Responding to Suicidal Statements in CCPT Sessions

In this episode, I respond to powerful questions from Angelica and Mikayla about how to approach suicidal statements made by children in CCPT sessions. These statements—like “I want to die” or “I wish I was never born”—can be deeply unsettling. But they don’t always mean what they seem. I walk through how to interpret these expressions through a child-centered lens and how to respond while remaining fully adherent to the model.

I explain the difference between a child expressing emotional overwhelm versus having intent to harm themselves, and why reflecting feelings and content—rather than probing or redirecting—is critical in preserving the relationship. I also share how to document these moments, communicate with parents, and maintain the therapeutic alliance without overreacting or breaking from the model. This episode is a reminder that we can hold space for big emotions without abandoning the principles that make CCPT so effective.

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Common References:
Cochran, N., Nordling, W., & Cochran, J. (2010). Child-Centered Play Therapy (1st ed.). Wiley.
VanFleet, R., Sywulak, A. E., & Sniscak, C. C. (2010). Child-centered play therapy. Guilford Press.
Landreth, G.L. (2023). Play Therapy: The Art of the Relationship (4th ed.). Routledge.
Bratton, S. C., Landreth, G. L., Kellam, T., & Blackard, S. R. (2006). Child parent relationship therapy (CPRT) treatment manual: A 10-session filial therapy model for training parents. Routledge/Taylor & Francis Group.
Benedict, Helen. Themes in Play Therapy. Used with permission to Heartland Play Therapy Institute.

Episode Transcript

(00:00):
You're listening to the Play Therapy Podcast with Dr. Brenna Hicks,
your source for centered and focused play therapy coaching.
Hi,
I'm Dr. Brenna Hicks,
The Kid Counselor.
This is the Play Therapy Podcast where you get
a master class in child-centered play therapy
and practical support and application for your
work with children and their families.
In today's episode,
we are talking through a question from Angelica in Wisconsin.

(00:25):
And actually I also received a question about this from Mikayla in Illinois,
so I'm kind of fusing two questions together
because they're very similar in nature,
and they're about
when a child references suicide or suicidal ideation
in session.
And best practices and how to handle that.

(00:45):
I did actually record an episode about this a while back,
but this is kind of a follow up to that and then also just
some additional questions that came up as a result of listening to that episode.
So I want to dive in a little bit deeply on that.
So,
I'm gonna hit
parts of each email,
so parts from Mikayla and parts from Angelica,

(01:07):
and then I'll be able to answer both.
So I'm curious about addressing suicide in sessions with kids that are younger,
specifically under the age of 11.
They run with impulsive emotion rather than reason.
How have you addressed this with kids?
If you have,
in a way that's in line with CCPT?
do you keep it as I'm wondering or curious if

(01:28):
you have thoughts about harming yourself or ending your life?
How do you reassure parents who are rightfully concerned about this and wanting
to shift sessions away from play therapy into coping and suicide prevention?
And then
second set of questions.
I listened to the podcast recently where you talked about suicidal ideation and how
a lot of kids don't really understand the meaning and the weight of statements.

(01:49):
I swear your podcasts always come in time
because shortly after I had a child say,
I,
I always say I want to kill myself when I'm anxious,
which he then shared,
he says,
and feels this almost daily.
If it weren't for you,
I probably would have panicked internally and went in a different direction.
Instead,
we explored the feelings.
And identified he doesn't actually want to die.
He just wants the chaos in his life to stop.

(02:11):
He had zero intent and true intention.
So my question is,
if and when kids make statements like this,
do you let parents know?
I did end up calling Dad and posed it as a general check in and said,
I wonder how he's been responding to his anger and anxiety lately.
Dad brought up the statements himself,
which I then high level shared that the client does
not present with intent or show risk to himself.

(02:33):
Even just in this last session,
he was able to identify the statement being false,
so I assured Dad that he is and will continue to make progress in therapy.
I'm curious how you would approach this.
And then my second question is how you would
engage with a child after statements like this.
I reflected his statement back,
which is what prompted him to explore he doesn't actually want to die.
Being non-directive,

(02:54):
how would you go about a conversation?
My job requires columbias to be completed.
I don't know if that was a typo.
I'm not even sure what a columbia is,
if that is actually what you meant to say.
So
that could be a misty,
so I don't know.
My job requires something to be completed.
So I did this through conversation,
but I'd love to hear a walkthrough of what a non-directive approach would be.

