How to set up a therapeutic alliance? With the family.
If it is the family who makes the request for therapeutic intervention, work with them to change the communication. As in the depressions, it is not appropriate to adopt a positive communication because it does not work. It is not always possible to enter therapy directly.
We must assess the risk well and we must admit that there are situations that we cannot manage; the hospital is then the only solution. The suicide attempt should be seen as a symptom and we need to look for what dysfunctional pathological structure lies behind it.
The definition of suicide attempt varies: for some, taking 50 grams of anxiolitic like Valium is presented as a suicide attempt when the only effect is to sleep.
On the contrary, other people minimize and may consider that taking the highway in reverse is not a suicide attempt. The situations are very different and so are the inherent risks.
