Mykka L. Gabriel, Laura G. Dunson Caputo, Jenny L. Cureton
Despite rising suicide rates and disparities in minoritized communities as well as calls from experts and community leaders to address cultural factors, most suicide risk assessment (SRA) approaches remain acultural. Counselors who use acultural SRA can cause harm by neglecting to address crucial factors that may heighten or protect clients from suicide risk. This article provides guidance for proactive and responsive broaching in SRA using the four dimensions of the Multidimensional Model of Broaching Behavior (Day-Vines et al., 2020). The model provides an overview of key concepts, explicit recommendations for counselors in diverse settings, and an illustrative case example. Concerns, limitations, and implications for counselors, supervisors, educators, and researchers are addressed.
Keywords: suicide, risk assessment, broaching, cultural factors, acultural
Recent suicide data demonstrate ongoing demographic disparities. Centers for Disease Control and Prevention (CDC; 2025) data showed an increase in suicide between 2018 and 2023 for some non-White racial groups, including a 25.2% increase among Black Americans and 10% increase among Hispanic persons. With a suicide rate of 23.8%, American Indian or Alaska Native persons continue to have the highest rate. Suicide ideation is more than twice as prevalent for adults with disabilities than those without disabilities (Czeisler et al., 2021). Kidd et al. (2023) found that significantly more transgender adults had attempted suicide than cisgender adults: 42% versus 10.6%. In a meta-analysis, Cogo et al. (2022) found that immigrants and refugees are at high risk for suicidal ideation, with rates as high as 70% in some groups. Risks also increase for immigrants and refugees if they experience trauma, socioeconomic disadvantage, or a lack of accessible care.
Recent surveys have highlighted the elevated suicide risk among LGBTQ+ youth with intersecting marginalized identities. Compared to White LGBTQ+ youth, non-White groups reported higher rates of suicidal ideation and attempts. For example, 43% of White, 46% of Latinx, and 55% of Native/Indigenous LGBTQ+ youth attempted suicide in 2022 (The Trevor Project, 2023). Findings from the 2024 survey continued to show higher rates of suicidal ideation among LGBTQ+ youth of color (The Trevor Project, 2024). Sallee et al. (2022) found similar results in their study on interpersonal predictors of suicide among “not straight” adolescents. The authors also highlighted the need for further research on the “unique stressors” of non-White “not straight” students. Collectively, these studies emphasize the necessity of integrating connections between suicide risk and minoritized identity.
Critical suicidology is an emerging qualitative approach increasingly recognized in the mental health field wherein suicidal experiences are contextualized through a cultural and social lens (Marsh, 2020; White, 2017). Community and government leaders have urged professionals to address cultural factors of suicide (Miller & Castle Work, 2024; Rhodes, 2023; U.S. Department of Health and Human Services [DHHS], 2024), which are both individual as well as socioecological (Compton et al., 2005; Day-Vines, 2007; Molock et al., 2023). For instance, systematic oppression is associated with increased suicide risk (Alvarez et al., 2022; Fulginiti et al., 2021). Other contextual factors, such as cultural sanctions and family or social conflict, are better predictors of suicide attempts than acultural factors (Chu et al., 2019; Compton et al., 2005). Acultural understandings of suicide do not include cultural considerations; instead, they only cover “classic risk and protective factors” (Chu et al., 2019, p. 56) such as depression (Chu et al., 2019; Khan, 2005), substance abuse (Lawson-Te Aho & Liu, 2010), and reasons for living (Chu et al., 2019), which are typically conceptualized without acknowledging systemic contributors (Hazan & Romberg, 2022; Lawson-Te Aho & Liu, 2010).
Counseling research has shown that mental health symptoms of Black, Indigenous, and people of color can present differently than those of White clients (Litam, 2020; Wright et al., 2023). However, most suicide risk assessment (SRA) approaches are acultural, which means that they lack consideration of sociocultural factors in suicide risk (Chu et al., 2019; Mendoza-Rivera et al., 2022). Neglecting to address culture in SRA can cause serious misunderstandings of the client’s experience and underestimate their risk of suicide (Rogers & Russell, 2014; Van Zyl et al., 2022). Counselors must consider suicide risk in the context of culture in order to meet clients’ needs as well as to maintain ethical and practice standards (American Association of Suicidology [AAS], 2023; American Counseling Association [ACA], 2014; Ratts et al., 2016). Yet, scant counseling literature (Chu et al., 2013; Molock et al., 2023) provides concrete guidance on how to address culture while assessing suicide risk.
