ABSTRACT
Your of®ce phone rings shortly after 5.30 p.m. on a Friday evening. You've had a long and stressful week and are anticipating a relaxing weekend. One of your clients is on the line. She reveals that she is in a suicidal crisis and is currently standing by a major transport bridge in your area (she is vague about which one) with the intention of jumping off. Her plan had been to leave a message for you on the of®ce answer phone apologizing for her action. She has ¯attened affect and indicates that several events have occurred in the last 48 hours that indicate to you that her already chronic risk has increased. She has frequently been hospitalized in similar situations in the past, but this has rarely helped. She expresses extreme hopelessness and remains reluctant to talk. Do you remain on the phone and try to soothe her out of the plan by offering extra support or other interventions? Do you remain matter of fact, attempt to solve the problem or problems that led to the crisis? Do you try to ®nd out where she is and then send emergency services to her aid? And if you do, do you stay on the phone while you wait for them to arrive? Do you try to arrange hospitalization? What do you do and, perhaps more importantly, what principles do you use to decide what to do?
