Age appropriate "no-suicide" agreements: Professionals' ratings of appropriateness and effectiveness

Michael Wade Davidson


In the present study, a random sample of non-student members of the American Psychological Association's (APA) Sections of Clinical Child Psychology (Division 12, Section 1), Pediatric Psychology (Division 12, Section 5), all non-student members of APA who listed 521-Clinical-Child-Psychology as a major field and all non-student members who listed 070107-Adolescent-Therapy, 234000-Child-and-Pediatric-Psychology, and 070206-Child-Therapy as "Psychological Specialty Areas," were asked to read one of six vignettes describing an interaction between a therapist and a suicidal youth in which the therapist used a "no-suicide" agreement. These six vignettes were also paired with one of three "no-suicide" agreements thus creating 18 treatments. The psychologists were asked to complete a questionnaire in which they rated the appropriateness and effectiveness of the intervention. Factors believed to influence appropriateness and effectiveness were examined utilizing a 3 x 3 x 2 (reading level of the agreement x age of client x level of academic performance of the client) factorial design. In the present study, professional psychologists indicated that they were mildly to moderately in favor of written "no-suicide" agreements regardless of a child's age, academic ability or the reading level of the agreement. However, there were some variations in their positive attitudes. They were slightly more positive about "no-suicide" agreements for older children rather than 6-year-olds. They were mildly supportive of their use with 6-year-olds. They were also more positive about "no-suicide" agreements for youth who have no history of academic problems than for youth who have a history of academic problems. The reading level of the "no-suicide" agreement made no difference in their ratings of appropriateness and effectiveness. This area of research is so new that everything should be taken with a note of caution. Clinicians in this study were mildly to moderately supportive--even if the child could not read the agreement. The process of getting the agreement may be the most important thing. In the case of "no-suicide" agreements the process may be far more important than the specifics.