Integrating the Multidimensional Model of Broaching Behavior (Day-Vines et al., 2020) into SRA procedures is a plausible solution for these challenges. Broaching explores racial, ethnic, and cultural (REC) contexts throughout the counseling process (Day-Vines et al., 2007). Broaching applications have been well-documented in the counseling literature (Bayne & Branco, 2018; Day-Vines et al., 2007, 2020; Jones et al., 2019; Jones & Welfare, 2017; King, 2021). In a recent Counseling Today article, counselors noted cultural norms that may exacerbate suicide risk and the use of broaching to build trust (Rhodes, 2023). Our article describes an application of the broaching model (Day-Vines et al., 2020) used in tandem with evidence-based SRA tools when assessing suicide risk with minoritized clients. We briefly review the intersection of culture and suicide, review broaching, compare acultural with culturally responsive SRA, and present the potential of broaching to address the barriers mentioned above. The proposed broaching application contains suggestions for when, what, and how to broach culture for SRA, along with brief illustrative examples. We include implications for counseling, supervising, and teaching, then conclude with critical considerations for counselors and directions to research broaching for culturally responsive counseling related to suicide.
Culture and Suicide
Recommended practice for SRA includes the combination of a formal instrument, or lethality measurement scale, and a clinical interview about the client’s protective factors, ideation, intent, plans, access to lethal means, behavior, and warning signs (AAS, 2023; Jackson-Cherry et al., 2017). Clinical judgment should consider “developmental, cultural, and gender-related issues related to suicidality” (AAS, p. 2). Cultural factors, such as oppression, stigma, misconceptions, and community disconnection, can influence suicide risk. A primary factor driving suicide risk is cultural oppression, including historical trauma, structural racism, and other discrimination (Fulginiti et al., 2021). Suicide risk is higher for individuals with multiple oppressed identities (Vargas et al., 2020), such as Latinx LGBTQ youth (Abreu et al., 2023). People from marginalized communities, such as sexual, gender, and racial minorities (Ayhan et al., 2019; Sim et al., 2021) and people with disabilities (Krahn et al., 2015) face harmful oppression from the health care system itself because of bias and preconceived judgments on presenting behaviors (Johnson, 2024).
Members of these communities also experience stigma and misconceptions. Several instruments measure suicide stigma or negative judgments toward people experiencing suicidal thoughts (Nicholas et al., 2023). Internalizing suicide stigma or stigmatizing messages about one’s minoritized identities increases suicide risk (Carpiniello & Pinna, 2017). Some suicide misconceptions are related to culture. For example, James et al. (2023) found misunderstandings among Black Americans that suicidal thoughts are temporary or not real and that only people from other races or those too weak to deal with life stressors have such thoughts.
These cultural factors can influence whether and how individuals seek support for suicide. Members of marginalized groups report avoiding seeking professional help because of health care oppression (Dautovich et al., 2021). They may not disclose suicidal thoughts to professionals, family, or friends based on messages in their cultural community that doing so would make loved ones disappointed in them, bring shame to their family, and/or prompt their isolation from the community (Knapp & Logan, 2023; Molock et al., 2023).
Suicide protective factors (SPFs) are internal and external factors that create protective barriers that reduce death by suicide (Crosby et al., 2011). Other cultural factors may protect against suicide. Most ethnoracial groups experience social support, community connectedness, and ethnic identity as SPFs (Odafe et al., 2016; Wang et al., 2020). Support from family and friends also acts as an SPF for LGBTQ+ individuals, including queer youth of color (Lardier et al., 2020) and transgender/gender-diverse adults (Rabasco & Andover, 2021). It is important to note that religious, moral, or cultural objections to suicide may be an SPF for some but a risk factor for others in their cultural group and can change from protecting to exacerbating an individual’s suicide risk because of isolation or distress from stigmatizing messages (Odafe et al., 2016; Sharma & Pumariega, 2018).