(03:14):
OK.
So I'm just gonna kind of fuse all of that together
into my response and hopefully this will be helpful for everybody.
So,
when we have a child that says something
that is
alarming or concerning or it indicates that
they are
in
stress,

(03:34):
duress,
or they're really emotionally overwhelmed,
and that can be a variety of things.
So that could say that could be saying I wish I was never born.
That could be saying,
I just want to die.
That could be saying,
sometimes I just want to kill myself,
that can be saying,
I wish that I could just go to heaven and be with
family member that's already died.

(03:55):
OK,
so
we understand back to the earlier episode.
That
kids are trying to communicate the depth of their feeling
without an emotional vocabulary.
Without
cognitive capacity.
And without the verbal ability to effectively communicate.
And therefore,

(04:17):
it's basically,
I feel so bad
and I just want to escape this.
I don't know any other way to escape it,
but I just want you to know how yucky this is for me.
So I think we have to think through this
in terms of it's never about what the child says.
Now,
are there children who are suicidal?

(04:38):
Absolutely.
And so,
that we need to be very intentional
about understanding what that looks and is like.
A child in a playroom with you,
Angelica,
for example,
saying,
I always say I want to kill myself when I'm anxious.
You hear what that says?
I always say

(04:58):
I want to kill myself when I'm anxious.
This is my pattern of behavior.
This is what I'm telling people so they understand the depth of my pain and misery.
This is how I'm trying to get my needs met.
I say that I want to kill myself when I'm anxious.
That's not I want to die.
That's not intention to die.

(05:18):
That's not suicidal ideation.
But we are so attuned again because of
potential lawsuits because of concern,
because of ethical and legal,
and I,
you know,
we've been bombarded
with
lawsuits and threats and malpractice and whatever,
and
I think it has spooked us to a degree.

(05:40):
CCPT
is,
we accept the child where they are.
And we sit with them in the pocket of their feelings.
And
we wait to see how things unfold.
So the very first thing you're gonna do is document
that the child expressed something.
Then you're going to use a reflective response.

(06:02):
So you're either going to reflect content or you're going to reflect feeling.
And you're gonna wait.
Because we feel like we need to fill
the silence,
we need to fill the gap.
We need to fill the pause.
We don't.
And Angelica,
you said that you reflected,
and that's when he said,
Well,
no,
I actually don't want to die.

(06:23):
I just want the chaos in my life to stop.
What insight?
A lot of kids aren't able to verbalize that,
but we can deduce that.
So,
it's really important that we remain adherent to the model,
so we're going to reflect content and reflect feeling.
If we believe that the child is actually suicidal.

(06:44):
Then we're going to,
yes,
of course,
have to call parents.
Yes,
of course,
we might have to make a report.
In 20 years in my career,
I've never had a child actually suicidal,
even if they've talked about it.
I'm not saying those will be your ratios or your odds.
I'm just saying in my experience,
anecdotal

(07:06):
experience,
20 years,
I've had lots of kids say stuff like this.
I've never had one that was actually suicidal.
So I think we need to be careful to be patient.
I think we need to be careful to
sit in the pocket with kids.
And often when we just are present,
and when we just listen,
and when we just reflect content and reflect feeling,

(07:29):
way more stuff starts pouring out of kids.
I had a 13 year old disclose recently
that she feels like she has no purpose
and she creates problems for everyone and she blames herself for everything.
And I don't even know why I'm here and sometimes I want to run away
and I just don't think my life has any meaning and blah blah blah.

