ANSA Risk & Safety Evaluation 5 — Questions and Answers
Question 1: A service plan developed from an ANSA assessment showing a '2' for Sexually Abusive Behavior should MOST likely include:
- No special provisions since a rating of 2 is considered mild
- Targeted interventions such as specialized treatment and safety planning to address the behavior (Correct answer)
- Immediate criminal referral as the first and only response
- A note to reassess in 90 days with no current action
Correct answer: Targeted interventions such as specialized treatment and safety planning to address the behavior
A rating of 2 indicates an actionable need requiring targeted service interventions; it is neither ignored nor solely criminally referred without a treatment component.
Question 2: On the ANSA, the 'Runaway' domain is rated based primarily on:
- Number of prior runaway incidents documented in the file
- The individual's current risk of leaving a care setting without authorization or notification (Correct answer)
- Whether the person has ever been reported missing to law enforcement
- The geographic distance the individual traveled during a prior runaway incident
Correct answer: The individual's current risk of leaving a care setting without authorization or notification
The Runaway domain on the ANSA focuses on current risk of unauthorized departure, not merely historical incidents.
Question 3: A practitioner disagrees with a client's self-rating of '0' on Danger to Others despite collateral reports of recent aggression. According to ANSA principles, the practitioner should:
- Always defer to the client's self-report to maintain the therapeutic alliance
- Use their clinical judgment and all available information to assign the rating, documenting the discrepancy (Correct answer)
- Skip the domain and note that the client refused to engage
- Submit a formal dispute to a supervisor before assigning any rating
Correct answer: Use their clinical judgment and all available information to assign the rating, documenting the discrepancy
ANSA ratings reflect the clinician's informed judgment integrating all available information; discrepancies between self-report and collateral data must be documented.
Question 4: Which of the following is NOT a valid reason to update ANSA risk domain ratings between scheduled reassessment windows?
- A significant incident such as a suicide attempt has occurred
- The individual reports new information about ongoing victimization
- A new practitioner joins the team and prefers different rating conventions (Correct answer)
- A change in living situation introduces new environmental safety concerns
Correct answer: A new practitioner joins the team and prefers different rating conventions
ANSA ratings should be updated based on changes in the individual's status or new clinical information, not to accommodate a practitioner's personal rating preferences.
Question 5: In ANSA risk assessment, 'Weapon Possession' as a standalone domain is MOST important because:
- It satisfies mandatory reporting laws in most states automatically
- Access to lethal means is an independent risk factor that elevates the potential lethality of Danger to Self and Danger to Others ratings (Correct answer)
- It replaces the need to assess Danger to Others when a weapon is present
- It is only rated for individuals on probation or parole
Correct answer: Access to lethal means is an independent risk factor that elevates the potential lethality of Danger to Self and Danger to Others ratings
Weapon possession is an independent risk factor because access to lethal means substantially increases the lethality of any risk involving harm to self or others.
Question 6: A 'strength' rating of '1' on the ANSA Family and Social Supports domain in the context of risk assessment MOST directly suggests:
- The individual has identified supports but they are not yet fully utilized to enhance safety (Correct answer)
- The individual has no social supports and is at maximum isolation risk
- Social supports are strong and fully protecting the individual from risk
- A referral to a social skills group is mandated immediately
Correct answer: The individual has identified supports but they are not yet fully utilized to enhance safety
A strength rating of 1 on the ANSA indicates the strength exists but is not yet leveraged; in safety planning, this means the support can be activated to reduce risk.
Question 7: When the ANSA is used in a team staffing meeting, risk ratings are PRIMARILY used to:
- Rank clients against each other to determine who receives services first
- Identify specific risk-related needs that require action and track progress over time across the team (Correct answer)
- Generate automated alerts to law enforcement when ratings reach level 2 or above
- Replace the need for individual clinical supervision of high-risk cases
Correct answer: Identify specific risk-related needs that require action and track progress over time across the team
In team settings, ANSA risk ratings drive shared understanding of specific needs and guide collaborative decision-making and progress tracking.
ANSA Risk & Safety Evaluation 5
A service plan developed from an ANSA assessment showing a '2' for Sexually Abusive Behavior should MOST likely include: