TTC Crisis Intervention and Management 3 — Questions and Answers
Question 1: When conducting a suicide risk assessment during a crisis, which factor is considered a STATIC (non-modifiable) risk factor?
- Current hopelessness level
- Access to lethal means
- History of prior suicide attempts (Correct answer)
- Presence of a safety plan
Correct answer: History of prior suicide attempts
History of prior suicide attempts is a static risk factor because it cannot be changed, unlike dynamic factors such as hopelessness or means access.
Question 2: A crisis counselor is working with a survivor of a mass casualty event who is displaying emotional numbing, dissociation, and avoidance 10 days after the incident. This presentation is MOST consistent with:
- Major depressive disorder
- Acute stress disorder (Correct answer)
- Borderline personality disorder
- Generalized anxiety disorder
Correct answer: Acute stress disorder
Acute stress disorder is diagnosed when trauma symptoms such as dissociation, avoidance, and numbing occur within 3 days to 4 weeks of a traumatic event.
Question 3: The 'safety planning' approach developed by Stanley and Brown differs from a 'no-suicide contract' primarily because it:
- Requires physician co-signature to be valid
- Is collaboratively developed and focuses on coping steps the client can take (Correct answer)
- Eliminates the need for hospitalization in all cases
- Focuses solely on removing access to lethal means
Correct answer: Is collaboratively developed and focuses on coping steps the client can take
The Stanley-Brown Safety Planning Intervention is collaboratively built with the client and includes personalized coping strategies, making it more clinically effective than no-suicide contracts.
Question 4: Which of the following is an example of a 'protective factor' that would reduce suicide risk during a crisis assessment?
- Social isolation
- Recent job loss
- Strong religious beliefs that prohibit suicide (Correct answer)
- Command hallucinations
Correct answer: Strong religious beliefs that prohibit suicide
Strong religious or spiritual beliefs that include moral objections to suicide are well-documented protective factors against suicidal behavior.
Question 5: In the context of Critical Incident Stress Management (CISM), a 'defusing' differs from a 'debriefing' in that it:
- Is led by a licensed psychiatrist only
- Is a longer, more formal group process conducted 24-72 hours post-incident
- Is a brief, informal group process conducted within hours of a critical incident (Correct answer)
- Focuses exclusively on treatment of PTSD symptoms
Correct answer: Is a brief, informal group process conducted within hours of a critical incident
A defusing is a short (20-45 minute) informal group process conducted within 8 hours of a critical incident, whereas a debriefing is more structured and occurs 24-72 hours later.
Question 6: A crisis worker at a crisis stabilization unit (CSU) should prioritize which action when a client with trauma history becomes acutely agitated?
- Immediately initiate mechanical restraint procedures
- Use verbal de-escalation and offer the client choices to increase sense of control (Correct answer)
- Remove all other staff from the room to avoid triggering the client
- Administer PRN medication without obtaining verbal consent
Correct answer: Use verbal de-escalation and offer the client choices to increase sense of control
Offering choices and using verbal de-escalation restores a sense of control, which is especially critical for trauma survivors whose crises often involve a loss of control.
Question 7: Which ethical obligation is MOST relevant when a crisis counselor must decide whether to breach confidentiality due to a client's threats toward a third party?
- The Tarasoff duty to protect (Correct answer)
- HIPAA minimum necessary standard
- Informed consent requirements
- Mandatory reporting of elder abuse
Correct answer: The Tarasoff duty to protect
The Tarasoff duty to protect (originating from Tarasoff v. Regents of the University of California) obligates clinicians to take steps to protect identifiable third parties from credible threats.
TTC Crisis Intervention and Management 3
When conducting a suicide risk assessment during a crisis, which factor is considered a STATIC (non-modifiable) risk factor?