Teens, Suicide and the Role of School Counselors
Abstract
The increase in suicidal tendencies among the youth in contemporary times has led to a problem of how to address suicidal thoughts. The role played by school counselors and the trainings they need in order to be effective in handling cases of students harboring suicidal thoughts is discussed in this paper. Based on a qualitative exploratory approach, this paper addresses the objectives of determining the role of school counselors with respect to prevention of suicide among teens, the trainings necessary for school counselors to perform their roles effectively and the discrepancies in suicidal thoughts based on gender, ethnicity and social class. In answering the research questions, it has been confirmed that the school counselors act as allies to all students, make the school environment accommodative for everyone, act as suicide gatekeepers and intervene in the prevention of suicide.
Introduction
In the recent years, there has been an increase in suicidal tendencies amongst school going children, particularly teenagers. The reasons for such suicidal tendencies are varied from poverty, social exclusion, sexual orientation challenges and family stress. It is not common for teens having suicidal thought to make reports on their own (Reis & Cornell, 2008). Consequently, it is the role of their fellow students and school counselors to recognize these tendencies and to offer assistance for suicide prevention. It has been reported that trained school counselors are more capable of identifying suicidal tendencies and subsequently helping in suicide prevention than other educators (Reis & Cornell, 2008). This paper therefore aims at addressing the issue of suicide in teens as it is relevant to the school counselor profession. This is because it is the role of school counselors to note these tendencies and to help students portraying the inclination to self harm as well as to suicide.
Objectives of the Paper
This research paper is aimed at finding out the relationship between the school counselor profession and the suicidal tendencies in various groups of teenagers based on discrepancies such as gender, ethnicity, race and social class. In order to achieve this aim, the specific objectives that will be aimed at include:
- To determine the role played by school counselors in the prevention of suicide among teens
- To find out trainings that are available for the enhancement of the school counselor career and the effectiveness of school counselors in suicide prevention
- To determine the patterns of suicidal thoughts among teens of varied ethnicity, gender, social class and race
Research Questions
In order to accomplish the stated objectives of the study, the questions that will be addressed by this study include:
- What is the role of school counselors in suicide prevention?
- What trainings are available for the enhancement of the school counselor profession?
- What are the suicidal tendencies in children based on gender, ethnicity, race and social class?
Overview of the Paper
This research paper is divided into 6 major sections. The first section of the paper is the introduction. This section contains an overview of the paper’s purpose, research questions, and the paper overview. The introduction is followed by the research methodology which contains a description of the method used in the study for data collection, analysis and presentation. The methodology is followed by the literature review which includes a description of particular secondary sources that are relevant to the study, and which covers their summaries, methods and findings. The literature review is the widest section of the research paper as it contains the information pertinent to other sections of the paper. The discussion section which follows the literature review is description and analysis of the findings related to the research questions. It is followed by the section on research implications and finally the conclusion to the paper.
Research Methodology
The research study was carried out based on a qualitative approach. The rationale behind the adoption of a qualitative approach is that it takes a human centered dimension, with a focus on data collection strategies that aim at exploration of meetings, and gathering of naturally occurring data. The advantages of qualitative study is that it enables collection of data on phenomena about which there is limited information such as the relationship between school counseling and suicide prevention. It also focuses on processes more than their outcomes and does not depend on numerical information (Given et al, 2014). While taking a qualitative approach, the study also aims at carrying out extensive exploratory procedures with the objective of obtaining a theoretical framework to the study.
During data collection, a secondary study approach was chosen. The focus of the secondary study was on relevant literature materials that had been selected during earlier assignments. In the selection of relevant material, a content based approach was decided upon as this enabled the study to be focused within its objectives. The content based selection approach was carried out through identification of the requirements for the study i.e. the study objectives, carrying out a topic based material search and going through each material to match the content to the objectives of the research and to the research questions. Materials with the most relevant contents were then chosen for the study. In data analysis, recursive abstraction was used. In this process, the data obtained from the various secondary sources was summarized over and over again until the most important information had been abstracted. This information was then presented as the findings for the study and the implications of the study noted.
Literature Review
Various studies have been carried out on the measures to be taken on the awareness of suicide intention as well as training processes for school counselors aimed at prevention of suicides and self harm. As Reis and Cornell (2008) says, teenagers have various reasons why they contemplate self injury or even suicide. It is the role of school counselors, who are referred to as gate keepers, to identify characteristics that indicate that a given teenager is a potential suicide victim and to offer preventive assistance in any such case (Reiss, 2008). While teenage students are likely to have suicidal thoughts at any given time in their lives, it is common for such thoughts to be dissipated and addressed as soon as they are realized. Everall et al (2006) assert that resilience is an important factor that helps to keep suicidal thoughts at bay. Without resilience, it is very likely that teenagers who have suicidal thoughts would go back to the thoughts over and over again.
In the article ‘Death with Honors: Suicide among Gifted Adolescents’, James Delisle (1986) highlights the plight of the gifted children with regards to suicidal thoughts. Delisle notes that although there is a common presumption that gifted children are too strong to commit suicide, they too face challenges that may drive them towards committing suicide. He states that as a matter of fact, statistics regarding the increasing number of gifted children who commit suicide are on the rise. This paper is relevant to the current study as it addresses some of the issues involved in prevention of suicide among teens. Besides highlighting the need for intervention in cases of gifted teens, it also offers insight into strategies that can be used by school counselors to help prevent suicide in such gifted children. Some of the characteristics of gifted children highlighted by the author that make them susceptible to suicide as highlighted by the author include: the quest for excellence, academic or otherwise; the need to fit in amongst peers; the tendency to downplay their capabilities in order to be considered normal; and their desire to help in adult issue. These characteristics bring frustration when any of them cannot be achieved. Delisle suggests intervention measures that can be used to prevent suicide among gifted children. Some of the measures include: beginning the intervention process with assessment of the situation to ascertain that there are suicidal tendencies, confronting the gifted teenager directly, and acting specifically to the teenager by living up to the promises made. In specific action, the author suggests that it may be necessary to find someone to stay with the teenager during the difficult periods. This study by James Delisle was carried out based on a review of relevant literature that was recapitulated into a comprehensive paper.
A second study titled ‘Creating a Future: A study of Resilience in Suicidal Females’ by Everall et al (2006) was also instrumental in this study. This is because instead of focusing on the issues that result in suicidal tendencies among teens, the study focuses on the factors that enhance resilience towards the avoidance of suicidal thoughts in females. The paper goes further by describing how these factors can be used by school counselors in helping to prevent suicide among teens. It also shows that resilience is an important characteristic for adolescents to overcome suicidal thoughts. In the research paper, factors mentioned as contributing to resilience include individual factors such as cognitive capabilities, family factors such as attachment to parents and community factors such as positive relationship with peers. These factors are said to be capable of contributing to increased resilience. However, the authors also report that brokenness in any of these factors contributes to increased stress and adversity. The recommendations for school counselors in dealing with
In the study, a group of 24 participants were interviewed on their suicidal tendencies and how they coped with suicidal thoughts. The inclusion criteria for the participants included: they must have experienced self-reported suicidal thoughts at 15-24 years of age the last of which should have been in less than three years prior to the interviews; they should have experienced no suicidal thoughts in the six months before the study and must have been willing to talk about their suicidal tendencies freely. The participants were engaged in a semi-structured interview where they were asked open ended questions relating to the subject of study. Only results from 13 of the 24 participants, all females were used in the study. The findings reported that the process of resilience is comprises of various social, emotional, cognitive process combined with purposeful action. According to the findings, the social process involves the assistance of peers, parents and extra-familial adults. The emotional process on the other hand is described as involving facing difficult feelings, expressing feelings and writing. The cognitive process involves shifting perspectives and recognizing personal choices while purposeful action encompasses taking action, exercising independence and creating a future among others. The main limitation of this study is that it focused on a tiny sample size of a single gender, which limits the applicability of the recommendations made unless supported by other findings.
Another study that addressed the issue of resiliency towards suicidal thoughts is that by Christie Eppler (2008). This study titled ‘Exploring Themes of Resiliency in Children after the Death of a Parent’, is relevant to this study as it also addresses the implications of working with children who have experience grief due to parental loss by school counselors. In addition to this, characteristics of children that enable them to handle various feelings may also be instrumental towards their development as teenagers and as young adults. The study describes the emotions of children who experience grief as being shock, anger and guilt and further mentions the role of these emotions in making the children vulnerable to stress and depression. The impacts of stress and depression are said to include the tendency to have suicidal thoughts.
