Key Concepts
Roberts' seven-stage crisis intervention model provides a structured approach: assess lethality, establish rapport, identify major problems, deal with feelings, generate alternatives, develop action plan, follow up
Suicide risk assessment should evaluate ideation, plan, means, intent, and protective factors
The Columbia Suicide Severity Rating Scale (C-SSRS) is a widely used evidence-based screening tool
Safety planning is a collaborative process that helps clients identify warning signs, coping strategies, social supports, and professional resources
Duty to protect may require breaking confidentiality when a client is at imminent risk of self-harm
Mandated reporting requirements for child abuse, elder abuse, and vulnerable adult abuse override client confidentiality
Critical incident stress debriefing (CISD) and psychological first aid are models for responding to traumatic events
Why This Matters for the Exam
Crisis intervention and suicide assessment are tested on all clinical licensing exams. The ASWB Clinical exam frequently presents vignettes involving suicidal clients and asks what the clinician should do first. The NCMHCE includes simulations requiring crisis assessment. Always prioritize client safety in your answer choices. Know the difference between suicidal ideation (thinking about it), a plan (how they would do it), and intent (motivation to act on the plan).
Study Tips
Memorize the key steps in a suicide risk assessment and know what constitutes high, moderate, and low risk. Practice with vignettes that require you to determine the most appropriate immediate action. Remember: on the exam, safety always comes first. If a question involves any level of suicidal risk, the correct answer will typically involve assessing the risk further, not ignoring it or immediately hospitalizing the client.