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    Discussing Suicidal Ideation and Self-Harm with Your Teen

    Throughout my time working with adolescents over the past three years, I have found that when teenagers experience suicidal ideation or engage in self-harm behaviors, they are often worried about telling their caregiver(s) for the following reasons:

    1. They are worried they will be in trouble with their caregiver(s)
    2. They are concerned that this will cause too much stress for their caregiver(s)
    3. They are nervous that their caregiver(s) will tell other people

    So, how do we have more open communication between caregivers and their teens around such a complex topic? An organization called Robbie’s Hope asked teens how they wanted to adults in their lives to talk to them about suicide and created a handbook for adults (Adult Handbook). This handbook includes things to consider such as location, timing, types of questions to ask and things to avoid when talking to adolescents about suicide and self-harm. This guide reminds adults that teens are often seeking an open ended conversation that shows we are listening, without judgment, by validating their emotions and challenging experiences, and not jumping to offer solutions or comparisons of our own lives. It is okay to ask your teen about depression, anxiety, suicidal ideation, and self-harm behaviors. How to ask them about it can be complex and based on the type of communication that already exists and is nuanced to each individual teen; however, I do think this guide is a helpful starting point. Perhaps, if you and your teen have already been discussing these topics, you could read it with your teen and ask them what they do and don’t relate to in this handbook.

    When I communicate with caregivers about the safety of their teen, I begin the conversation by bringing up the three concerns of teens mentioned above. I remind caregivers that suicidal ideation and self-harm is not something that is wrong or needs to be punished. When people experience these thoughts or behaviors, they are attempting to find ways to protect themselves and cope with the challenges they are experiencing. Often, these are intrusive thoughts that feel impossible to “control” or “get rid of.” Avoid using judgmental language or language that indicates that these thoughts are wrong, ridiculous, deserving of punishment or that your teen “doesn’t have it that bad.” Instead, provide supportive language that reminds your teen it’s okay to not be okay.

    I also empathize with parents about how challenging it can be to hear that your teen is dealing with such difficult emotions and thoughts. It is normal for caregivers to be concerned and your adolescent might benefit from a reminder that their emotions and experiences are not too much and that they are not a burden, even when they are experiencing some scary feelings that might feel like too much for them.

    Lastly, I communicate to caregivers the bravery it takes for an adolescent to open up about their suicidal ideation or their engagement in self-harm behaviors. This is vulnerable and often pretty scary to open up about! Avoid sharing this information with people who do not need to know that this is happening. There may be times when you have to loop in other adults in order to help keep your child safe. Communicate that with them and seek consent around who they feel comfortable supporting them and knowing about their suicidal ideation and self-harm.

    Have more questions about how to talk to your teen about suicide? I offer both individual therapy and family therapy sessions to hold space for you and your teen to navigate these conversations together.