In the study, a qualitative method was taken for the purpose of obtaining information regarding resiliency in children aged 9-12 years after the loss of their parents. A group of 12 bereaved children were taken to participate in the study, answering questions and writing stories about their grief process. The participants had lost a parent each in the 36 months prior to the study and were recruited by posters. The data was collected through open ended questions administered in individual interviews at a local mental health facility. The grounded theory was the basis of action in the research study. This method, as reported by Eppler is based on the use of deductive codes to interpret data. This process was used in the data analysis where the answers to various questions were coded prior to summary. From the study, it was observed that the grief process was covered in a range of emotions including fear, anger, sadness and sometimes happiness when thinking about moments spent with the lost parents. The children also reported that they could talk to the remaining parents and to grandparents who proved instrumental in their grieving process. The study recommends that for school counselors to help in preventing suicide among grieving children it is necessary for them to foster positive adjustment and resilience through using strength based strategies in individual counseling, using small groups with the same strength based strategies and collaboration to support children in grief. The main limitation of the study is cited by Epprel as being its limited sample size and focus on children.
Gibbons and Studer (2008) also carried out a study on Suicide Awareness Training for Faculty and Staff: A Training Model for School Counselors. This study, which provides information regarding one of the most pertinent objectives of the current study, gives a recommendation for school counselors to organize suicide awareness trainings in schools. By first recognizing the fact that very few counselors do this, Gibbons and Studer mention the importance of suicide awareness trainings and their implications on preventing suicide among teens. In their recommendation, the authors highlight the procedure to be taken in suicide awareness trainings as involving pre-training planning which is mainly the process of gaining the administration’s support for the training; once this support has been gained, the authors suggest that the next step is to decide where and when to hold the trainings. During the training itself, five steps are described by the authors as being suitable for the process. The five steps include: presentation of a short quiz, the presentation of both non-verbal and verbal warning signs for suicidal thoughts, presentation of earlier prepared suicide intervention policy for staff use, creating awareness of personal feelings and finally carrying out role plays and issuing case demonstrations. A final step in the process is identified as the evaluation stage whose purpose is to assess knowledge development and to determine the effectiveness of the procedure used. In the presentation of warning signs, the authors assert that mere mentioning is not sufficient; rather, the signs should be deeply discussed to enable identification at the slightest whims in potential victims. The study, carried out through a secondary qualitative approach was mainly exploratory since it focused on the use of existing literature only. All the information presented in the study was based on literature review. In conclusion, the authors suggest activities for staff to consider during the training process such as writing down common phrases they have heard being used by suicidal students.
In dealing with suicidal cases, an important role that is said to be performed by school counselors is that of handling issues of self injury or harm. According to an article by Kress et al (2006), counselors must consider some ethical implications in dealing with students who have the tendency to harm themselves. This article is relevant to this study since the same ethical considerations that a school counselor is subject to when dealing with teens that have the tendency to injure themselves applies to dealing with teens who exhibit suicidal tendencies. According to Kress et al, school counselors have the role of indentifying, intervening, preventing and advocating for the prevention of self injury among students. The tendency to be self injurious is said to begin during the early teens of students and increase till their early college years. According to this study by Kress et al, self injury is mainly triggered by reason such as hurt, anger, pain or any other negative emotions. They are also carried out as a way of dealing with social exclusion, and to release feelings of emptiness.
The research study was carried out using a case study approach aimed at identifying and illustrating the ethical considerations of the school counseling career. The considerations discussed in the paper include: maintaining responsibility and confidentiality towards the students, and practicing in competence. In addition to this, the authors also report that the students also possess an ethical duty of confidentiality towards their parents and teachers. While thoughts of self harm are said not to be synonymous to suicidal thoughts, the authors also describe the tendencies to harm self as being one of the most disturbing scenarios that a school counselor may face. Besides the identified ethical considerations, the authors also recommend that school counselors should also sign contracts to confirm their responsibility in ensuring that no student performs harm to himself/ herself by making reports if and when necessary. Another recommendation is that schools should form policies directed toward the prevention and management of self injurious behaviors. In conclusion, the authors affirm that anticipating ethical issues in dealing with self-injurious tendencies in students helps prevent ethical issues in dealing with students with self-injurious thoughts.
Besides the children with self injurious tendencies, another group of individuals at risk of suicide, stress and depression is described by Byrd and Hays (n.d) as comprising of students in their teens who are considered to be sexual minorities such as lesbians, gays, bisexual, transgender individuals, questioning teens. In the article ‘Evaluating a Safe Space Training for School Counselors and Trainees using a randomized control group design’, the authors describe the process by which suicidal tendencies occur in the sexual minority individuals defined as LGBTQs. The authors further describe the role played by school counselors in assisting these individuals as being to understand and to offer guidance without judgment. According to this article, it is essential for school counselors to assist other students in understanding the LGBTQs as individuals and accepting them in the school set up. In this role, the authors suggest trainings for school counselors and trainees to enable them deal with sexual minority teens effectively. According to Byrd and Hays, it is the ethical obligation of school counselors to be allies to all students regardless of their sexual orientations. The study aims at describing the impacts of safe space training on the effectiveness of the counseling process on dealing with LGBTQs.
