Collaborative Assessment and Management of Suicidality
Highlights from Psychotherapy Matters’ 6th Collaborative Care Conference on Suicidality
At Psychotherapy Matters, we believe that the most complex challenges in mental health care, like suicidality, are best addressed together. That commitment to collaboration was at the heart of our 6th Collaborative Care Conference, which brought together psychotherapists, psychiatrists, and members of the Ontario Society of Registered Psychotherapists (OSRP) for an evening of learning, reflection, and dialogue.
Suicide: An Urgent and Shared Concern
Suicide is among the leading causes of death in Canada, with approximately 4,000 lives lost each year. While the numbers are sobering, they are not abstract. As clinicians, we know that many of our clients will struggle with suicidal thoughts at some point in their lives. For some, these thoughts are fleeting; for others, they persist and intensify, leading to risk of self-harm or death.
Regardless of the context, one truth remains: therapists cannot avoid this issue. Even if suicidality is not the presenting concern, it often emerges during the therapeutic process. This reality underscores the importance of collaboration, clear assessment, and shared responsibility.
Balancing Clinical Care and Liability
One of the core themes explored during the conference was liability—both professional and personal. Supporting clients with suicidality can feel overwhelming. Clinicians often experience stress, fear, or even countertransference reactions that may complicate the therapeutic alliance. Alongside these personal challenges, we also navigate the legal and professional standards of care.
The best protection? Thoughtful, well-documented assessment and planning—and, whenever possible, sharing that responsibility within a collaborative model. At Psychotherapy Matters, our Virtual Collaboration Clinic (PMVC) is specifically designed to enable psychotherapists and psychiatrists to partner in managing risk, supporting clients, and protecting clinicians.
From Assessment to Intervention
During the conference, Dr. Allan Steingart emphasized three interconnected priorities:
- Liability: Recognizing both the personal toll and professional responsibility involved in supporting suicidal clients.
- Assessment: Asking the right questions consistently, documenting risk factors clearly, and using structured tools like the Columbia Suicide Severity Rating Scale to guide decision-making.
- Treatment: Developing collaborative, evidence-informed plans that address both psychiatric and psychotherapeutic needs.
This model emphasizes that assessment and treatment are inextricably linked to documentation and planning. A well-structured safety plan protects both clients and therapists from isolation during these challenging clinical moments.
Collaborative, Not Contractual
One of the most compelling insights of the evening was the shift away from outdated “no-suicide contracts” toward collaborative crisis response plans. Research shows that contracts focused on what a client must not do are far less effective than collaborative safety planning that helps clients identify warning signs, protective factors, and concrete steps for managing crises.
This approach reflects the ethos of Psychotherapy Matters: collaboration instead of coercion, support instead of isolation.
Treatment Modalities that Work
Evidence continues to show that specialized approaches can make a difference for chronically suicidal clients:
- Dialectical Behaviour Therapy (DBT): The gold standard for treating chronic suicidality, though resource-intensive.
- Cognitive Behavioural Therapy for Suicide Prevention (CBT-SP): A structured approach that targets suicidal thoughts and behaviours directly.
- Collaborative Assessment and Management of Suicidality (CAMS): A flexible, brief intervention model that aligns seamlessly with PM’s collaborative philosophy and can be integrated into many therapeutic approaches.
In every case, the goal is the same: meeting clients where they are, respecting their autonomy, and helping them find reasons to live.
Why Collaboration Matters
At PMVC, collaboration with psychiatrists allows psychotherapists to share the responsibility of care, develop comprehensive treatment plans, and support clients in ways that recognize the full complexity of their struggles.
As Dr. Steingart reminded participants:
“The empathic response to suicidality is recognizing that suicide may feel like an option, but it is not the only solution. Together, we can instill hope, broaden perspective, and work with clients to find other paths forward.”
September is Suicide Awareness Month
Conversations like this one remind us why awareness, prevention, and collaboration are so urgent. As we mark Suicide Awareness Month this September, let’s commit to reducing stigma, strengthening our professional networks, and standing with clients in their most vulnerable moments.
🌿 At Psychotherapy Matters, we know that we are stronger together. And when it comes to preventing suicide, collaboration truly matters.