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Teen Suicide: Practical Interventions for Adolescents in Crisis
10 CEUs Teen Suicide: Practical Interventions for Adolescents in Crisis

Section 5
Parental Involvement in Adolescent Suicide

CEU Question 5 | CEU Test | Table of Contents | Crisis CEU Courses
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On the last track, we discussed four barriers to communication between adolescents and parents that may compound a teen’s suicidal crisis.  These four barriers are labeling, mixed messages, over or underreacting, and nonverbal messages.

On this track, we will discuss 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.

The next three tracks will focus on specific parenting skills that the therapist can introduce to the parents of a teen in a suicidal crisis.  These techniques may help stabilize the teen’s home environment and increase the social support resources available to the teen.  By setting limits for the teen in a suicidal crisis, the parent conveys a message that someone cares enough to watch out for them. While the teen may at first resent the presence of limits, limits provide a sense of security that is invaluable to the teen in crisis. 

4 Parenting Skills for Setting Limits

Skill #1 - Develop Clear Rules
A first technique for setting limits is to develop clear rules.  Communicating rules is an essential part of setting limits, and I recommend that parents keep their statements of limits as clear as possible by keeping the message short, simple, and to the point, giving a reason for the rule, and stating rewards or consequences for the actions.  For example, a parent might state, "Nina, I want you home by nine o’clock because it is a school night.  You can stay out later on Friday night."

Skill #2 - Eliminate Vagueness
A second technique for setting limits is to eliminate vagueness.  Parents may have difficulty sending clear messages when they don’t know if they should take a stand on a particular issue, or if they have an uneasy feeling about a situation but don’t know why.  One method I encourage parents to use to eliminate vagueness is to be up front and say "I don’t know" if they feel unclear about how to respond to a teen’s request.  Stating, "I don’t know" is much more clear than stating, "We’ll see," or "I’ll think about it." 

I recommend to parents that they state clearly, "I don’t know" followed by an expression of feelings and a statement that the parent will think about the issue for a specific amount of time.  For example, Ryan, 17, had recently displayed self-destructive behavior such as alcohol use and burning himself with cigarettes.  Although Ryan was making progress in therapy, his father Grady remained concerned about his son’s risk of suicide. 

When Ryan requested to stay overnight at a friend’s house, Grady was uneasy.  Grady stated to Ryan, "I don’t know if I want you to stay overnight at Brian’s house, because I don’t know Brian’s family well and I worry what would happen if you needed help in the middle of the night.  Let me talk it over with your mother, and I’ll let you know this afternoon so that you can make plans one way or another."

Skill #3 - Be Direct
In addition to developing clear rules and eliminating vagueness, a third technique for setting limits is to be direct.  I encourage parents not to hide a request in the form of a question.  This approach, for example stating, "Amy, do you want to clean your room now?" indicates that the parent is unsure of him or herself and how he or she feels. 

This indirect request also leaves Amy the option of saying "not now," since she probably does not in fact want to clean her room.  By making a statement instead of asking a question, the parent may be able to lessen resistance.  In the case of a teenager in a suicidal crisis, a parent may want the teen to seek help from a  therapist or crisis counselor.  By asking the teenager, "Would you like to make an appointment to see a therapist?" the parent’s message is not clear, and there is implied permission for the teenager to refuse help. 

By stating directly, "We’re going to make an appointment for you to see a therapist," the teen may still raise objections, but her or his opportunities for manipulation are lessened.

Skill #4 - Developing a Joint Language Technique
A fourth technique for setting limits is to use the develop a joint language technique.  The joint language technique involves parents teaching and sharing key words, phrases, and expressions in order to reinforce a common, mutually understood method of communication.  

Step 1 - The first step in the develop a joint language technique is for the parent to teach, or review with the teen words that are used to describe people’s actions and feelings, such as acceptance, left out, stressed, upset, confident, and lost.  The parent then continues to discuss these specific phrases so that when either teen or parent uses these feeling words in conversation, both parties have previously agreed on how to interpret what each other means. 

Step 2 - The next step in the develop a joint language technique is for the parent and teen to agree on phrases or pet expressions that can be a nonthreatening or humorous signal for a complex communication.  The whole family can be involved in making up these shorthand expressions, and I have found that the phrases that arise from using the develop a joint language technique can reduce the stress a suicidal teen may feel in trying to effectively communicate her or his feelings. 

For example, Grady and his son Ryan agreed that the phrase "I draw the line" meant, "That’s it, I have had enough, no more pushing the limits."  Both Grady and Ryan agreed that if one of them used the phrase "I draw the line," the other would back off and reassess his or her behavior.  Grady and Ryan also agreed that if Ryan stated, "Up up and away," Grady would stop asking so many questions, because the phrase would signify in a nonconfrontational way that Ryan was feeling like he was being interrogated.

However, as part of the develop a joint language technique, Grady and Ryan also agreed that if one of them used a conversation-ending pet expression, they would give each other space for one hour, and then meet to reassess the conversation. Think of your Grady and Ryan.  Would the develop a joint language technique help your Grady set limits, while improving communication patterns within the family?

On this track, we have 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.

On the next track, 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.

Peer-Reviewed Journal Article References:
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. 

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.

Zisk, A., Abbott, C. H., Bounoua, N., Diamond, G. S., & Kobak, R. (2019). Parent–teen communication predicts treatment benefit for depressed and suicidal adolescents. Journal of Consulting and Clinical Psychology, 87(12), 1137–1148.

Online Continuing Education QUESTION 5
What are four parenting skills for setting limits that can help a teen in a suicidal crisis? To select and enter your answer go to CEU Test.

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