How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 160
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What are some of the legal implications of working with suicidal people?
If a person completes suicide after a crisis services provider intervenes, it is possible that the family or friends
of the individual may hold the crisis services provider responsible for the suicide. Three sorts of suicides are
most prone to this sort of blaming and/or legal suits:
1) Outpatient suicides (should the clinician have hospitalized the individual?),
2) Inpatient suicides (Did the institution provide a safe environment?), and
3) Suicide following discharge or escape.
In determining malpractice/liability, four elements must be present:
1.A therapist-patient relationship must exist which creates a duty of care to be present.
2.A deviation from the standard of care must have occurred.
3.Damage to the patient must have occurred.
4.The damage must have occurred directly as a result of deviation from that standard of Care.
Risk management guidelines:
Documentation - always document, what is not documented, did not happen per most entities' opinion.
Information on previous treatment
Involvement of family and significant others
Consultation on present clinical circumstances
Sensitivity to medical issues
Knowledge of community resources
Consideration of the effect on self and others
Preventive preparation.
DO'S and DON’TS in suicide prevention
Remove opportunities
Receive and accept suicidal communication
Do intrude
Prevent isolation and involve significant others
Transfer rather than refer
Follow-up
Always obtain consultation when unsure
Do know your own value system about suicide
Get precipitant (Identify those issues, concerns, and/or events that led up to the current crisis.)
Use self as instrument of prevention
Do not worry about saying the wrong thing
Do not consider suicidal persons as special
Do not assume ability to solve problem(s)
Do not try to talk the person out of committing suicide
Do not engage in abstract discussion about suicide, death,
Do not be too accepting of suicide
Do not delegitimatize
Do not give cheap general reassurance
Do not lose confidence (may need more limited goals)
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