Competent counseling for suicide involves assessing for suicide risk factors and SPFs and then using that information to inform interventions and continuity of care (AAS, 2023). Standard suicide assessment practices are largely acultural, omitting essential factors like race, ethnicity, and culture in a client’s suicide risk (Chu et al., 2013; Day-Vines, 2007; Molock et al., 2023; Van Zyl et al., 2022). Common SRA tools include the Columbia-Suicide Severity Rating Scale (C-SSRS; Posner et al., 2008), the Collaborative Assessment and Management of Suicidality (Jobes & Drozd, 2004), and the Ask Suicide-Screening Questions (Horowitz et al., 2012). For example, nearly two decades of C-SSRS validation provides evidence across 10 psychometric properties (The Columbia Lighthouse Project, n.d.). This research has examined samples diverse in setting, diagnoses, age, and cultural demographics, and it has been translated into over 150 languages. The C-SSRS contains questions related to suicide ideation, intensity, and behavior to determine the level of risk (Posner et al., 2008). It has shown high specificity in multiple studies (Kumar et al., 2025) and is one of the few suicide scales that demonstrates sensitivity to change in suicide risk across time (Riblet et al., 2023). However, researchers have noted a persistent lack of meta-analyses investigating the C-SSRS and similar acultural measures with culturally diverse samples (Nam et al., 2024; Pollak et al., 2024).
A few recent SRA tools explicitly address culture, including the Cultural Assessment of Risk for Suicide (CARS; Chu et al., 2013); its screener version, CAR-S (Chu et al., 2018); and SHORES (Cureton & Fink, 2019). CARS is a formal instrument tested with samples including racial, ethnic, and sexual minority adults (Chu et al., 2013, 2019). These validation studies showed acceptable internal consistency for its subscales and high internal consistency overall compared to acultural SRA measures. A recent investigation of CARS with Black American adolescents (Francois et al., 2025) revealed acceptable internal consistency overall but divergent factor structure, indicating that the modified version of CARS-S may not adequately represent minority stress, family conflict, or cultural objections in Black youth suicide risk. SHORES (Cureton & Fink, 2019) is an SPF mnemonic to support recall during SRA, safety planning, and other suicide prevention, intervention, and postvention. To date, no research on its use has been published. Counselors can also utilize the Cultural Formulation Interview (CFI; American Psychiatric Association, 2022) to assess the cultural context of diagnostic symptoms. Whether an SRA tool is acultural or culture-focused, empirically supported or still emerging, two recommendations are consistent in the literature: 1) use it only as an initial or adjunct tool toward comprehensive suicide assessment (e.g., Cureton & Fink, 2019; Kumar et al., 2025) and 2) make adaptations to better address culture (e.g., Chu et al., 2019; Francois et al., 2025; Pollak et al., 2024).
Suicide Risk Assessment and Clinical Interview
As previously stated, recommended SRA practice consists of an evidence-based tool and a clinical interview (AAS, 2023; Jackson-Cherry et al., 2017). Counselors can integrate broaching into the clinical interview to explore cultural factors that shape the client’s level of risk and their subjective experience. We used the C-SSRS (Posner et al., 2008) for illustration and built on previous guidance for broaching practices in counseling (Day-Vines et al., 2020; Erby & White, 2022; Jones & Welfare, 2017) to recommend ways counselors can incorporate cultural considerations effectively into the SRA interview. Although broaching may benefit culturally responsive suicide intervention and ongoing management, we focused on its use in counselor–client collaborative risk assessment as a first step for improved practice.
Broaching
Day-Vines et al. (2007) coined the term broaching to define the counselor’s “ability to consider the relationship of racial and cultural factors to the client’s presenting problem, especially because these issues might otherwise remain unexamined during the counseling process” (p. 401). Broaching facilitates dialogues regarding power and privilege (Erby & White, 2022), strengthens the therapeutic relationship (Knox et al., 2003), and deepens alignment with the Multicultural and Social Justice Counseling Competencies (Day-Vines et al., 2007; Ratts et al., 2016). Broaching has four dimensions of counselor acknowledgment (Day-Vines et al., 2020): (a) intracounseling: REC similarities, differences, and interpersonal processes in the counselor–client relationship; (b) intraindividual: confluence of the client’s identities; (c) intra-REC: within-group concerns between the client and one or more of their cultural communities; and (d) inter-REC: the client’s experiences of oppression. As shown in Table 1 and described below, counselors can integrate each dimension to elicit discussion about culture alongside an evidence-based SRA tool.
