Preparing for the MFT & LCSW Exam: Exploring Suicide & Self-Harm

By Bethany Vanderbilt on February 8, 2012


If you’re getting ready to take the LCSW Exam or MFT Exam, this blog is for you!  This week, we’re taking a closer look at the topic of Suicide/Self Harm.  This is an extremely important topic, not only because it’s bound to come up on the LCSW exam, but also because it’s so critical to client safety.  Here’s one way it might appear in a test item:

Sample Question:

A 66 year-old man is referred to a social worker by his adult daughter.  During the initial assessment, the man reports poor sleep and increased feelings of hopelessness after being laid off from his job.  He goes on to tell the social worker that “things just seem to keep going downhill since my wife died a year ago.”  What should the social worker do FIRST:

A. Refer the client to an employment agency

B. Teach the client relaxation skills to help him sleep

C. Assess the client for suicidal ideation

D. Refer the client to a support group for widows/widowers

Most of us share an understanding of what suicide is: the act of intentionally taking one’s own life.  Self-harm is not defined in the Social Work Dictionary, but based on the previous idea my working definition is: intentional acts aimed at physically harming oneself.

I’m going to list some of the risk factors that have been linked with a high risk of suicide; these are all things that you can be looking for in test items as an indirect assessment of a person’s risk.  Taken individually, they may not necessarily point to a risk of suicide, but in conjunction with other factors (such as hopelessness or depression) they indicate a need for a risk assessment and direct questioning about a person’s intentions or ideation.  Some of the factors associated with a high risk of suicide are: gender (men are more likely than women to complete the act), age (older people are typically more likely than younger people), race (in most cases whites are more likely than any other group), marital status (being married is a protective factor) and life stressors (recent losses, unemployment, isolation, etc.).


In the item above, the correct answer is C, since the stem provides the test-taker with multiple risk factors for suicide.  Answers, A, B and D may all be viable options later in treatment, but not until client safety is established.

Here’s a quick LCSW exam tip: if you’re reading an answer set and one of the options includes doing a risk assessment, or asking the client about suicidal feelings, etc., AND the risk of self-harm hasn’t occurred to you yet, it’s time to go back up to the stem and see if you missed something.  While it’s never 100%, if assessing for suicide or self harm is in an answer option, there’s a good chance the stem gave you some clues of suicidal risk. 

Coming up next week: Topic 5: Danger to Others

Think our straightforward, sensible approach could help you PASS your social work or MFT exam? If you're preparing for a social work exam, check out our Social Work Study Materials. If you're preparing for an MFT exam, check out our MFT Study Materials. Learn more about our offerings at The Therapist Development Center.

Looking for more practice questions and some study tips? Check out our new Social Work Exam Study Guide:

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