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Section 11
Systems of Support for Adolescent Suicidality

Question 11 | Test | Table of Contents

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In the last section, we discussed four parenting skills for setting limits that can help a teen in a suicidal crisis.  These four skills are develop clear rules, eliminate vagueness, be direct, and develop a joint language.

In this section, we will discuss four techniques available to parents to help foster independence in a teen undergoing a depressive or suicidal crisis.  These four techniques are providing choices, problem solving, listening techniques, and active interest.

As you are well aware, a teen in a suicidal crisis may feel incapable of handling and solving problems. By providing a teenager with choices, and by teaching self reliance, a parent can promote independence in the teenager. By encouraging feelings of competence and self-reliance, a teen will feel more capable of solving their own problems when in crisis, which in turn may increase the teens’ ability to perceive options for crisis resolution beyond suicidal behavior.

4 Techniques to Foster Independence

♦ Technique #1 - Provide Choices
A first technique for parents to foster independence is to provide choices.  I have found that many parents feel that they are ‘good’ parents because they are involved with their children and do everything for them.  These parents often have a great deal of difficulty understanding why their teenager is undergoing a suicidal crisis.  By not giving their children the opportunity to think and act for him or herself, they may prevent their son or daughter from realizing the limits of the world, or from becoming a confident and independent person. 

I explain to parents that teenagers need to be allowed to make choices and to learn from the consequences of their choices.  Of course, dangerous situations are exceptions, as in the case of escalating depression or suicidal behavior.  But in cases of clothing selection, homework routines, or bedtimes, it is often beneficial for parents to provide a free choice, or a list of options, to a teenager and allow her or him to learn how their own decisions can improve or detract from their situation.

♦ Technique #2 - Teaching Problem Solving
A second technique for parents to foster independence is to teach problem solving.  As you are well aware, a great part of our work with teenagers in a suicidal crisis is to teach these clients to think through a problem to its conclusion, to try to anticipate the results of a decision, to check out and be prepared to accept the consequences of a choice, and to feel good about themselves even if the choice was wrong. 

Within the home, parents can instill this skill easily by being a model for the teen and by guiding the teen solving a problem on his or her own.  I provide the following 5-step problem solving technique to the parents of teenagers in a suicidal crisis to serve as a model for problem-solving conversations.

Five-Step Problem Solving Technique
--Step 1. Encourage the teen to identify the problem.  Ask the teen specifically, "What is the problem?"
-- Step 2. Be sure to look at the alternatives, be creative with them.  Ask the teen specifically, "What are your choices?"  Be encouraging and practice passive listening.
--Step 3.  Concentrate and try to anticipate the consequences of a choice.  Encourage the teen to "think hard" and provide guidance mostly when indicates a choice that is dangerous.  However, remain encouraging and accepting while the teen lists possible choices.
-- Step 4. Select a response.  Once the teen has listed possible choices, and their merits or detriments, specifically ask the teen to make a choice.
-- Step 5. Analyze the choice.  If the choice was a positive one, be sure that the teen learns to give himself or herself a pat on the back.  Encourage comments such as, "I did great," or "I really thought that out well!"  If the choice was negative or potentially harmful, encourage the child to consider what would have been a better choice.  Most important, encourage a pat on the back anyway, through encouraging such statements such as "I made a poor choice.  But I’ll do better next time!"

♦ Technique #3 - Practicing Listening Techniques
In addition to providing choices and teaching problem solving, a third technique for parents to foster independence involves practicing listening techniques.  Active listening, repeating back to the teenager both his or her verbal and nonverbal messages, as we discussed in Section 3, expresses to the teenager that his or her words and feelings are important and accepted.  This acceptance implies that the parent recognizes what the teen is able to do, and thus recognizes important aspects of the teen’s independence. 

