Whether you are a pastor, church staff member, deacon, Sunday School teacher, or anyone else in the Christian ministry, you most likely engage in counseling, whether formal or informal, on a regular basis. Most persons keep things light in terms of theology and/or spiritual advice. Yet, because of the sin-sick world in which we live, we may end up speaking to someone with serious problems whether we realize it or not. The fact that we represent God, the fact that thoughts and actions have eternal consequences, and the fact that Christ is the answer, necessitate that we be as prepared as possible no matter what situation befalls us. Most of us can give an account of the hope that lies within us. Most of us can engage in evangelism. Many of us can share adequate biblical counsel. Many of us are prepared for a variety of questions and situations. But, how many of us are prepared for the threat of suicide? I do not mean how many of us can counsel those who are threatening suicide, though we should be prepared for such as I have been called out on more than one occasion to deal with individuals so-inclined, I am speaking about something more subtle than that. I am speaking of preventative understanding and counsel.
Those of us committed to the discipline of biblical counseling have, among others, the convictions that the Scriptures are sufficient for counseling because in them we have everything we need for life and godliness (2 Pet. 1:3), and that biblical counseling is a ministry in which all Christians should engage as they understand the discipling nature and body dynamic of the church (Rom. 15:14). At the same time, biblical counseling is a serious issue and persons should understand the eternal significance of that which we do when we seek to counsel others from the Scriptures (2 Cor. 2:14-17). Moreover, those who see the church as a biblical counseling center, that is, a place where hurting souls come for help, those who have biblical counseling ministries that reach beyond the bounds of the church roll, should be on the alert regarding the gravity of the ministry to which they have been called and the battle they have been called to wage. For example, think of the counselee who comes to you, and unbeknownst to you, is contemplating suicide. Are you prepared for this inevitability? Do you proactively probe this potential threat with certain "at risk" counselees? Do you have a protocol in place? While this article can in no way be exhaustive regarding this issue, let me offer some helpful counsel that should aid in your preparedness.
First, it is critical that you have each counselee fill out a Personal Data Inventory (PDI) form prior to or during your first session. You will have in your hand key information regarding the counselee that simply will not come out in a regular counseling session. Answers to probing questions will be given in written form for you to see, contemplate, and explore as you gather data when dialoguing with the counselee. You may very well spot something that raises a "red flag" in your mind. You will then have an opportunity to minister with the utmost effectiveness for the glory of God and the sake of your counselee. You may find a sample PDI in The Christian Counselor’s Manual: The Practice of Nouthetic Counseling by Jay Adams. The same form is printed in Introduction to Biblical Counseling: A Basic Guide to the Principles and Practice of Counseling by John F. MacArthur, Jr. and Wayne A. Mack. For a more detailed form with relevant probing questions, simply e-mail me and I will be happy to forward a copy of what we use in our counseling ministry.
Second, ask probing questions when encountering "red flags" on the PDI form or in the counseling session. For example, if on the PDI form, in response to the question, "What do you hope to gain from counseling?" an individual writes, "I want to get on with my life," ask the counselee to explain what he means by the statement. Most persons are indicating simply that they are ready to move into the next phase of their lives and leave the past behind. However, rare occasions exist when a person, though inarticulate, is indicating something much deeper. He may be in a state of depression, even to the point of having suicidal thoughts. You as a counselor may not glean this information without this type of probing. Another example may prove helpful. On the PDI form the question is asked, "Can you describe how you feel?" The counselee may respond, "I feel weighted down." Again, probe this response. She may be saying that she is exhausted or stagnant. On the other hand, she may mean that she is overwhelmed, depressed, or at the brink of suicide. In any answer, if an individual indicates that he has contemplated or attempted suicide in the past, simply ask, "Are you contemplating suicide now?" Do not rely upon the fact that your counselee seems to be in a good mood. He may be trying to mask his real feelings. Always ask the question. Information is more likely to be forthcoming and you will have a clean conscience before God.
