ACT Emergency Procedures & Response 3 — Questions and Answers
Question 1: When conducting a suicide risk assessment using the Columbia Suicide Severity Rating Scale (C-SSRS), 'active suicidal ideation with plan and intent' indicates which risk level?
- Low risk requiring psychoeducation only
- Moderate risk manageable in outpatient settings
- High risk potentially requiring hospitalization or intensive intervention (Correct answer)
- Minimal risk with no follow-up needed
Correct answer: High risk potentially requiring hospitalization or intensive intervention
Active suicidal ideation with a specific plan and intent to act places a client in the high-risk category and typically warrants intensive intervention.
Question 2: Which of the following represents an ACT-consistent approach to safety planning that differs from traditional cognitive approaches?
- Identifying and disputing cognitive distortions about hopelessness
- Helping the client identify values-based reasons for living rather than logical counter-arguments (Correct answer)
- Reinforcing positive thinking patterns to replace negative ones
- Scheduling pleasant activities to reduce depressive symptoms
Correct answer: Helping the client identify values-based reasons for living rather than logical counter-arguments
ACT-based safety planning emphasizes connecting with values and psychological flexibility rather than challenging or replacing thoughts.
Question 3: A mandated reporter in a mental health context is legally required to report when there is reasonable suspicion of:
- A client's financial mismanagement
- Child abuse or neglect, elder abuse, or dependent adult abuse (Correct answer)
- Marital conflict that could affect children indirectly
- A client's use of recreational marijuana in a legal state
Correct answer: Child abuse or neglect, elder abuse, or dependent adult abuse
Mandated reporting laws require mental health professionals to report reasonable suspicion of abuse or neglect of protected populations including children, elders, and dependent adults.
Question 4: During a group ACT session, one participant discloses active suicidal ideation. The therapist should:
- Continue the group session and address the disclosure at the session's end
- Dismiss the disclosure as attention-seeking within group dynamics
- Pause the group, address the individual privately, and follow standard crisis protocols (Correct answer)
- Ask group members to use peer support to talk the individual out of suicidal thoughts
Correct answer: Pause the group, address the individual privately, and follow standard crisis protocols
Crisis disclosure in a group setting requires pausing group process to attend to the individual privately and follow established emergency protocols.
Question 5: The purpose of conducting a 'means restriction counseling' conversation with a at-risk client is to:
- Empower clients by educating them on safe firearm storage and handling
- Reduce access to lethal methods that could be used for self-harm during a crisis (Correct answer)
- Comply with state licensing requirements for firearm discussions
- Help clients redirect focus from suicidal urges to practical household tasks
Correct answer: Reduce access to lethal methods that could be used for self-harm during a crisis
Means restriction counseling reduces the lethality of a suicidal attempt by putting distance and barriers between the at-risk person and lethal methods.
Question 6: A client who has been stable for months arrives to session visibly intoxicated and reveals they drove to the appointment. The ACT therapist's emergency response should include:
- Proceeding with the session as usual since it is a scheduled appointment
- Addressing the impaired driving risk, arranging safe transportation, and possibly contacting authorities if the client insists on driving (Correct answer)
- Rescheduling the session and asking the client to leave immediately
- Exploring the psychological flexibility deficits that led to drinking
Correct answer: Addressing the impaired driving risk, arranging safe transportation, and possibly contacting authorities if the client insists on driving
Impaired driving creates imminent danger to the client and others, requiring the therapist to address transportation safety and potentially involve emergency services.
Question 7: In the context of ACT emergency protocols, 'valued living' is used during crisis intervention primarily to:
- Distract the client from thinking about their crisis situation
- Anchor the client's motivation for safety planning to personally meaningful life directions (Correct answer)
- Replace crisis-focused conversations with more productive goal-setting
- Satisfy documentation requirements for insurance billing
Correct answer: Anchor the client's motivation for safety planning to personally meaningful life directions
Connecting crisis intervention to the client's identified values provides intrinsic motivation for safety and can strengthen commitment to a safety plan.
ACT Emergency Procedures & Response 3
When conducting a suicide risk assessment using the Columbia Suicide Severity Rating Scale (C-SSRS), 'active suicidal ideation with plan and intent' indicates which risk level?