ANSA Risk & Safety Evaluation 3 — Questions and Answers
Question 1: A client with a history of fire-setting has not exhibited the behavior in 18 months and is engaged in treatment. The MOST appropriate ANSA rating for this risk domain is:
- 0 — no evidence of need
- 1 — history suggests watchfulness is warranted (Correct answer)
- 2 — action is required to address current risk
- 3 — immediate intervention is needed
Correct answer: 1 — history suggests watchfulness is warranted
A rating of 1 reflects a history that warrants monitoring even when current behavior is absent, guiding ongoing vigilance in the safety plan.
Question 2: When completing the ANSA with someone who has intellectual disabilities, the assessor should:
- Skip risk domains and rely solely on caregiver report
- Use simplified language and augmentative communication supports to gather the individual's perspective (Correct answer)
- Default all risk ratings to 2 due to elevated vulnerability
- Only administer the ANSA in a clinical office setting
Correct answer: Use simplified language and augmentative communication supports to gather the individual's perspective
The ANSA is designed to be adapted to the individual's communication needs so their voice is included in the assessment.
Question 3: Which of the following BEST describes the purpose of the ANSA 'Risk Behaviors' module compared to the 'Needs' module?
- Risk behaviors focus on strengths while needs focus on deficits
- Risk behaviors capture potential harm to self or others; needs capture functional impairment areas (Correct answer)
- Risk behaviors are only completed for court-involved individuals
- The modules are interchangeable and cover the same content
Correct answer: Risk behaviors capture potential harm to self or others; needs capture functional impairment areas
Risk Behaviors in the ANSA specifically target safety-related concerns such as danger to self or others, while the Needs module addresses broader functional and psychiatric challenges.
Question 4: A practitioner is updating an ANSA after a client was involved in a domestic violence incident as a victim. Which domain rating is MOST likely to change?
- Psychosis
- Victimization (Correct answer)
- Substance Abuse
- Delinquency
Correct answer: Victimization
Victimization on the ANSA directly captures whether an individual has experienced abuse, violence, or exploitation, and would be updated to reflect the new incident.
Question 5: In ANSA-based safety planning, a rating of '3' for Danger to Others obligates the assessor to:
- Document the rating and review it at the next 90-day assessment
- Notify the team and initiate immediate action, which may include a duty-to-warn assessment (Correct answer)
- Lower the rating to 2 if the person denies intent
- Obtain a second opinion before changing the service plan
Correct answer: Notify the team and initiate immediate action, which may include a duty-to-warn assessment
A rating of 3 on Danger to Others triggers immediate action protocols including team notification and potential duty-to-warn obligations.
Question 6: The ANSA's strengths domains are incorporated into safety planning primarily to:
- Offset high risk scores to produce a lower overall risk rating
- Identify protective factors that can be leveraged to mitigate identified risks (Correct answer)
- Satisfy accreditation requirements for a balanced assessment
- Replace evidence-based risk tools like actuarial assessments
Correct answer: Identify protective factors that can be leveraged to mitigate identified risks
Strengths in the ANSA identify protective factors — such as social supports and personal resilience — that can buffer risk and inform a realistic safety plan.
Question 7: A client reports using alcohol daily but denies it causes any problems and refuses treatment. For the Substance Abuse domain, the ANSA rating is MOST likely:
- 0 — no evidence of a need
- 1 — mild concern that is currently managed
- 2 — an actionable need requiring intervention despite client denial (Correct answer)
- 3 — requires immediate action such as hospitalization
Correct answer: 2 — an actionable need requiring intervention despite client denial
Daily use with functional impact is an actionable need even if the individual lacks insight; the rating reflects the clinician's evidence-based judgment, not solely client self-report.
ANSA Risk & Safety Evaluation 3
A client with a history of fire-setting has not exhibited the behavior in 18 months and is engaged in treatment.
The MOST appropriate ANSA rating for this risk domain is: