CCIS CCIS Suicide Risk Assessment & Prevention 2 — Questions and Answers
Question 1: Which of the following best describes 'suicidal ambivalence'?
- Certainty about wanting to die
- Simultaneous desire to live and to die (Correct answer)
- Psychotic break from reality
- Refusal to engage with the counselor
Correct answer: Simultaneous desire to live and to die
Suicidal ambivalence is the coexistence of wanting to end one's life and wanting to survive, which is common and represents a critical point of engagement for crisis counselors.
Question 2: A safety plan differs from a no-suicide contract primarily because:
- Safety plans are created by the therapist alone
- Safety plans are collaborative, coping-focused tools with specific steps (Correct answer)
- No-suicide contracts are evidence-based while safety plans are not
- Safety plans require hospitalization
Correct answer: Safety plans are collaborative, coping-focused tools with specific steps
Safety plans are collaboratively developed, include personalized coping strategies, warning signs, and support contacts, and are considered more clinically effective than simple no-suicide contracts.
Question 3: The term 'postvention' in suicide crisis work refers to:
- Preventing a first suicide attempt
- Intervention during an active suicide attempt
- Support provided to survivors after a suicide death (Correct answer)
- Medication management post-discharge
Correct answer: Support provided to survivors after a suicide death
Postvention involves providing support, counseling, and resources to individuals who have lost someone to suicide to reduce grief, trauma, and contagion risk.
Question 4: Suicide contagion (the 'Werther Effect') is most likely to occur when:
- Suicides are reported in detail and glamorized by media (Correct answer)
- Media reports focus on available crisis resources
- Survivors receive professional support
- Schools implement mental health education
Correct answer: Suicides are reported in detail and glamorized by media
Detailed, sensationalized media coverage of suicide — including method and romanticized framing — is associated with increased suicide rates, known as the Werther Effect.
Question 5: When a client refuses hospitalization and the crisis specialist believes they are in imminent danger, the appropriate action is to:
- Respect client autonomy and end the session
- Consult supervisor and consider initiating an involuntary hold if legally warranted (Correct answer)
- Document and schedule a follow-up call
- Ask the client to sign a no-harm contract
Correct answer: Consult supervisor and consider initiating an involuntary hold if legally warranted
When a client poses imminent risk and refuses voluntary care, crisis specialists may need to initiate an involuntary psychiatric hold in accordance with state law and agency protocol.
Question 6: Which question is part of a direct inquiry approach to assessing suicidal ideation?
- 'Are you feeling a little down today?'
- 'Have you been having any thoughts of killing yourself?' (Correct answer)
- 'Is everything okay at home?'
- 'Do you ever feel sad?'
Correct answer: 'Have you been having any thoughts of killing yourself?'
Direct, explicit questions about suicidal thoughts are recommended because they do not increase risk and provide clear clinical information needed for proper assessment.
CCIS CCIS Suicide Risk Assessment & Prevention 2
Which of the following best describes 'suicidal ambivalence'?