SUICIDAL IDEATION 357 C. The client has used the personalized crisis cards and was encouraged to continue. D. The client has not used the personalized crisis cards and was redirected to do so. 45. Identify Suicidal Gestures I mpact ( 45) A. The powerful responses that others have to a suicidal gesture were reviewed with the client. B. The client was assisted in identifying and listing healthy ways in which he/she can have his/her need for attention and affirmation of caring me t, without eroding trust or acting in a dangerous, suicidal manner. C. The client received positive feedback as he/she has decreased his/her suicidal gesturing. D. The client was reinforced for identifying a variety of ways in which he/she can attempt positive attention. E. The client has not decreased his/her suicidal gestures, and was provided with additional feedback, support, and supervision. 46. Decrease Secondary Gain ( 46) A. A specialized treatment plan was developed to assist in decreasing seco ndary gain from suicidal gestures. B. An appropriate authorization to release confidential information was obtained in order to share the secondary gain treatment plan with other agencies that may be involved with the suicidal gestures (e. g., local emerge ncy room). C. The client's secondary gain for his/her suicidal gestures has been decreased, and he/she was focused on being more direct in order to meet his/her attentional and affirmational needs. 