Morality and emotion in therapy clients’ accounts for suicidality

Suicide is a substantial public health problem, yet little is understood about the ways in which clinicians and clients discuss suicide attempts. This study investigates commonalities in psychology clients' accounts of suicide attempts that were survived, or aborted after being enacted or planned and prepared. We used conversation analysis to investigate conversations within psychosocial (risk-assessment) sequences during four initial psychology consultations (interviews) recorded in an Australian voluntary outpatient multidisciplinary healthcare clinic. Analysis showed that clients' suicidality accounts routinely included reports of morally problematic treatment by others, with clients typically seeking clinician responses to these elements of their accounts. Clinicians were not, however, observed to engage the moral dimensions of clients' accounts and instead routinely oriented to the impact of these behaviours on clients. We conclude by discussing the implications and consequences of these differing orientations for psychologists, clients, and future suicide-risk research.