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Suppose you are faced with a terminally ill client with AIDS who is in a great deal of pain. The client indicates to you in a calm, reasonable way that he/she is going to drive out to an isolated spot in a state park, drink a thermos of margaritas, take out her 9 mm automatic, make an audio tape telling her family how much she loves them and how she doesn’t want to be a burden on them, and then kill herself. Run a five minute crisis intervention session.. With the following criteria in mind, how do you feel you did?

-being objective

-your own moral view of AIDS and suicide

-following Tarasoff

Answer

While offering counselling services to the patient, the objective of the session should be to offer the patient the reasons to live, not to mention restriction of means. Motives for being alive or reasons to continue living is well documented. In this regard, the session would highlight the patient’s reasons for staying alive as a result of her responsibility to the family as well as concerns related to her children (Cureton et al., 2019). These would counteract the patient from her suicidal thoughts. Again, restriction to means would limit the patient from carrying weapons such as a firearm that she would use to facilitate her suicidal thoughts (Cureton et al., 2019).

Cultural or moral objections concerning suicide can potentially be a protective factor. Research indicates that while religious attendance may not prevent issues of suicidal ideation, they provide a projection of limited suicidal attempts (Cureton et al., 2019). In this regard, patients with reduced moral objections are likely to be characterized by increased suicidal attempts. In the session, it will be imperative to evaluate the objections of the patient concerning suicide to understand her beliefs and the existence of objections as a probable protective factor against suicide (Cureton et al., 2019). Thus, from a personal moral perspective, AIDS should not be viewed as the end of life, and committing suicide is not a solution.

According to the ruling of the California Supreme Court ruling between Tarasoff vs Regents, mental health professionals are obligated to offer protection to persons who may be harmed by a patient (Adi et al., 2018). This ruling gives a mandate to the mental health provider to employ reasonable care in giving information to authorities as well as warning possible victims through the use of any means deemed necessary should they determine that the patient poses some danger to a third party (Adi et al., 2018). In this case, it is the mental health professional’s obligation during the crisis intervention session to identify that the decision of the patient is not just a danger to herself, but also to the relatives and people around her.

References

Adi, A., & Mathbout, M. (2018). The duty to protect: Four decades after Tarasoff. American Journal of Psychiatry Residents’ Journal. Retrieved from https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201900060

Cureton, J. L., & Fink, M. (2019). SHORES: A Practical Mnemonic for Suicide Protective Factors. Journal of Counseling & Development, 97(3), 325-335. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1002/jcad.12272?casa_token=jSTiSrT_QsIAAAAA%3AUrPTNhpZ8Xr32zNKH7Uwb6CBSorQUb3dAO3PvpoTbze2LG1OwJoksgvyg0h1mP2J2DDYbwT8yekXi6wp

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