SUICIDAL IDEATION 347 C. The client has made a suicide attempt within the last month. D. The client denied any inter est in suicide currently and promised to engage in no self-harmful behavior. 6. Suicide Attempt History (6) A. The client reported a history of suicide attempts that have not been recent but did require professional and/or family/friend intervention to g uarantee safety. B. The client minimized his/her history of suicide attempts and treated the experience lightly. C. The client acknowledged the history of suicide attempts with appropriate affect and explained the depth of his/her depression at the time the suicide attempt occurred. D. The client indicated no current interest in or thoughts about suicidal behavior. 7. Family History of Depression (7) A. There is a positive family history of depression. B. There is a positive family history of suicide. C. The client acknowledged the positive family history of depression or suicide and indicated a concern as to the impact of this tendency on himself/herself. 8. Extreme Impulsivity (8) A. The client displayed an extreme level of impulsivity due to his/ her mania, psychosis, or other severe and persistent mental illness symptoms. B. The client displayed impulsive thoughts about committing suicide. C. The client has a history of acting on his/her impulsive thoughts due to mania, psychosis, or other sever e and persistent mental illness symptoms. D. As the client has stabilized his/her severe and persistent mental illness symptoms, he/she has decreased his/her level of impulsivity. 9. Increased Depression and Stress (9) A. The client displayed a signific ant increase in depressive symptoms, coupled with a recent increase of severe stressors. B. The client displayed a bleak, hopeless attitude toward life. C. The client has encountered significant losses, relationship problems, or other crises. D. As the client's depressive symptoms have stabilized, he/she has begun to cope with recent severe stressors. E. The client's severe depression has lifted, and he/she is no longer a suicide risk. INTERVENTIONS IMPLEM ENTED 1. Ask about Suicidal Ideation (1) * A. The client was asked to describe the frequency and intensity of his/her suicidal ideation, the details of any existing suicide plan, history of any previous suicidal attempts, and family history of depression or suicide. * The numbers in parentheses correlate to the number o f the Therapeutic Intervention statement in the companion chapter with the same title in The Severe and Persistent Mental Illness Treatment Planner, 2nd ed. (Berghuis and Jongsma) by John Wiley & Sons, 2008. 