Table 1
Multidimensional Model of Broaching Behavior in SRA
| Dimension | Purpose | Focus in SRA |
| Intracounseling | Acknowledges similarities, differences, and interpersonal processes that may impact the client–counselor relationship |
Invites the client to take the lead role as the expert of their experience and formulate a genuine trust between the client and counselor |
| Intraindividual | Acknowledges intersecting identities that shape the client’s experience and view of their presenting concern |
Invites the client and counselor to explore connection(s) between intersecting REC-specific experiences and suicidal ideation |
| Intra-REC | Identifies within-group concerns between the client and one or more of their cultural communities |
Creates an opportunity to explore the context of the client’s belongingness, possible isolation, coping, and contribution to follow-up care |
| Inter-REC | Acknowledges the client’s experiences specific to racism, oppression, and social justice | Creates an opportunity for the client and counselor to specifically address barriers and disparities that directly contribute to the client’s suicidal ideation |
Note. Table 1 includes the purpose of each MMBB dimension (Day-Vines et al., 2020) and its corresponding focus applied in SRA. Specific examples appear throughout the case study. REC = racial, ethnic, and cultural.
Application of the Multidimensional Model of Broaching Behavior in Suicide Risk Assessments
Broaching race, ethnicity, and culture is crucial in culturally responsive SRA. We propose this approach as an additive component with evidence-based tools (e.g., the C-SSRS). Broaching during the interview provides essential context for results to inform a comprehensive assessment of the client’s suicide risk. Using a case example, we explain how counselors can practically incorporate each dimension of broaching within the SRA clinical interview process.
Case Study
Elliana (she/her) presents to the university counseling center for a walk-in appointment. She is a 19-year-old first-generation college student from another state and identifies as a Black cisgender lesbian. She remembered that her professor mentioned the counseling center at the start of the semester and noticed its promotion as LGBTQ+ inclusive with culturally responsive counselors. Elliana finds it difficult to concentrate, which has resulted in lower grades. Her counselor, a Black heterosexual woman, notices that Elliana has indicated headaches, lack of sleep, feelings of hopelessness, sadness, and suicidal ideation on her intake paperwork. Elliana has not verbally disclosed her suicidal ideation to her counselor. Elliana tells her counselor she has a strong relationship with her family and a strong LGBTQ+-affirming community in her hometown. Elliana is the eldest of three from an intact family. Elliana reports feeling disconnected and isolated at school. Despite participating in various student organizations, Elliana feels like an “outsider” with little sense of belonging and conflicts with her roommate. Elliana shares that she has not disclosed her sexual orientation to her roommate because her roommate made negative comments about the LGBTQ+ community and listens to podcasts with anti-LGBTQ+ rhetoric. The counselor’s primary goal in her first interaction with Elliana is to build a therapeutic relationship and assess for safety. She administers the C-SSRS, which indicates a low level of risk (e.g., Elliana denies having any intent or plan). Therefore, the counselor can assist Elliana with a safety plan and follow-up care. To ensure a more comprehensive understanding of her risk, the counselor incorporates broaching questions to explore how Elliana’s cultural background and lived experiences influence her thoughts and coping.
Opportunities for Broaching
An element of integrating broaching in SRA is determining when to do so. SRA (AAS, 2023) and broaching (Day-Vines et al., 2020) should involve an ongoing and collaborative process. Two forms of broaching are proactive and responsive (Day-Vines et al., 2013; King, 2021). We describe each form as an opportunity to broach SRA with Elliana.
Proactive Broaching
Proactive broaching involves a counselor-led orientation to discussing cultural experiences (King, 2021). Proactive broaching initiates opportunities for clients to discuss cultural concerns (Day-Vines et al., 2020), encourages client openness (Drinane et al., 2018), and ensures more accurate information during diagnosis and assessment (King & Borders, 2019). Proactive broaching ranges from a question on a structured intake to the counselor first introducing cultural considerations into the risk assessment. For Elliana, her counselor may say, “As I’m getting to know you, can you tell me a bit about your culture?” Counselors can strengthen their proactive broaching by providing a rationale for the topic change; addressing verbal and nonverbal reactions to broaching; and utilizing skills of active listening, paraphrasing, and reflections (King & Jones, 2019).
