Case Study

John is your fourteen-year-old client. You started seeing John at the request of his teachers as he had been displaying suicidal ideation in his art class. Many of his drawings were dark and centered around death. Getting to know John you began to realize art was an outlet for him to express some deep-seated emotions and fears. John struggled to verbally communicate his feelings and it was easier for him to express himself through art. At first John only presented with ideation, but over time you began to realize that a plan started to creep in. John kept on denying means. John is currently sitting in your office and has indicated that he wants to die, he has disclosed that he would most likely take his dad’s gun and shoot himself. As you dug deeper into his plan, you realize that though John’s dad has the gun in a safe, John has figured out the code to the safe. What should be your next step?

  1. You immediately call law enforcement to come and transport your client to the hospital?
  2. You involve parents and work on creating a safety plan?
  3. You involve parents and convince them to take John to the hospital to receive further assessment?

Each scenario has its pros and cons. Spend some time exploring each and the potential outcomes therein. Think about what assessment you would use to justify clinical significance? How might each scenario play out?