When someone seeks treatment after trauma, counselors must complete a risk assessment, even when clients may not be demonstrating behaviors that seem high risk. Assess risk for the c
When someone seeks treatment after trauma, counselors must complete a risk assessment, even when clients may not be demonstrating behaviors that seem high risk.
Assess risk for the client in the following case study using the Suicide Risk Assessment Form, which is based on the Suicide Assessment Five-step Evaluation and Triage from SAMHSA in this week’s learning activities. Use full sentences and appropriate grammar.
Katina is a 37-year-old heterosexual female of Serbian and Italian descent. She met Jonathan when she was in college, and they have had an on-and-off-again relationship over the past 15 years. During that time, they have had four children together, ages 4 to 13. She and Jonathan are currently working on their relationship and live together in the family home.
Katina states that she has experienced mental health problems since adolescence, and recently receiving a diagnosis of anxiety and depression. She reports having been abused during her childhood by a family friend, who was imprisoned briefly as a result, but never received counseling for it. When younger, Katina took party drugs to cope with her anxiety and depression but feels now that she has grown out of the habit.
Katina describes her long relationship with Jonathan as turbulent and dysfunctional. The abuse started as name calling; he would call her “fat,” “ugly,” and a “loser” if he felt he wasn’t getting his way or if he objected to her spending money. They had a joint bank account where Katina deposited her salary. If she didn’t pay bills and get household necessities immediately, Jonathan would clean out the account. As time went by, Jonathan’s abuse became physical. He frequently spat on Katina, pulled her hair, dragged her through the house, smashed her head into the wall, and threw drinks over her, on many occasions in front of the children. Throughout the relationship, she has experienced negative, controlling interference from Jonathan’s family, including verbal and physical abuse in the presence of the children as well.
Yesterday, Katina was attempting to pay bills and noticed that there was not enough money to cover the household expenses. When she brought it up to her husband, he told her she was just trying to get extra money out of him and called her a “mooch” and “too dumb to add 2+2.” As Jonathan approached her, their eldest child stepped in to shield her. The husband then struck the eldest child and they continued in a physical altercation. Per Katina’s report, the child has bruises and a black eye, but the police were not called, and she has not told anyone else about this occurrence.
Katina describes feeling guilty that she got her children involved in this situation. She explains that she wants everything to just go away. She describes feeling that, if she were not here any longer, everyone in her life would be much happier. Katina explains that she has these feelings often but never thought about acting on them until now. She explains that her child stepping in “pushed me to the edge.”
Katina explains that, when she was driving yesterday, she thought about how free it would feel if she were to just keep driving off the bridge. She said that she has had the thought several times since. She expresses being unsure if she is trying to end her life but admits that “it might just be for the best.”
Submit the completed form for your assignment
CCMH/558 v3
Suicide Risk Assessment Form
CCMH/558 v3
Page 2 of 2
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Suicide Risk Assessment Form
When someone seeks treatment after trauma, counselors must complete a risk assessment, even when clients may not be demonstrating behaviors that seem high risk.
Complete Parts 1 and 2 of this form including references. Submit the completed form for your assignment.
Instructions
Part 1: Suicide Risk Assessment
Assess risk for the client in the case study using the Suicide Risk Assessment Form based on the Suicide Assessment Five-step Evaluation and Triage from SAMHSA in 175–260 words. Use full sentences and appropriate grammar.
Support your assessment with appropriate terminology from the DSM-5.
Part 2: Crisis Intervention and Safety Plan
Describe how you would apply the ABC model of crisis intervention in this situation in 260–350 words.
List the next steps you would take and what might be included in a safety plan for this individual in 50–100 words.
Cite the selected case and any other supporting resources used.
Format your citations and references according to APA guidelines.
Part 1: Suicide Risk Assessment
Step 1: Identify Risk Factors
What risk factors exist for this individual? Which factors can be modified to reduce risk?
|
Risk Factors |
Notes |
|
Precipitants and stressors · Recent trauma, triggering events (real or anticipated), another prior crisis · Medical illness, intoxication · Family or interpersonal turmoil, history of physical or sexual abuse, social isolation · Change in treatment or treatment provider, or discharge from psychiatric hospital |
Enter notes here. |
|
History of risk factors · Attempts to die by suicide · Self-injurious behavior · Psychiatric disorders, comorbidity, and mental health treatments · Attempts of family members to die by suicide · Family diagnosed with Axis 1 psychiatric disorders that required hospitalization |
Enter notes here. |
|
· Anhedonia · Impulsivity · Hopelessness · Anxiety or panic · Global insomnia · Command hallucinations
|
Enter notes here. |
|
Lethal Access · Access to firearms or other lethal methods |
Enter notes here. |
Step 2: Identify Protective Factors
Which factors can be enhanced to protect the patient? Note: These protections may not counteract high risk factors.
|
Protective Factors |
Notes |
|
Internal · Ability to cope with stress or frustration · Spiritual beliefs |
Enter notes here. |
|
External · Social supports · Responsibility to loved ones, children, or pets · Positive therapeutic relationships |
Enter notes here. |
Step 3: Conduct Suicide Inquiry
Has this individual had any ideations, plans, behaviors, or intentions to die by suicide? To what extent does the patient intend to carry out their plan? How lethal or self-injurious do they think their plan would be? What are their reasons to live or die?
|
Notes |
|
|
Ideations · Frequency, intensity, and duration of suicidal thoughts and ideations in: a. the last 48 hours b. the past month c. the worst ever |
Enter notes here. |
|
Plan · Time · Place · Lethality of their method · Availability of their method · Ways they have prepared for death |
Enter notes here. |
|
Behavior · History of attempts (and aborted attempts) to die by suicide · Rehearsal behaviors for suicide vs. non-suicidal self-injurious actions |
Enter notes here. |
|
Intent · Extent to which the patient expects to carry out the plan · Extent to which the patient believes it to be lethal versus self-injurious |
Enter notes here. |
|
Special Considerations · For youth and parents/guardians of minors: ask about evidence of suicidal thoughts, plans, or behaviors as well as changes in mood, behaviors, or dispositions · When indicated, or for character disordered or paranoid males dealing with loss or humiliation: ask about 4 areas above and conduct homicide inquiry |
Enter notes here, if applicable. |
Step 4: Determine Risk Level / Intervention
After using your best judgment to assess the patient in Steps 1-3, what risk level do you think they are demonstrating?
|
Risk Level |
Risk Factor |
Protective Factor |
Suicidality |
Possible Interventions |
|
High |
Psychiatric diagnoses with severe symptoms or acute precipitating event |
Protective factors not relevant |
Potentially lethal suicide attempt or persistent ideation with strong intent or suicide rehearsal |
· Admission generally indicated unless a significant change reduces risk. · Take suicide precautions. |
|
Moderate |
Multiple risk factors |
Few protective factors |
Suicidal ideation with plan, but no intent or behavior |
· Admission may be necessary depending on risk factors. · Develop crisis plan. · Give emergency and crisis numbers. |
|
Low |
Modifiable risk factors |
Strong protective factors |
Thoughts of death, no plan, intent, or behavior |
· Outpatient referral, symptom reduction. · Give emergency and crisis numbers. |
Step 5: Document
1. What do you think is the patient’s risk level? Justify your reasoning for this determination.
Enter your response.
2. What intervention do you recommend that addresses the current risks? What is your plan for treatment? What can you and the client do to reduce these risks (e.g., medication, setting, psychotherapy, interventions, contact with significant others, consultation)?
Enter your response.
3. Provide firearms instructions, if relevant.
Enter your response, or N/A if not applicable.
4. What is the follow-up plan? In the case of youths, what roles should the parent/guardian have?
Enter your response.
Part 2: Crisis Intervention and Safety Plan
Crisis Intervention
Enter your response.
Safety Plan
Enter your response.
References
Enter your references for both Parts 1 and 2 in APA format.
Copyright 2021 by University of Phoenix. All rights reserved.
Copyright 2021 by University of Phoenix. All rights reserved.
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