Responsive Broaching
Responsive broaching involves a counselor’s response to a client’s disclosure (Day-Vines et al., 2020; King, 2021). This helps counselors avoid broaching at the wrong time and can particularly benefit counselors who use an organic, conversational counseling style rather than a structured style (Jones & Welfare, 2017). Responsive broaching manifests uniquely based on the situation. Counselors can respond to the client’s spoken cultural content using clinical skills. For example, in response to Elliana telling her counselor that she has a strong relationship with her family and a strong LGBTQ+-affirming community in her hometown, her counselor may paraphrase Elliana’s cultural protective factor by stating, “It sounds like you feel closely connected to your family and the LGBTQ+ community back at home. How do your connections affect your thoughts of suicide?” Responsive broaching could also invite the counselor to be more specific by asking, “How does being a part of a Black family and the LGBTQ+ community influence your thoughts of suicide?” This may invite Elliana to expand on these connections as protective factors contributing to her sense of belonging (Cureton & Fink, 2019).
Because Elliana shares common adjustment experiences with out-of-state first-year students (e.g., anxiety, time management), her counselor may utilize open questions to clarify cultural idioms of distress (APA, 2022). Counselors can also respond to a client’s unspoken cultural content. For example, clients may discuss cultural experiences, such as marginalization or belonging, without explicitly referencing specific cultural identities or terms. Counselors can broach these moments responsively by asking for clarity or gently positing the possibility of culture. For example, Elliana’s counselor may notice her isolation as a potential suicide risk and state, “I heard you say you are feeling like an outsider. Does being a young first-generation college student or having other cultural experiences play a role in your thoughts to kill yourself?” Counselors can strengthen responsive broaching by attending to client responses and utilizing immediacy to process the experience of discussing culture.
Content of Broaching
Another element of integrating broaching in SRA is determining what to broach. Both broaching (Day-Vines et al., 2020) and suicide assessments (AAS, 2023) encompass clients’ holistic experiences, suggesting that broaching can include any part of the client’s lived experience. King (2021) indicated that broaching typically serves one of two purposes: broaching cultural similarities and differences within the counseling relationship or broaching cultural content within the client’s experience. Similarly, Day-Vines et al. (2020) illustrated four dimensions of broaching: intracounseling, intraindividual, intra-REC, and inter-REC. We propose that the Multidimensional Model of Broaching Behavior can be used as a guide for counselors to utilize during the interview process of the suicide risk assessment. This section includes an interactive review of each dimension of broaching regarding an SRA with Elliana.
Intracounseling
Broaching the intracounseling dimension includes broaching similarities, differences, and interpersonal processes between client and counselor (Day-Vines et al., 2020), which communicates to the client that talking about race, ethnicity, and culture is permissible and explores how to navigate these topics within the counseling relationship (Day-Vines et al., 2020). Broaching cultural experiences within the counseling relationship strengthens the relationship (King, 2021). Counselors can broach intracounseling factors proactively or responsively. In the case of Elliana, her counselor may proactively broach by saying:
I often ask clients about their cultural identities during a suicide assessment because I want to understand how culture may play a role in their experience of suicide and mental health. We are both Black women, but I try not to assume our experiences are the same. For example, I am older than you, and we may have different generational experiences. We may also have other identities and cultural experiences that are different. I encourage you to share your experiences with me as we go through this assessment.
Here, the counselor comments on observable shared identities and invites Elliana to share her cultural experiences. The counselor also tells Elliana that she is the expert in her experience.
Counselors can also broach intracounseling factors responsively. Broaching for the relationship responsively involves identifying cultural concerns in the client’s disclosure and inviting discussion contextualized within the counseling relationship (Day-Vines et al., 2020). For example, a counselor may say, “You mentioned that you decided to come to the counseling center because your professor mentioned we are culturally responsive and LGBTQ+ affirming. I am here to support you, and together, we will make a plan of action.” With each approach, her counselor is direct and invites therapeutic support by intentionally keeping the client’s identities at the center of their relationship.
Intraindividual Factors
Counselors can assess intraindividual factors (Day-Vines et al., 2020) related to suicide, such as how cultural experiences may influence suicidality. The counselor explores Elliana’s experiences related to her intersecting identities and possible connections to her suicidal ideation. For example, the counselor may initially assess intraindividual factors by introducing the exploration: “Thank you for sharing your identities with me. You told me you do not feel like you belong, despite being involved in various activities. Could you tell me more about not belonging?” The counselor would use clinical skills to explore Elliana’s sense of belonging, reflecting on her experiences and possible distress connected to her intersecting identities.
