SAC Risk Assessment & Management 2 — Questions and Answers
Question 1: When a student discloses a plan to harm themselves but has no means available, how should this be classified on a lethality continuum?
- Low risk requiring monitoring only
- Moderate risk requiring safety planning (Correct answer)
- High risk requiring immediate hospitalization
- No risk since means are absent
Correct answer: Moderate risk requiring safety planning
The presence of a plan without means places the student at moderate risk, warranting a collaborative safety plan and increased monitoring.
Question 2: Which structured tool is most commonly used by school counselors to assess the severity of suicidal ideation in adolescents?
- Beck Depression Inventory (BDI)
- Columbia Suicide Severity Rating Scale (C-SSRS) (Correct answer)
- Achenbach System of Empirically Based Assessment (ASEBA)
- Conners' Rating Scales
Correct answer: Columbia Suicide Severity Rating Scale (C-SSRS)
The C-SSRS is a validated, widely used instrument specifically designed to assess the intensity and severity of suicidal ideation and behavior.
Question 3: A student who has made a previous suicide attempt is being re-integrated into school. What is the MOST critical first step for the SAC?
- Notify all teachers about the student's history
- Conduct a fresh risk assessment before the student returns (Correct answer)
- Place the student in a smaller class setting immediately
- Inform the student's peer group so they can provide support
Correct answer: Conduct a fresh risk assessment before the student returns
A prior attempt is the single strongest predictor of future suicidal behavior, making an updated risk assessment essential before re-entry.
Question 4: In risk management, what does the term 'means restriction counseling' refer to?
- Limiting a student's access to social media platforms
- Educating families to secure or remove lethal items from the home (Correct answer)
- Restricting a student's movement within the school building
- Counseling focused on reducing access to peer networks that encourage risk
Correct answer: Educating families to secure or remove lethal items from the home
Means restriction counseling involves working with families to reduce access to lethal means such as firearms and medications, which significantly lowers suicide risk.
Question 5: A student expresses passive suicidal ideation ('I wish I were dead') but denies a plan or intent. What is the appropriate response?
- Dismiss it as normal adolescent expression and continue the session
- Conduct a full risk assessment and document findings (Correct answer)
- Immediately call emergency services
- Refer the student to a peer mediation program
Correct answer: Conduct a full risk assessment and document findings
Passive ideation still warrants a thorough risk assessment because it can escalate; documentation protects both the student and the counselor.
Question 6: Which environmental factor most significantly amplifies suicide risk in adolescents according to research?
- Academic pressure from AP courses
- Access to lethal means in the home (Correct answer)
- Participation in competitive sports
- Frequent use of social media
Correct answer: Access to lethal means in the home
Access to lethal means, especially firearms, is the single most potent environmental amplifier of completed suicide in adolescents.
Question 7: When documenting a student risk assessment, which element is LEAST appropriate to include in the school record?
- Risk level determination and rationale
- Safety plan agreed upon by student and parent
- Verbatim session transcript of sensitive disclosures (Correct answer)
- Actions taken and referrals made
Correct answer: Verbatim session transcript of sensitive disclosures
Verbatim transcripts of sensitive clinical disclosures can compromise confidentiality and are not standard documentation practice; summary notes are appropriate.
SAC Risk Assessment & Management 2
When a student discloses a plan to harm themselves but has no means available, how should this be classified on a lethality continuum?