Psychologists’ Experiences Conducting Suicide Risk Assessments

Abstract

Psychologists regularly conduct suicide risk assessments (SRAs) to identify and prevent client self-harm. Although much is known about suicide risk and protective factors, little is known about psychologists’ experience of the process. Filling this knowledge gap is critical, as we are currently unaware of how, why, and when psychologists conduct SRAs and how it affects them and their practice. The overarching research question is “What are psychologists’ experience of conducting SRA?”, with an additional focus on how psychologists perceive suicidal clients, and how psychologists are affected by SRA. An additional fourth research question emerged during analysis, that is, “How do psychologists view their SRA training?” To answer these questions, an interpretative phenomenological analysis (IPA) qualitative design was used and five registered Canadian psychologists were interviewed about the essence of their SRA experiences. Results suggest psychologists struggle to weave tenants of assessment and therapy in SRA and that they often rely on clinical intuition to conduct SRA. Additionally, psychologists invest their professional and personal lives into suicidal clients and, while they have an empathic view of suicide, they believe it is often poorly rationalized and can be addressed in psychotherapy. Psychologists often experience anxiety working with suicidal clients, where the fear of client suicide guides and motivates their SRA practices. Indeed, psychologists reported feeling pressure from peers, clients, and colleagues to conduct ethical and useful SRA, despite reporting poor SRA graduate training. These results are enlightening and important to the field of psychotherapy, as they inform psychologists’ current ethical, training, and practical difficulties with SRA. With recent empirical evidence suggesting SRAs are largely ineffective, new approaches are necessary. Implications for SRA theory, research, practice, and future training are discussed.