Licensed Professional Counselor, Helen, is a 43 year old single mother of a thirteen-year old girl. Nicole has a real gift for working with adolescents and their families at her private practice in Dallas.

Her new clients, Ellie Smith and her 16 year old daughter, Heather, reported problems getting along with each other. Since their appointments were always after school, Heather came in wearing her plaid school uniform, which she seemed proud of. Mother and daughter argued a lot with each other, but after only a few sessions, they seemed to be making progress. Late one afternoon, a sobbing Ellie called Helen. She said Heather had killed herself.  She'd made a macabre scavenger hunt of her suicide, leaving a note on the front door telling her mother to look in the bedroom. A note in the bedroom sent Ellie to the barn, where she discovered Heather hanging from a thin leather strap, her feet dangling inches from the floor.

Helen assured Ellie that she and her husband could not have known Heather would do this. There had been no warning, no threats, no indications of suicidal ideation, or history of drugs, alcohol or violence. The family was grieving, and adding the burden of guilt for not “knowing” or anticipating Heather's destructive act would have been more than they could bear. It was only two hours before Helen's next client would be there, and after talking with the distraught mother, she was exhausted. Later that week, she attended the funeral, and the church was filled with rows of girls wearing the same plaid uniform Heather had worn just a week earlier at her appointment. After the service, Helen could not stop thinking about Heather, and began to doubt herself, wondering if she could have done something to prevent the suicide, if there were signs she should have noticed. Because of client confidentiality there was no one she could talk with about her own feelings. The work that had once been so fulfilling was now overwhelming, and she is considering looking for a less stressful occupation.

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