CPSS Crisis Support 5 — Questions and Answers
Question 1: A peer support specialist is working with someone who has experienced multiple hospitalizations and expresses fear about being hospitalized again. How should the specialist respond?
- Reassure the peer that hospitalization is always the safest option and they should not worry
- Acknowledge the peer's fear, explore their past experiences, and collaboratively explore less restrictive alternatives while maintaining safety (Correct answer)
- Avoid discussing hospitalization entirely to prevent triggering the peer
- Inform the peer that hospitalization is unavoidable and they need to accept it
Correct answer: Acknowledge the peer's fear, explore their past experiences, and collaboratively explore less restrictive alternatives while maintaining safety
Acknowledging past negative experiences with hospitalization and exploring alternatives respects the peer's autonomy while still prioritizing safety.
Question 2: What is the significance of the '988 Suicide and Crisis Lifeline' in North Carolina's crisis support system?
- It is only available to licensed mental health professionals, not the general public
- It is a 24/7 crisis line providing immediate support for people in suicidal or mental health crisis and can connect callers to local resources (Correct answer)
- It replaces all other forms of crisis intervention in North Carolina
- It is only available during business hours on weekdays
Correct answer: It is a 24/7 crisis line providing immediate support for people in suicidal or mental health crisis and can connect callers to local resources
988 is a 24/7 nationwide crisis lifeline that connects callers to local crisis counselors and can dispatch Mobile Crisis Management teams in North Carolina.
Question 3: Which of the following BEST describes 'peer-driven crisis planning' as opposed to traditional crisis planning?
- A clinician develops the crisis plan and the peer signs it for compliance
- The peer leads the development of their own crisis plan with support from the peer specialist, based on their own values, strengths, and preferences (Correct answer)
- The peer specialist creates the plan based on their clinical judgment
- Crisis planning is conducted only during inpatient psychiatric admissions
Correct answer: The peer leads the development of their own crisis plan with support from the peer specialist, based on their own values, strengths, and preferences
Peer-driven crisis planning centers the peer's own voice, strengths, and choices, making plans more personally meaningful and more likely to be used.
Question 4: A peer support specialist notices a peer is showing warning signs of an impending crisis but the peer denies anything is wrong. The BEST approach is to:
- Ignore the observation to respect the peer's self-report
- Gently share the observed changes with compassion, ask open-ended questions, and revisit the safety plan together (Correct answer)
- Immediately notify the peer's treatment team without speaking to the peer first
- Confront the peer directly and insist they acknowledge the warning signs
Correct answer: Gently share the observed changes with compassion, ask open-ended questions, and revisit the safety plan together
Compassionately naming observed changes and using open-ended questions invites the peer to engage without feeling confronted or dismissed.
Question 5: When using Motivational Interviewing (MI) techniques during a crisis, which approach is MOST aligned with MI principles?
- Persuading the peer with logic and facts about why they should accept help
- Exploring the peer's own ambivalence and affirming their strengths to build intrinsic motivation for safety (Correct answer)
- Telling the peer what steps they must take to resolve the crisis
- Avoiding any discussion of the peer's resistance to help
Correct answer: Exploring the peer's own ambivalence and affirming their strengths to build intrinsic motivation for safety
MI works with ambivalence rather than against it, using affirmation and exploration of the peer's own motivations to support change.
Question 6: Which factor is MOST associated with increased risk of suicide attempt following discharge from a psychiatric inpatient setting?
- Having a well-developed safety plan and a scheduled follow-up appointment
- Lack of immediate follow-up care and social isolation in the days and weeks after discharge (Correct answer)
- Having access to peer support services in the community
- A history of previous outpatient therapy attendance
Correct answer: Lack of immediate follow-up care and social isolation in the days and weeks after discharge
The post-discharge period is a high-risk window, with lack of follow-up and social isolation being major risk factors — making peer support during this time critically important.
Question 7: How does the peer support specialist's own recovery story function as a 'tool' specifically in crisis settings?
- It allows the specialist to diagnose and treat the peer based on shared experiences
- It provides authentic evidence that recovery from crisis is possible, reducing hopelessness and building alliance (Correct answer)
- It excuses the specialist from following standard crisis protocols if their experience differs
- It means the specialist can manage all crises independently without supervision or escalation
Correct answer: It provides authentic evidence that recovery from crisis is possible, reducing hopelessness and building alliance
The specialist's lived recovery narrative serves as powerful, credible hope — demonstrating that crisis can be survived and that recovery is real, not just theoretical.
CPSS Crisis Support 5
A peer support specialist is working with someone who has experienced multiple hospitalizations and expresses fear about being hospitalized again.
How should the specialist respond?