CCS CCS Crisis Intervention and Risk Assessment 1 — Questions and Answers
Question 1: When a supervisee reports that a client has made a direct suicidal threat, the CCS's FIRST action should be to:
- Review the supervisee's documentation style
- Ensure the supervisee conducts or has conducted a thorough suicide risk assessment immediately (Correct answer)
- Advise the supervisee to schedule a follow-up appointment next week
- Refer the client to a higher level of care without assessment
Correct answer: Ensure the supervisee conducts or has conducted a thorough suicide risk assessment immediately
A direct suicidal threat requires immediate and thorough risk assessment to determine the appropriate level of intervention and protect the client's life.
Question 2: The acronym IS PATH WARM is used in suicide risk assessment to identify:
- A structured suicide intervention protocol
- Warning signs of imminent suicide risk (Correct answer)
- Levels of care for suicidal clients
- Documentation requirements for suicide risk
Correct answer: Warning signs of imminent suicide risk
IS PATH WARM (Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood changes) is an American Association of Suicidology warning signs mnemonic.
Question 3: A supervisee's client expresses passive suicidal ideation with no plan or intent. The CCS should guide the supervisee to:
- Hospitalize the client immediately
- Document the ideation, assess for risk factors, and increase monitoring while developing a safety plan (Correct answer)
- Ignore the ideation since there is no plan
- Terminate therapy to avoid liability
Correct answer: Document the ideation, assess for risk factors, and increase monitoring while developing a safety plan
Even passive ideation requires documentation, risk factor assessment, and a safety plan to monitor changes in risk level over time.
Question 4: Which risk factor is MOST strongly associated with completed suicide in the US?
- Recent job loss
- Previous suicide attempt (Correct answer)
- Social media use
- Low academic achievement
Correct answer: Previous suicide attempt
Prior suicide attempt is consistently identified in research as the single strongest predictor of completed suicide, making it the most critical risk factor to assess.
Question 5: When supervising a clinician working with a homicidal client, the CCS must ensure the supervisee understands the duty to protect under:
- HIPAA regulations only
- Tarasoff v. Regents of the University of California and applicable state laws (Correct answer)
- Only the agency's internal risk management policy
- The ADA provisions for mental health clients
Correct answer: Tarasoff v. Regents of the University of California and applicable state laws
Tarasoff established the legal precedent for duty to protect identified third parties from client threats, and supervisors must ensure supervisees understand their obligations under this ruling and their state's specific laws.
Question 6: A safety plan developed collaboratively with a suicidal client should include:
- Only a crisis hotline number
- Warning signs, coping strategies, social supports, means restriction, and emergency contacts (Correct answer)
- A medication schedule determined by the psychiatrist
- Only the therapist's contact information
Correct answer: Warning signs, coping strategies, social supports, means restriction, and emergency contacts
An effective safety plan addresses multiple layers of protection including personal warning signs, internal coping skills, external supports, means restriction, and professional emergency contacts.
CCS CCS Crisis Intervention and Risk Assessment 1
When a supervisee reports that a client has made a direct suicidal threat, the CCS's FIRST action should be to: