This document provides guidelines for clinicians working with gifted, suicidal adolescents. It addresses: (1) the need to set limits in the early sessions of psychotherapy; (2) the necessity of maintaining a presence by making personal sacrifices through being accessible, talking on the phone, scheduling extra sessions and, in extreme cases, visiting the adolescents in the community; (3) enforcing therapeutic limits by using an active crisis intervention model that protects the adolescent from harm; (4) working with families in an outpatient setting to help parents protect their children from self-harm; (5) informing the youth that there will be disclosure to third parties when there is a threat of personal harm or violence; (6) maintaining therapeutic perspective when attempting to stabilize self-annihilative behavior; (7) instilling hope in the future and decreasing chances of future suicidal acts; (8) dealing with death of an adolescent; (9) helping an adolescent reclaim his or her life by regaining self-respect; and (10) terminating the treatment relationship. (Contains 41 references.) (CR)