LSP Crisis Intervention & Emergency Services 4 — Questions and Answers
Question 1: When using the Stanley-Brown Safety Planning Intervention, what is the FIRST step completed with the client?
- Identifying reasons for living
- Recognizing personal warning signs of a suicidal crisis (Correct answer)
- Listing emergency contacts and crisis line numbers
- Removing lethal means from the environment
Correct answer: Recognizing personal warning signs of a suicidal crisis
The Stanley-Brown Safety Plan begins by identifying the client's personal warning signs so they can recognize early when a crisis is emerging.
Question 2: A psychologist working in a hospital emergency department evaluates a client who is intoxicated. Regarding decisional capacity, the MOST accurate statement is:
- Intoxication always eliminates decision-making capacity
- Capacity must be assessed in the current moment regardless of substance use (Correct answer)
- Intoxicated clients can never be evaluated until fully sober
- Capacity is a legal determination made only by a judge
Correct answer: Capacity must be assessed in the current moment regardless of substance use
Decisional capacity is a clinical, time-specific determination; the clinician must assess the client's current ability to understand, appreciate, reason, and communicate a choice.
Question 3: Which crisis intervention approach emphasizes the ABC model: Achieving rapport, Boiling down the problem, and Coping with the problem?
- Caplan's public health model
- Gilliland and James's ABC model (Correct answer)
- Lindemann's grief crisis framework
- Aguilera's equilibrium model
Correct answer: Gilliland and James's ABC model
Gilliland and James described the ABC model as a practical framework for telephone and brief in-person crisis counseling.
Question 4: A client discloses during a crisis call that they have a specific, detailed plan to harm their neighbor tomorrow. Under the Tarasoff duty, the psychologist must PRIMARILY:
- Maintain confidentiality and explore the client's feelings about the neighbor
- Warn the identifiable potential victim and/or notify law enforcement (Correct answer)
- Consult with a supervisor before taking any action
- Wait to see whether the client acts on the threat
Correct answer: Warn the identifiable potential victim and/or notify law enforcement
Tarasoff v. Regents of the University of California established the duty to protect identifiable third parties from serious, credible threats made by clients.
Question 5: In disaster mental health response, 'psychological triage' is used to:
- Diagnose PTSD in the field immediately after disaster
- Identify individuals who need immediate versus delayed mental health support (Correct answer)
- Assign pharmacological treatment to acutely distressed survivors
- Prioritize medical injuries over psychological needs
Correct answer: Identify individuals who need immediate versus delayed mental health support
Psychological triage rapidly identifies levels of distress to match survivors with the appropriate intensity of support during mass disaster response.
Question 6: A crisis counselor notices that a caller becomes calm and resolute after weeks of expressing hopelessness. This shift should be interpreted as:
- A sign of successful coping and reduced risk
- A potential warning sign indicating the client may have made a decision to act (Correct answer)
- Evidence the treatment plan is working well
- A natural stage of emotional regulation
Correct answer: A potential warning sign indicating the client may have made a decision to act
A sudden calm or apparent resolution of distress in a suicidal client can signal that they have made a decision to attempt suicide, paradoxically reducing subjective distress.
Question 7: Which of the following BEST describes the role of crisis intervention relative to ongoing psychotherapy?
- Crisis intervention replaces the need for psychotherapy
- Crisis intervention stabilizes acute distress and bridges clients to longer-term care (Correct answer)
- Crisis intervention requires the same depth of exploration as psychotherapy
- Crisis intervention is only appropriate for first-time psychiatric contacts
Correct answer: Crisis intervention stabilizes acute distress and bridges clients to longer-term care
Crisis intervention is time-limited and focused on stabilization, restoring equilibrium, and connecting clients to follow-up services rather than conducting in-depth therapeutic work.
LSP Crisis Intervention & Emergency Services 4
When using the Stanley-Brown Safety Planning Intervention, what is the FIRST step completed with the client?