Third, document your counseling sessions. Of extreme importance is the practice of taking notes and keeping those notes in a file for future reference for counseling, education, or protection. Regarding counseling, you will be better equipped to minister if you remain informed and up-to-date with your counselee. Do not rely solely on your memory. It is weak and fallible. Casual comments may be probed in future sessions if written down. Regarding education, good notes may be used as a teaching tool as you train others to counsel from the Scriptures. Regarding protection, if a counselee does something unexpected, your notes may be the very thing that protect you emotionally, spiritually, and legally. Some of our staff counselors even go so far as to tape record their more difficult cases.
Fourth, when dealing with difficult cases, we make it a practice to have two counselors work the case together. In addition to providing more resources to bring to bear upon the problem, this practice provides added protection for you and the counselee. Your partner may pick up on something you do not and in so doing help the counselee.
Fifth, know the laws in your state regarding information obtained in counseling. We have the conviction that biblical counseling is the only type of counseling sufficient to meet human need. At the same time, we are directed by Scriptures to submit to governmental authority (Rom. 13:1; 1 Pet. 2:13). In our state, if we have direct and immediate information concerning the threat of suicide, we are under obligation to report it to the authorities. For example, if a counselee reveals that she is contemplating suicide, we must report that information immediately. However, if a counselee tells us that he was having suicidal thoughts last year, but no longer has those thoughts, then we are under no obligation to report that information. We would certainly take that information into account in our counseling and be aware that those thoughts could resurface. We would continue to apply the Scriptures to the heart knowing that Christ is the answer to the problem. We are simply making the point that it is your responsibility before the law and the Lord to know the laws in your area and obey them for your protection and God's glory.
Sixth, act with common sense. If a person becomes violent, out of control, or gives indication that he could harm himself or someone else, we would call the appropriate authority in order to "buy time" for the counselee that we might have opportunity to counsel biblically when the counselee has returned to a state of calm. We only call for outside help when obligated by law or when someone is in immediate danger.
Seventh, maintain the conviction that you have the best counsel for those contemplating suicide. Persons in this state of mind need a change of heart. You have the only counsel that can produce genuine change (Rom. 1:16; 10:17; 1 Thes. 2:13; 2 Tim. 3:16; Heb. 4:12; Jas. 1:18; 2 Pet. 1:3). Thus, even if your counselee has been taken by the authorities, make every effort to follow-up with biblical counsel.
Eighth, take encouragement from knowing that God is sovereign in all things including the circumstances in the life of the counselee, His providence in bringing this counselee to you, and the change or lack thereof in the hearts of individuals. Never be intimidated by psychology, state law, or results. Because psychology is vain and deceptive (Col. 2:8), you must counsel from the Scriptures. While you must adhere to state law, you may and must follow-up with your counselee in giving biblical admonition. Though results vary, God is sovereign. If you counsel someone who has had suicidal thoughts or someone who is in a deep state of depression, simply pray, counsel, and trust the Lord. If that person ultimately rejects your counsel, or, if that person seemingly responds to the counsel and then surprises you and everyone else by ultimately committing suicide, remember the sovereignty of God. We are not saying we will not grieve. An understanding of God's sovereignty does not remove hurt or compassion. What we are saying is that you are the messenger and God is the One who determines the results. Do not forsake your convictions or your confidence if and when persons reject the message. The apostle Paul wrote, "But thanks be to God, who always leads us in His triumph in Christ, and manifests through us the sweet aroma of the knowledge of Him in every place. For we are a fragrance of Christ to God among those who are being saved and among those who are perishing; to the one an aroma from death to death, to the other an aroma from life to life. And who is adequate for these things? For we are not like many, peddling the word of God, but as from sincerity, but as from God, we speak in Christ in the sight of God (2 Cor. 2:14-17)."
Putting this protocol into place--utilizing the PDI form, probing "red flags," documenting your sessions, employing the practice of team counseling, adhering to local laws, acting with common sense, maintaining a commitment to biblical counsel, and taking encouragement from God’s sovereignty--will enable you to counsel more effectively in those difficult cases. You will be at peace in your ministry knowing that you are fulfilling your responsibility before God and others. In this way, you will "Be diligent to present yourself approved to God as a workman who does not need to be ashamed, handling accurately the word of truth (2: Tim. 2:15)," for the good of others and the glory of God.