The study carried out using a randomized control group approach was qualitative in nature, a group of 77 school trainers of varied ethnicity, race, and gender. A pre-test and post-test evaluation procedure was used in determining the effectiveness of the safe space training in improving the capabilities of the school counselors. The participants were each allocated to either the treatment group or the control group at random then trained. The evaluation was carried out on Privilege and Oppression inventory (OPI) and on Sexual orientation Competency Scale (SOCS). Focus on the demographics and school level differences were not considered in the evaluation of the results. The result showed that there was a positive correlation between the reception of safe space training and the competency level in LGBTQ; competency was also found to be correlated to awareness of sexual orientation. The implication of the study is that training of school counselors guarantees a positive environment for the growth of all students, not only those identifying with sexual minority.
In another comparative study by Reis and Cornell (2008) on the suicide gate keeping capabilities of teachers and counselors, it was ascertained that counselors are more competent at identifying and addressing suicidal tendencies among students. In the study referred to as ‘An Evaluation of Suicide Gatekeeper Training for School Counselors and Teachers,’ the authors address the issue of the role played by school counselors in the prevention of suicide among teens, a concept of importance in this study. The Question, Persuade and Refer Program is mentioned as being effective in enhancing the competency of both school counselors and teachers. The rationale behind this strategy is that students harboring suicidal thoughts rarely make individual efforts to report the same. It is therefore the role of the school gatekeepers and their fellow students to report any observed signs of suicidal risk.
In the above study, a group of 74 counselors and 165 teachers was given trainings on the QPR strategies against a control group comprising of 74 counselors and 98 teachers. After the training, the participants were given the opportunity to apply the lessons learnt in their various schools. Follow up exercises were then carried out periodically. It was found out from the study that the participants trained in QPR reported higher capabilities of identifying suicidal signs and making contact without any potential harm to the students at risk than did the control group. At the same time, it was also noted that the school counselors reported high competencies as regards to being able to identify suicide risk factors as compared to the teachers. The implication for this study is that for the process of suicide gate keeping to be effective, training of counselors and teachers is mandatory.
A final study addresses the disparities in suicidal tendencies by gender. According to the study by Nowotny et al (n.d), it is proposed that females tend to develop suicidal tendencies more frequently than males. In this study, the authors describe suicidal tendencies as being more pronounced in females residing in gender restrictive environments. This assertion is based on a qualitative secondary study carried out by the authors based on data from the National Longitudinal Survey of Adolescent Health. From this data, Nowotny et al affirm that suicidal ideation is independent of gender in states where there is weak or no control over gender identities. However, in states where there is significant control over gender identities, suicidal ideation grows on the gender against which there is more inclination.
Results and Discussions
1. Role of School Counselors in Suicide Prevention
From the literature reviewed, the most important role that has been associated with school counselor is that of being an ally to all the students. In this role, the school counselor performs a responsibility of listening to the students’ needs and stories without judgment. In this way, the counselor makes the school environment suitable for all students. In the event that the school is comfortable for all students, the students consider their fellow students as being normal regardless of their sexual orientation, or even academic capabilities. The school counselor, being more capable than the teachers in identifying the suicide risk factors in the students, acts as the suicide gatekeeper for all the students for whom he/she is responsible. The school counselor is also supposed to intervene in cases where there are signs of suicidal risk. The first step in achieving this is identified as making harmless contact with the suspected potential victim of suicide. In performing these roles, the school counselor has the obligation to adhere to ethical concerns for the counseling profession. The ethical issues mentioned include upholding the confidentiality and responsibility towards both students and parents and acting in competence with respect to their profession.
2. Trainings required to make the School Counselor Effective
In dealing with suicidal tendencies among teens, it has been ascertained from the literature reviewed that trained counselors perform better both at suicide gate keeping and intervention. For the counselors to enhance their capabilities, two main types of trainings have been identified. The first training is the Safe Space Training which is aimed at making the school environment effective for the learning process as well as accommodative of all groups of students regardless of their capabilities. This has been portrayed as being particularly effective for students in the minority sexual groups identified by the acronym LGBTQs. Another training that has been confirmed to be effective in addressing the issue of suicidal tendencies among teens is the use of Question, Persuade and Refer strategy, which aims at encouraging the identification of suicidal tendencies and intervention beginning with making initial harmless contact with the supposed victim.
