In this week’s practice question, we explore the subject of suicide. You will likely see several questions on this subject regardless of which exam you take. This topic can be difficult to navigate whether you are working in the clinical setting or trying to determine the best answer on an exam question. However, reviewing the audio lectures that Amanda Rowan developed teaches you how best to approach these questions on the exam. You will also be able to take this knowledge with you into your clinical practice!
I am frequently asked about issues regarding our legal and ethical requirements with suicidal clients. Common questions include, “Aren’t I mandated to break confidentiality if my client is suicidal?” or “How do I know which intervention is most appropriate?” Although we are not mandated to break confidentiality, we are legally and ethically obligated to assess a client’s level of risk and take a measured approach to address their safety. What this looks like will depend on the information shared by the client and the therapist’s understanding of risk factors. With this in mind, let’s review our question of the week:
Jill, an 18-year-old college student who is living at home, has been meeting with a therapist on a weekly basis for several months. She was referred for therapy after receiving medical treatment for alcohol poisoning. Jill reports feeling alone, lacking direction, and does not believe the future has much to offer her. She cut back on drinking after her experience with alcohol poisoning, but continues to smoke marijuana on a regular basis and has experimented with other drugs. In session, she shares that her boyfriend broke up with her over the weekend and now that she is completely alone she wants to go to sleep and not wake up. How should the therapist manage the legal and ethical issues presented in this case?
a. Determine if she has a plan and means to commit suicide before taking other steps
b. Inform parents of risk because client lives with them and is a danger to self
c. Initiate involuntary hospitalization due to stated suicidal ideation and substance use
d.Validate client’s feelings of helplessness and help her identify healthier coping strategies
This week we are doing something a little different with our practice question: we are waiting to post the answer and rationale until tomorrow! We encourage you to post an answer in the comments section below (you can also post your reasoning behind your answer choice!). Then check back in tomorrow for the correct answer and rationale explaining why the correct answer is correct and why the other answers are not correct!
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Comments
I choose A as the answer, we Ned to find out if she has a plan and means and if so we will proceed with keeping her safe
A - the question asks how Therapist would manage legal and ethical issues presented, so A would be the first step to do this.
A is the answer- The therapist would have to assess intent and means to harm herself...b and c you couldn't do because you don't know if she is actually a danger to herself. d...providing coping skills should come after assessing her safety.
A - The client did not give any information that requires you to break confidentiality yet. But therapist need to asses further to find out if she has means or plan.
A - you have to assess further based on her comment, but she hasn't given you any information that requires you to break confidentiality yet.
Response "A" is most consistent w/what the question is asking in that it addresses the legal & ethical responsibilities of the therapist in relation to the client.
A. There is a concern of possible imminent danger so we have to do more than what's in answer D. We shouldn't do answer C because there is no reported plan or access to lethal means at this time. The best option is to assess for a plan and lethal means.