When working with a client presenting suicidal behavior, what is an initial step a DBT therapist would take?

In the context of Dialectical Behavior Therapy (DBT), when working with a client who exhibits suicidal behaviors, it is crucial to establish a commitment to therapy as an initial step. This commitment serves as a foundation upon which the therapeutic relationship can be built. It emphasizes the importance of the client's intention to engage in the therapeutic process and helps foster a sense of responsibility for their own well-being.

Requiring a commitment helps to create a sense of safety for both the client and the therapist. It allows the therapist to address the client’s concerns directly and collaboratively. By having the client express their willingness to continue working together, it can also empower them, making them feel more actively involved in their recovery journey.

In contrast, other methods such as challenging coping skills or involving family members may not immediately address the client's crucial need for safety and stability in the therapeutic process. Referring to a psychiatric hospital could be necessary in some cases, but it may not always be the first immediate step in a DBT setting, particularly if the therapist can ensure safety within the treatment context.