clinical records is illegal, but understanding potential problems can help you focus on how to deal with legal inquiries.
Peer consultation groups also provide professional connection for solace and understanding from friends and colleagues. Emotional support from colleagues who face similar challenges can be especially meaningful. Wellness Practice 2.1 includes a mood management strategy that you can use yourself or with your colleagues.
Wellness Practice 2.1 Happy Songs in Your Life
Music in general, and songs in particular, can trigger happiness, sadness, other emotions, and life memories. Sometimes emotional responses to music are all about the music. Other times emotional responses are about the personal associations or memories that the songs trigger. For example, when John listens to “Joy to the World” by Three Dog Night, he is transported back to positive memories of ninth-grade basketball. It is not unusual for people to turn to music to help regulate emotions or to heighten particular feelings.
For this wellness practice, experiment with the following, and then later consider engaging clients with this activity:
1 Select a song that triggers positive emotions for you.
2 Listen to the song twice in a row and just let the song do its work. You can do this with a friend or by yourself.
3 After you have listened twice and let the positive feelings come, respond to the following prompts:What emotion does the song bring up?What is your best guess (hypothesis) for why the song brings up that particular emotion?Do you usually intentionally listen to this song or just randomly wait for the song to pop into your life?Optional: Share the song with someone and tell that person why the song triggers positive emotions for you.
At the time of this writing, we have located several articles that illuminate issues that might emerge following a client death by suicide:
“Facing the Specter of Client Suicide” by Laurie Meyers (2015) in Counseling Today (https://ct.counseling.org/2015/10/facing-the-specter-of-client-suicide/)
“As a Therapist, How Should I Grieve After a Patient’s Suicide?” by Lucy Maddox (2018) on Mosaic (https://mosaicscience.com/story/therapist-how-should-i-grieve-after-patients-suicide/)
“Paradise Lost: When Clients Commit Suicide” by Marian Joyce (2013) on Psychotherapy.net (https://www.psychotherapy. net/article/client-suicide-article)
Many other articles are available that focus on how counselors can deal with client suicides. We recommend that you explore this important area and find resources that fit your needs.
Postvention
Postvention is an essential component of dealing with completed suicides. The term postvention was first coined by Edwin Shneid-man in 1968 at the inaugural gathering of AAS. In 2017, the Psychopathology Committee of the Group for the Advancement for Psychiatry defined and articulated the rationale for suicide postvention: “Postvention, or how clinicians manage the postsuicide aftermath, strengthens suicide prevention, destigmatizes the tragedy, operationalizes the confusing aftermath, and promotes caregiver recovery” (Erlich et al., 2017, p. 507).
Although research on postvention is limited, many different postvention protocols and strategies have been developed. For instance, a 234-page document titled Coming Together to Care is available for download at www.texassuicideprevention.org/wp-content/uploads/2013/06/TexasSuicidePrevention-2012Toolkit_8-31.pdf. This document is a postvention toolkit developed in Texas by a consortium of organizations dedicated to suicide prevention.
Postvention is an underdeveloped pillar of suicide prevention (Maple et al., 2019). This is partly because postvention effects are notoriously difficult to assess. Given that every suicide and community or school context is unique, identifying a control group for postvention efficacy research is impossible. In one review of 16 published studies of high research quality, the researchers concluded, “No protective effect of any postvention program could be determined for number of suicide deaths or suicide attempts” (Szumilas & Kutcher, 2011, p. 18). However, “contact with a counseling postvention for familial survivors of suicide generally helped reduce psychological distress in the short term” (p. 18).
Nationally and internationally, beliefs vary regarding how much attention to give a death by suicide. Famous or infamous deaths by suicide get substantial press coverage, and sometimes this raises awareness of the problem. However, the tone of the coverage is influential. A group of 21 academic, community, and not-for-profit organizations published a checklist of dos and don’ts for media reporting on suicide. They recommend that media organizations avoid the following:
Running sensationalistic headlines
Including photos of the location, the method, grieving families, or memorials
Using terms like epidemic to describe suicide
Describing suicides as not explainable or as happening “without warning”
Quoting from suicide notes
Using crime investigation reporting styles
Quoting police or first responders on suicide causes
Referring to suicides as “committed,” “successful,” “unsuccessful,” or “failed” (this list is adapted from “Recommendations for Reporting on Suicide,” n.d.)
Although tragic, suicides are not the fault of loved ones, caregivers, schools, or law enforcement. The best postvention efforts do not level blame or sensationalize but rather encourage grieving, healing, and prevention. (The Suicide Prevention Resource Center has information on an array of suicide-related topics, including postvention, at https://www.sprc.org/news/postvention-prevention.)
Concluding Comments
Competency not only helps ensure that you are meeting professional standards and standards of ethical practice, it also helps reduce anxiety and relieve self-doubt. In this chapter, we summarized competencies for working with clients or students who are suicidal. Although the breadth and complexity of suicide-related competencies may feel overwhelming, as you progress through this book your confidence and comfort with suicide competencies will increase.
Practitioner Guidance and Key Points to Remember
Core suicide competencies, as described by Cramer and his colleagues (2013), include the following:
1 Be aware of and manage your attitude and reactions to suicide.
2 Develop and maintain a collaborative, empathic stance with clients.
3 Know
