CBHT Crisis Intervention 3 — Questions and Answers
Question 1: A client reports hearing voices telling them to hurt themselves. The BHT's PRIORITY response is to:
- Tell the client the voices are not real
- Assess the content and command nature of the hallucinations and report to the clinical team (Correct answer)
- Distract the client with an activity
- Isolate the client in a quiet room
Correct answer: Assess the content and command nature of the hallucinations and report to the clinical team
Command hallucinations directing self-harm require immediate clinical assessment to determine level of risk and appropriate intervention.
Question 2: The term 'lethality' in suicide risk assessment refers to:
- The likelihood that the client will attempt suicide in the future
- The medical severity or deadliness of the planned method (Correct answer)
- The client's intent to die
- The availability of means
Correct answer: The medical severity or deadliness of the planned method
Lethality specifically refers to how medically dangerous or likely to cause death the chosen method would be if carried out.
Question 3: Which communication style is MOST effective during the acute phase of a crisis?
- Using complex therapeutic language to demonstrate competence
- Short, clear, direct statements delivered in a calm tone (Correct answer)
- Challenging the client's irrational beliefs immediately
- Providing detailed psychoeducation about their diagnosis
Correct answer: Short, clear, direct statements delivered in a calm tone
During acute crisis, cognitive capacity is reduced; simple, calm, direct communication is most likely to be received and understood.
Question 4: A safety plan developed with a client in crisis should include:
- A list of triggers, warning signs, coping strategies, and emergency contacts (Correct answer)
- Only the phone number for a crisis hotline
- A promise from the client that they will not harm themselves
- The therapist's personal cell phone number as the primary contact
Correct answer: A list of triggers, warning signs, coping strategies, and emergency contacts
Comprehensive safety plans include personalized warning signs, coping strategies, social supports, and emergency resources to use in escalating order.
Question 5: What is 'means restriction counseling' in the context of suicide prevention?
- Limiting a client's access to therapy if they are non-compliant
- Advising clients and family members to remove or secure lethal means such as firearms and medications (Correct answer)
- Restricting a suicidal client's movement within the facility
- Requiring a client to sign a no-harm contract
Correct answer: Advising clients and family members to remove or secure lethal means such as firearms and medications
Means restriction counseling involves working with clients and their support network to reduce access to lethal items, which is evidence-based for reducing suicide completion.
Question 6: During a crisis, a client becomes tearful and whispers 'I can't do this anymore.' The BEST initial response by the BHT is:
- Ask directly: 'Are you thinking about suicide?' (Correct answer)
- Say 'Everything will be okay, just calm down'
- Change the subject to a more positive topic
- Leave the client alone to collect themselves
Correct answer: Ask directly: 'Are you thinking about suicide?'
Asking directly and compassionately about suicidal ideation is best practice and does not increase risk; it opens the door for honest communication.
Question 7: Which behavioral sign would MOST concern a BHT regarding a previously suicidal client who has recently 'calmed down'?
- The client is now sleeping more than usual
- The client is giving away personal belongings (Correct answer)
- The client refuses to participate in group therapy
- The client is eating less than normal
Correct answer: The client is giving away personal belongings
Giving away prized possessions is a serious warning sign that a person may be planning to end their life and saying goodbye to things they value.
CBHT Crisis Intervention 3
A client reports hearing voices telling them to hurt themselves.
The BHT's PRIORITY response is to: