LICSW Crisis Intervention 2 — Questions and Answers
Question 1: A client presents in a domestic violence crisis shelter. According to trauma-informed crisis intervention, which response by the social worker is MOST appropriate?
- Immediately develop a detailed safety plan and require the client to follow it
- Ask the client to explain exactly what happened in chronological order for documentation
- Provide choices and options to restore a sense of control and safety (Correct answer)
- Encourage the client to return home to retrieve personal belongings
Correct answer: Provide choices and options to restore a sense of control and safety
Trauma-informed care in crisis emphasizes empowerment and restoring a sense of control, as domestic violence survivors have often experienced profound loss of agency.
Question 2: The Caplan model of crisis theory identifies three types of crises. Which of the following is classified as a maturational or developmental crisis?
- Loss of employment due to company downsizing
- Hurricane destroying a family's home
- A teenager leaving home for college for the first time (Correct answer)
- Unexpected diagnosis of a terminal illness
Correct answer: A teenager leaving home for college for the first time
Maturational (developmental) crises arise from normal life transitions such as adolescence leaving home, whereas situational crises result from unexpected external events.
Question 3: Which of the following tools is MOST widely used by social workers to conduct a structured suicide risk assessment?
- Beck Anxiety Inventory (BAI)
- Columbia Suicide Severity Rating Scale (C-SSRS) (Correct answer)
- PHQ-9 Patient Health Questionnaire
- Adverse Childhood Experiences (ACE) questionnaire
Correct answer: Columbia Suicide Severity Rating Scale (C-SSRS)
The Columbia Suicide Severity Rating Scale (C-SSRS) is a standardized, evidence-based instrument specifically designed to assess the presence, intensity, and lethality of suicidal ideation and behavior.
Question 4: A social worker receives a call from a client who states: 'I just can't take it anymore and I've been thinking about ending it all.' What is the MOST clinically appropriate immediate response?
- Reflect feelings: 'It sounds like you're really exhausted.'
- Ask directly: 'Are you thinking about suicide?' (Correct answer)
- Reassure the client: 'Things will get better, I promise.'
- Immediately contact emergency services without further engagement
Correct answer: Ask directly: 'Are you thinking about suicide?'
Directly asking about suicide is clinically indicated and research shows it does not increase risk; it opens communication and enables accurate assessment of the client's intent.
Question 5: In crisis intervention, a safety plan is distinguished from a 'no-suicide contract' primarily because:
- Safety plans are legally binding documents while contracts are not
- Safety plans provide concrete coping steps and resources, whereas no-suicide contracts lack evidence of effectiveness (Correct answer)
- No-suicide contracts are required by NASW Code of Ethics; safety plans are optional
- Safety plans are only used in inpatient settings while contracts are used outpatient
Correct answer: Safety plans provide concrete coping steps and resources, whereas no-suicide contracts lack evidence of effectiveness
Safety plans are evidence-based collaborative tools outlining warning signs, coping strategies, and contacts, whereas no-suicide contracts have been shown to be ineffective and may create a false sense of security.
Question 6: A social worker in a hospital emergency department encounters a client experiencing a psychiatric crisis related to acute psychosis. What is the MOST important initial step?
- Conduct a comprehensive biopsychosocial assessment immediately
- Ensure the environment is safe and the client is not in physical danger (Correct answer)
- Begin psychoeducation about their diagnosis
- Contact the client's family to gather collateral information
Correct answer: Ensure the environment is safe and the client is not in physical danger
Ensuring environmental and physical safety is the foundational first step in any psychiatric crisis, as a psychotic client may be at risk of self-harm or harm to others.
Question 7: Which of the following BEST describes 'defusing' in the context of Critical Incident Stress Management (CISM)?
- A formal group process conducted 24-72 hours after a critical incident
- An informal, brief group intervention conducted within hours of a critical incident (Correct answer)
- An individual one-on-one session addressing PTSD symptoms after trauma
- A written debriefing protocol submitted to supervisors after a workplace crisis
Correct answer: An informal, brief group intervention conducted within hours of a critical incident
Defusing is a short, informal CISM intervention provided within hours of a critical incident to reduce acute stress reactions, distinct from the more formal debriefing conducted 24-72 hours later.
LICSW Crisis Intervention 2
A client presents in a domestic violence crisis shelter.
According to trauma-informed crisis intervention, which response by the social worker is MOST appropriate?