TPC Journal-Vol 10- Issue 3-FULL ISSUE

The Professional Counselor | Volume 10, Issue 3 361 It is worth noting that family functioning alone did not sufficiently predict suicidal SIB. One possible explanation is that our family functioning variables did not encompass the factors of thwarted belongingness and perceived burdensomeness, both of which Joiner (2005) suggested may lead to suicide. Limitations and Future Directions A strength of this study is that the results may generalize to other real-world settings in which adolescent clients seek counseling services from community-based master’s-level clinicians who specialize in dialectical behavior therapy. However, this ecological validity comes with some relative limitations. One notable limitation of this study is that we examined family functioning at one point in time, when the adolescent was beginning treatment. Given this single timepoint, we are unable to fully describe the relationship between family functioning and SIB. Considering the biosocial theory, it seems likely that the distressed family environment preceded the SIB; however, it is possible that the SIB caused greater familial distress. Therefore, it would be useful to assess changes in family functioning and SIB across time. Another limitation is our SIB measure; as Crowell et al. (2013) explained, the LSASI is commonly used in clinical practice but not often in research. In addition to issues with reliability, the LSASI is a lifetime measure as opposed to one focusing on recent behavior. Although all participants reported engaging in SIB in the past year, it is unclear how recently they engaged in SIB relative to the time of the study. Despite the benefit of creating more variability in the data by allowing participants to report their specific frequency of SIB, the alternative of a dichotomous variable of current SIB might be more compatible with our measures of current family functioning. Additionally, the small sample size limits the power of our analyses as well as the generalizability of our results. A small sample increases the likelihood of a Type II error, meaning an increased likelihood of not finding significant results. However, it is notable that we found statistically significant results (e.g., good model fit of family functioning) despite our low power. Nevertheless, replication studies with much larger samples are needed. Implications for Practice Our findings suggest that family functioning is related to SIB in adolescents, particularly nonsuicidal and ambivalent SIB. Although counselors often include families when working with young children, it is common for counselors to work with adolescents individually. This practice is consistent with state laws allowing adolescents to consent to their own mental health treatment, and there are many presenting concerns and situations in which individual counseling may be the most effective modality. However, the connection between family functioning and SIB in adolescents in our sample indicates that it may be important to include family members in treating adolescent SIB; in fact, dialectical behavior therapy for adolescents (originally adapted by A. L. Miller et al., 1997) encourages family involvement in treatment. Counselors therefore need to educate parents and caregivers who may be reluctant to engage in the counseling process with their teen that SIB is an issue for which their participation in counseling could make a positive difference in treatment outcome. Further, from a family systems perspective, it can be challenging for teens to successfully use the coping skills and strategies they learn in counseling if the rest of the family system remains unchanged. Including at least some family members may therefore help adolescents maintain changes gained through the counseling process.