Intra-REC Dimension
Counselors can assess the intra-REC dimension, which includes within-group concerns between the client and one or more of their cultural communities (Day-Vines et al., 2020) related to suicide. The counselor could continue to explore the differences between Elliana’s strong connections with her family and the LGBTQ+ community in her hometown and her lack of school belonging as a first-generation college student. For example, a counselor may ask Elliana, “I’m hearing you’re involved in various campus organizations, yet you feel like an outsider. From your perspective, what, if any, cultural factors contribute to this feeling?” This conversation could introduce a conversation about existing coping skills and her interpretation of her experiences. The counselor could use this information to assist with identifying Elliana’s needs, along with a focused follow-up care plan for appropriate mental health services.
Inter-REC Dimension
Counselors can assess the inter-REC dimension, which is the client’s experiences of oppression (Day-Vines et al., 2020) related to suicide. Elliana talked about her roommate making negative comments and listening to podcasts with anti-LGBTQ rhetoric. The counselor could assess the level of impact of this concern relating to her suicidality by asking “When you hear your roommate make negative comments and listen to podcasts with anti-LGBTQ rhetoric, what thoughts come to your mind?” Questions like this can help Elliana connect her own experiences and allow her to clarify if and how her roommate contributes to her suicidal ideation.
Discussion
This case study provides several factors to consider alongside an evidence-based SRA. Counselors must follow the guidelines of an SRA to ensure client safety and protective factors and make informed decisions for continuity of care. The intentional use of the Multidimensional Model of Broaching Behavior can serve as a guide to assist counselors in applying an integrative approach to the SRA interview process. Establishing trust between client and counselor can encourage insight into the client’s unique needs. The Multidimensional Model of Broaching Behavior provides the framework for intentional relationship building and conceptualizing the client—in this case, Elliana—through her overlapping identities (young adult, first-generation college student, Black, cisgender, and lesbian).
Broaching race, ethnicity, and culture applies to all clients and is not exclusive to cross-cultural experiences (Bayne & Branco, 2018). In alignment with current research (Bayne & Branco, 2018; Erby & White, 2022), broaching can be a valuable tool for assessing risk while recognizing and validating the client’s unique experiences, regardless of whether they share identities with the counselor. This idea aligns with other scholars who suggest that “all counseling is multicultural counseling” (Ivey & Ivey, 2001). Culturally competent counselors are encouraged to self-explore their broaching attitude (i.e., avoidant; Day-Vines et al., 2007, 2020) for an insightful self-assessment of the multiple dynamics within the crisis therapeutic relationship.
Broaching is a promising approach to exploring culture during SRA. However, there are some considerations. First, the nature of acute crisis often requires that responders abbreviate their assessment and hasten action to best prevent risk (Collins & Collins, 2005). In these circumstances, counselors may need to prioritize acultural SRA prompts and/or vary broaching statements based on the goal at hand (King, 2021). For instance, counselors might broach content to conceptualize risk for an immediate plan, or they might broach the relationship to promptly reduce the power differential. Indirect and/or closed-ended broaching (e.g., “Even though we are different, I want to understand what is happening for you right now so we can be together on this.”) may be sufficient in time-limited crisis response.
Second, counselors will ineffectively apply broaching if they expect universal client reactions. Day-Vines et al. (2007) suggested that client reactions to broaching vary based on internal and external factors. For example, a client may prefer to focus on a specific pressing concern instead of discussing culture. Counselors should follow the client’s lead in how culture informs the remaining SRA. If Elliana had declined to discuss her intra-REC experiences when her counselor asked about cultural factors when she feels like an outsider in various campus organizations, the counselor should refrain from asking further questions or details to respect her decision.
Implications for Counselors
There are implications for counselors when using broaching during SRA. Rather than replacing existing practice, a counselor can incorporate broaching into their typical SRA procedures. A broaching conversation with an instrument that explicitly addresses culture, such as CARS or CARS-S (Chu et al., 2013, 2018), may provide a smooth orientation to the survey and/or support nuanced exploration of its results. Counselors can prepare to use broaching in SRA by understanding which cultural factors typically increase suicide risk and which operate as protective factors. Attuning to these factors during SRA may help counselors explore social determinants of mental health (Lenz & Lemberger-Truelove, 2023; Lenz & Litam, 2023). The scope of this article was necessarily limited to SRA because of its conceptual and logistical complexity in counselor practice; however, broaching factors and determinants can inform case conceptualization, safety planning, ongoing counseling intervention, and case management.