In explaining active listening, I explain to parents that research estimates that nonverbal behavior accounts for 55% of the communication process.  The vocal tone and quality account for 38%, and the actual words used account for only 7% of the communication process.  I feel it is vitally important for parents to learn to pay attention to the teen’s nonverbal behavior during the listening process.  A good joint technique for parent and teen working together is to have the parent listen to the teen for two to five minutes, making an effort not to interpret, become defensive, or angry while the teen is talking. 

At the end of the set time, the parent repeats back as much as possible of what the child has said, using the teen client’s words and including observations of the teen’s nonverbal communication.  The teen client then indicates whether the parent has gotten it right, or if something has been left out.  Then the teen client and parent switch roles.

♦ Technique #4 - Take an Active Interest
A fourth technique for parents to foster independence is by taking an active interest. Often I find that parents confuse active interest with probing questions. However, when probing questions are asked at an inappropriate time, any teen client, especially one experiencing depression or a crisis, may react by withholding or omitting information to protect his or her privacy. 

Susan, 16, came home from a long-anticipated date looking obviously upset.  Her mother, Diana, met Susan at the door and stated, "What’s the matter?  What happened?  Did you two have a fight?  Are you OK?  Why are you so upset?  What did David do?"  Susan responded by stating, "Nothing happened.  I’m fine," and continued to use this response to all of Diana’s questions.  An active interest conversation follows a different track.  After I practiced active interest conversations with Diana, Diana reported the following later conversation between her and Susan following another date. 

Susan again came home looking upset, and Diana stated.  "Hi Susan.  Gee hon, it doesn’t look like you had a good time at the party." Susan stated, "Oh, it was ok." Rather than asking probing questions, Diana showed interest by asking, "Could have been a little more fun, huh?"  Susan responded to this invitation to talk openly by stating, "I’ll say.  David was a real jerk.  He acted like I wasn’t even there all night." "It’s not fun being ignored." "Yeah.  All the other guys seem to pay attention to me." "Sounds like everyone but the one important to you paid attention to you."

Think of your Diana.  Would practicing active interest in your next session help her or him improve communication and foster independence in a teen client undergoing a suicidal crisis?

In this section, we have discussed four techniques available to parents to help foster independence in a teen undergoing a depressive or suicidal crisis.  These four techniques are providing choices, problem solving, listening techniques, and active interest.

In the next section, we will discuss guidelines for parents regarding intervention during a teen’s suicidal crisis in four situations.  These four situations are, an emergency life threatening attempt, a non-emergency life-threatening attempt, possible suicide, and a low-risk situation.
Reviewed 2023

Peer-Reviewed Journal Article References:
Braun, M., Till, B., Pirkis, J., & Niederkrotenthaler, T. (2020). Suicide prevention videos developed by and for adolescents: A qualitative study. Crisis: The Journal of Crisis Intervention and Suicide Prevention. Advance online publication.

Cheng, Q., Shum, A. K. Y., Ip, F. W. L., Wong, H. K., Yip, W. K. K., Kam, A. H. L., & Yip, P. S. F. (2020). Co-creation and impacts of a suicide prevention video: A case study of a YouTube short film on youth suicide prevention. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(1), 7–14.

Christensen, K., Hom, M. A., Stanley, I. H., & Joiner, T. E. (2021). Reasons for living and suicide attempts among young adults with lifetime suicide ideation. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 42(3), 179–185.

Connor, J. J., & Rueter, M. A. (2006). Parent-child relationships as systems of support or risk for adolescent suicidality. Journal of Family Psychology, 20(1), 143–155. 

Emery, A. A., Heath, N. L., & Rogers, M. (2017). Parents’ role in early adolescent self-injury: An application of self-determination theory. School Psychology Quarterly, 32(2), 199–211.

Flouri, E., & Buchanan, A. (2002). The protective role of parental involvement in adolescent suicide. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 23(1), 17–22.

QUESTION 11
What are four techniques available to parents to help foster independence in a teen undergoing a depressive or suicidal crisis? To select and enter your answer go to Test.

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