3. Suicidal Ideation by Gender, Ethnicity, and Social Class
While ethnicity has not been addressed in depth with respect to suicidal thoughts, the roles of gender and social class are clearly identified. It has been confirmed that in societies where there is a strong sense of gender control, the gender against which the control is over experiences distress and is more likely to chose suicidal motives. For instance, in states where the female gender is considered of a low standing, it will be common to find more girls tending to have suicidal thoughts than boys. Similarly, boys will tend to have more suicidal thoughts than girls where they are oppressed. However, in states with weak gender controls, suicidal thoughts occur based on other factors rather than gender related issues. In terms of social class, it has been confirmed that teens from poor families tend to have more suicidal thoughts than their wealthier counterparts. However, the role played by social status is based more on the need for inclusion rather than the status itself. For instance, teenagers from poor backgrounds may be happy and devoid of suicidal thoughts mainly because they are accepted among their peers while those from wealthier backgrounds may be subject to suicidal thoughts due to their lack of support from family and peers.
Implications of the study
From the findings of this study, it is clear that suicidal thoughts are imminent and on the rise among teens. For school counselors to be able to manage these cases effectively, training is imperative both in recognition of suicide risk and in the intervention measures. It is recommended that teachers should also be included in gatekeeper trainings to ensure there are a high number of individuals looking out for the students. In addition to this, activities that include all students may also help in addressing the issue of social exclusion, which has been identified as being a possible cause of the stress that leads to the development of suicidal tendencies among teens. For instance, it has been observed through the literature review that gifted students are susceptible to suicide due to their consideration as being special. By engaging in all inclusive extra-curricular activities, it is possible to achieve relief from suicidal tendencies from such students. It was also noted that in all cases, suicide victims have underlying issues that make them experience high levels of stress. It is therefore essential for school counselors to be versed with strategies for exploring these underlying issues and subsequently addressing the suicidal tendencies from the root.
Conclusion
The school counselor has immense responsibilities towards students. One of the most challenging issues to address in counseling is when a student has suicidal thoughts. This is however increasing among teens of about 14 years of age and above. While the school counselors may be faced with the dilemma as to whether to make a report on suicidal tendencies versus upholding student confidentiality, the role of resiliency in dealing with suicidal thoughts overrides the decision to report. The school counselor is to act as an ally to all students, besides being the suicide gatekeeper to the students and making the school environment a safe place. In order to this effectively, trainings in QPR and safe place are essential.
While the counselor plays an important role in assisting students deal with suicidal thoughts, individual capabilities, family and community issues all play a role in developing resilience within the potential victim. It is the position of this paper that despite all that the school counselor might do for a teenager contemplating suicide, successful prevention cannot be achieved without individual resilience. The study can therefore be concluded to have been instrumental in addressing all the research questions effectively. However, the major limitation of the study is that it was based on existing literature review which was limited in scope.
References
Byrd, R. & Hays, D. (n.d). Evaluating a Safe Space Training for School Counselors and Trainees using a Randomized Control Group Design. ASCA
Delisle, J. (1986). Death with Honors: Suicide Among Gifted Adolescents. Journal of Counseling and Development, Vol. 64: 558-560.
Everall, R., Altrows, J. & Paulson, B. (2008). Creating a Future: A Study of Resilience in Suicidal Female Adolescents. ASCA.
Gibbons, M., & Studer, G. (2008). Suicide Awareness Training for Staff and Faculty: A Training Model for School Counselors. ASCA.
Given, L. M., Winkler, D., & Willson, R. (2014). Qualitative research practice: Implications for the design and implementation of a Research Impact Assessment Exercise in Australia. Research Institute for Professional Practice, Learning and Education
Kress, V., Drouhard, N., & Costin, A. (2006). Students who Self-Injure: School Counselor Ethical and Legal Considerations. ASCA
Nowotny, K, Peterson, R, & Boardman, J. (n.d). Gendered Contexts: Examining the Variation of Suicidal Ideation for Female and Male Youth across U.S. States. University of Colorado Press.
Reis, C. & Cornell, D. (2008). An Evaluation of Suicide Gatekeeper Training for School Counselors and Teachers. ASCA.