(07:50):
I could have
really interpreted those statements differently.
Could have really been concerned for her.
And I just continued to reflect content and I continued to reflect feeling,
and then she whispered to me.
I want you to know that I've never wanted to kill myself.
End quote

(08:12):
Kids are very quick
to make sure you know
to the best of their ability where they are.
You'll know if a kid is actually suicidal,
you'll know.
So
be cautious,
be careful,
be intentional
about sitting in it with them
and
Almost always

(08:33):
they end up.
Changing
their lens.
They end up
solving their problem,
they end up seeing something positive,
they end up
giving you a different perspective.
Why?
Because they're self-actualizing.
And they have the relationship with you,
they have the environment with you,

(08:53):
which creates the time,
the tools,
and the opportunity to work through anything.
So,
therefore,
we don't need to say I'm wondering if you,
or I'm curious if you.
If we don't
have a lot of reason to believe the child is actually suicidal.
Then we're just going to use reflective responses.

(09:16):
Now,
if we have reason to believe the child is suicidal,
has intent,
is actually in that place,
then we're not wondering and we're not curious.
We're stating facts at that point.
I told you when we first met on our very first week
that the only time I would ever have to tell someone
what you said or did in here.

(09:38):
Was if
you're not safe,
if I'm not safe or if a judge tells me that I have to,
and right now you're not safe.
So I'm gonna have to talk to your
caregiver,
parent,
loved one,
whomever.
We're just stating facts at that point.
We're also gonna say something like,
hmm.

(09:59):
You are just,
you're really upset and things feel really bleak,
and
you're not sure that you want to live,
but you know that you're not for hurting.
We're gonna pseudo limit set and set an expectation.
So we're not going to do the dance of I wonder,
I'm curious,
I'm not sure.
I,
I'm trying to like gently probe around this.

(10:20):
If we believe that a child is truly suicidal,
we move into facts
and we move into action.
And we
talk to parents and we call appropriate people if necessary,
because we have to take that very seriously.
But like I said,
in my experience,
20 years,
I've never had one
that has actually been at that point.

(10:41):
So then we err on the side of adherence to the model,
and we sit in the pocket with the kid
and that's uncomfortable and it is hard
and it makes everyone uneasy.
And so
my approach,
if I don't believe the child is suicidal,
I make
my documents,
my documentation for my in session notes,
and then at the next 5 week parent consult,

(11:03):
I bring up that the child is trying to find
ways to express the depth of what they're going through,
and they're saying some things that could be concerning,
but
your child's working through the things that they need to work through,
and I'm,
I do not believe that they are suicidal.
I'm not concerned for that.
They're just really wrestling with some stuff
and because they don't have emotional vocabulary,

(11:26):
they're grasping at something that can express the depth of their feelings.
And so if they say things like that to you at home,
Here's what you might do,
and I have parenting podcast episodes
that have talked about this very thing because
kids say this stuff to their parents too.
I wish that I would just die.
I wish that I would just have never been born.

(11:47):
I don't even want to live anymore and parents freak and they call me and they're like,
my kid is suicidal
and they're 5 years old.
And
they're just
miserable.
So,
it's also helping parents understand not only
appropriate ways to respond,
but help them understand the why.

(12:07):
So it's a very delicate balance,
but we can remain fully adherent to the model whether
there's just discussion of the thoughts
or actual intention.
We still can remain fully adherent and that is always the
goal because the last thing that we would want to happen.
is for the child to feel like the relationship got fractured or ruptured.

(12:29):
And deviation
is gonna be your fastest way to get there.
If they feel that they're being interrogated,
fastest way to get there.
If they feel that you can't handle it,
fastest way to get there.
If you react
and they sense your own emotion,
fastest way to get there.
We remain adherent to the model no matter what,

(12:50):
because that preserves relationship
so that
growth and self-actualization can continue.
So I hope that that's helpful
and I know that we've talked about this several times,
but this is
pressing on a lot of people right now.
I,
I keep getting this in waves,
so I know that this is a really important topic,
and I hope that that encourages you and equips you so

(13:11):
that you feel more confident in circumstances like that moving forward.
If you want to reach out to me,
I'd love to hear from you,
[e-mail].
You can also leave a voice message on 813-812-5525 if you're in the states.
And
I love y'all.
We'll talk again soon.
Have a good week.
Bye.
Thank you for listening to the Play Therapy Podcast with Dr.

(13:31):
Brenna Hicks.
For more episodes and resources,
please go to www.playtherapypodcast.com.