An exploratory investigation of psychologist approaches to and experience with client suicidality

In psychological practice, how therapists support clients with suicidality while maintaining their own wellbeing is poorly understood. Addressing this gap may help inform training and professional development needs. A mixed-method approach was employed. Psychologists working in private practice were asked about treatment approaches, training and self-care behaviours using questionnaire (<i>n</i> = 59) and semi-structured interviews (<i>n</i> = 11). Most practitioners reported treating clients who had expressed suicidal ideation (98%), intent (86%), plan (85%) and attempt (75%), and almost half reported having experienced a client death (45–46%). The most reported treatment approaches included risk assessment, safety planning and tailored interventions (often involving family and support networks). Reflexive thematic analysis of open-ended questionnaire and interview responses revealed six themes: suicidality as a human experience, impact of client suicidality on psychologists, supporting clients with suicidality, navigating the impact of client suicidality, training needs and challenges treating clients with suicidality. The present findings indicate the multifaceted challenges psychologists encounter when supporting clients with suicidality and highlight the need for enhanced training and professional development. Future research could explore the development of more comprehensive and experiential-based training strategies for psychologists, as well as investigate the long-term impact of such training on their ability to effectively support clients with suicidality. <b>What is already known about this topic:</b>Client suicidality is commonly experienced in psychologists’ clinical practice.Client suicidality is one of the most challenging tasks for psychologists, often resulting in adverse impacts.Psychologists report a lack of training in effectively supporting clients experiencing suicidality. Client suicidality is commonly experienced in psychologists’ clinical practice. Client suicidality is one of the most challenging tasks for psychologists, often resulting in adverse impacts. Psychologists report a lack of training in effectively supporting clients experiencing suicidality. <b>What this topic adds:</b>Findings highlight the specific challenges psychologists encounter when supporting clients with suicidality, including systemic, client-related and practitioner-related obstacles.Psychologists emphasised the need for more practical, applied training specifically focused on suicidality.The importance of normalising suicidality as a potential client issue is underscored, while cautioning against overnormalisation and desensitisation. Findings highlight the specific challenges psychologists encounter when supporting clients with suicidality, including systemic, client-related and practitioner-related obstacles. Psychologists emphasised the need for more practical, applied training specifically focused on suicidality. The importance of normalising suicidality as a potential client issue is underscored, while cautioning against overnormalisation and desensitisation.