain. Analysis Tip 80: Evaluate Where the Safety Plan Fell Short. Tip 81: Take Advantage of the “Teachable Moment.” Tip 82: Attend to the Therapeutic Relationship. Tip 83: Address the Trauma of the Suicide Attempt. Tip 84: Explore Shame and Stigma.
XV. Building Resilience
Tip 85: Warn about the Possibility of Relapse. Tip 86: Review Lessons Learned. Tip 87: Complete a Relapse Prevention Protocol. Tip 88: Propose a Letter to the Suicidal Self. Tip 89: Follow Up.