Implications for Educators and Supervisors
Implications of broaching in SRA also exist for educators and supervisors. Their professional roles include preparing trainees to address crises and provide culturally responsive care (ACA, 2014; Council for the Accreditation of Counseling and Related Educational Programs [CACREP], 2023). Preparing trainees and licensed counselors to broach in SRA aligns with current counseling literature that advocates for improvements to suicide training (Binkley & Elliot, 2021) and a social justice framework for supervision (Dollarhide et al., 2021). Educators and supervisors would benefit from ongoing professional development, reflexive practices, and consultation to prepare them to address broaching in SRA.
Educators can introduce broaching strategies during suicide counseling instruction. This integration could help programs address CACREP (2023) standards on suicide (G.16) and multicultural counseling (Section B). Students who received suicide counseling instruction before practicum reported lower anxiety (Binkley & Leibert, 2015) and higher levels of preparedness, knowledge, and comfort in suicide response (Shannonhouse et al., 2018). Introducing broaching strategies during suicide counseling instruction has the potential to produce similar results.
Supervisors can integrate broaching SRA into supervision practice. Supervisors can broach culture within the supervisory relationship (King & Jones, 2019) to strengthen the supervisor’s understanding of the supervisee’s culture, help the supervisee comprehend their own positionality in counseling and supervision, and increase the supervisee’s understanding of broaching itself. Supervisors use discussion and case conceptualization to support supervisees’ preparedness for SRA, broaching, and their synthesis. Modeling or roleplaying broaching (Erby & White, 2022; Jones et al., 2019) in SRA may help supervisees practice skills.
Future Directions
Future scholarship can explore broaching race, ethnicity, and culture in SRA even when the client is not affiliated with a minoritized status. For instance, a White, Christian, heterosexual, cisgender male may hold multiple privileged identities, yet White males continue to show high suicide death rates (CDC, 2025). Counselors may consider using a similar approach to proactive and responsive broaching to inquire about religious and family values, social ideals, and beliefs about suicide, which shape both risk and protective factors.
Research on broaching in SRA is needed to determine the impact on client conceptualization, clinical decision-making, and postvention. Qualitative research with counselors and minoritized clients could provide insight into the experiences of broaching in SRA, informing clinical perspectives on topics such as relativity, therapeutic rapport, and training needs. Quantitative research might reveal the differential effectiveness of SRA with and without broaching. A future investigation of the Broaching Attitudes and Behavior Survey (Day-Vines et al., 2013, 2024) may determine the effectiveness of broaching in SRA. Educational research may assess the impact of incorporating broaching into SRA instruction (e.g., on confidence and skill development) and supervision in practicum and internship. Another direction is to advance the applications for broaching for intervention and ongoing management of suicide in counseling.
Conclusion
People from minoritized groups experience increased suicide risk (CDC, 2025; Czeisler et al., 2021; Kidd et al., 2023; The Trevor Project, 2023) and specific suicide risk and protective factors, such as systemic oppression (Alvarez et al., 2022; Fulginiti et al., 2021), cultural sanctions against suicide, and the impact of family/social relationships (Chu et al., 2019; Compton et al., 2005). Despite ethical and practice standards (AAS, 2023; ACA, 2014; Ratts et al., 2016) and calls from professional and community leaders (DHHS, 2024; Miller & Castle Work, 2024), most SRA practice neglects these factors (Mendoza-Rivera et al., 2022), which can increase harm (Rogers & Russell, 2014; Van Zyl et al., 2022). Counselors can improve their SRA practice by utilizing the Multidimensional Model of Broaching Behavior (Day-Vines et al., 2020) to explore REC contexts (Day-Vines et al., 2007) during initial and repeat assessments to inform intervention. Supervisors and educators can inform and guide counselors in broaching in SRA to ensure ethical and effective practice. Existing research demonstrating the positive impacts of broaching can expand to examine its use for assessing suicide risk for clients across identities.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.
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Mykka L. Gabriel, LPCC-S, is a doctoral candidate at Kent State University. Laura G. Dunson Caputo, PhD, LPCC-S, is an assistant professor of practice at John Carroll University. Jenny L. Cureton, PhD, LPCC (OH), LPC (CO, TX), is an associate professor at Kent State University. Correspondence may be addressed to Mykka L. Gabriel, Kent State University, White Hall 310, PO Box 5190, Kent, OH
44240-0001, mgabri12@kent.edu.
