INFORMED CONSENT WITH SUICIDAL PATIENTS: RETHINKING RISKS IN (AND OUT OF) TREATMENT M. DAVID RUDD University of Utah THOMAS JOINER Florida State University GREGORY K. BROWN University of Pennsylvania KELLY CUKROWICZ Texas Tech University DAVID A. JOBES Catholic University of America MORTON SILVERMAN University of Chicago LILIANA CORDERO Texas Tech University Informed consent is uniformly accepted as essential to the treatment process. However, the relevant literature has not discussed issues of risk specific to sui- cidal patients, nor has such information routinely been included in the informed consent process. The implications of including suicide-specific risk informa- tion in the informed consent process is discussed and examples provided. Keywords: informed consent, suicidal, reattempt rates, collaborative, treatment compliance Informed consent is an essential element in psychological assessment and treatment, with ethics codes for mental health professionals rou- tinely addressing the need for informed consent (American Association of Marriage and Family Therapy, 2001; American Counseling Associa- tion, 2005; American Psychiatric Association, 2006; American Psychological Association [APA], 2002; Canadian Psychological Associa- tion, 2000). For example, the APA ethics code (APA, 2002) provides clear guidelines for obtain- ing informed consent to both psychotherapy and assessment. Most state licensing boards have sup- plemented these guidelines with additional re- quirements known as board rules for practice; routinely in much greater detail and more specific to clinical application than that provided by the ethics code (e.g., Association of State and Pro- vincial Psychology Boards, 2003). In accordance with the APA ethics code informed consent has a number of identifiable features including: obtain- ing it “as early as is feasible” (p. 1072), recog- nizing the limits to privacy and confidentiality, providing the client/patient the chance to ask questions about the assessment/treatment pro- cess, as well as providing information about the “developing nature of treatment, the potential risks involved and alternative treatments” (p. 1072). In short, every individual that enters psychological treatment (or assessment) partici- pates in an informed consent process; one that Bennett et al. (2006) noted is a continuous and evolving process not completed in just the first session or two. Many have written about the application of the ethics code to the treatment process and informed consent procedures (Fisher, 2003; Haas & Mal- ouf, 2005; Knapp & VandeCreek, 2006; Nagy, 2005), but we were unable to identify anything specific to suicidal thoughts, suicide attempts, or M. David Rudd, Kelly Cukrowicz, and Liliana Cordero, Department of Psychology, Texas Tech University; Thomas Joiner, Department of Psychology, Florida State University; Gregory K. Brown, Department of Psychology, University of Pennsylvania; David A. Jobes, Department of Psychology, Catholic University of America; Morton Silverman, Univer- sity Counseling Center, University of Chicago. Correspondence regarding this article should be addressed to M. David Rudd, PhD, College of Social and Behavioral Science, University of Utah, 260 S. Central Campus Drive, Salt Lake City, UT 84112. E-mail: david.rudd@csbs.utah.edu Psychotherapy Theory, Research, Practice, Training © 2009 American Psychological Association 2009, Vol. 46, No. 4, 459 – 468 0033-3204/09/$12.00 DOI: 10.1037/a0017902 459