SOCW 6090 Week 3 Post Responses - Discussion: Assessing Suicide Risk

Respond to colleagues in the following ways:

· Provide suggestions to manage the emotional responses your colleague identified

· Explain why consideration of culture is important when working with diverse clients

Be sure to refence the following resources:

Required Readings

Morrison, J. (2014). Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). New York, NY: Guilford Press.

· Chapter 10, “Diagnosis and the Mental Status Exam” (pp. 119–126)

· Chapter 17, “Beyond Diagnosis: Compliance, Suicide, Violence” (pp. 271–280)

American Psychiatric Association. (2013t). Use of the manual. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.UseofDSM5

American Psychiatric Association. (2013b). Assessment measures. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasures

Focus on the “Cross-Cutting Symptom Measures” section.

Chu, J., Floyd, R., Diep, H., Pardo, S., Goldblum, P., & Bongar, B. (2013). A tool for the culturally competent assessment of suicide: The Cultural Assessment of Risk for Suicide (CARS) measure. Psychological Assessment, 25(2), 424–434. doi:10.1037/a0031264

Osteen, P. J., Jacobson, J. M., & Sharpe, T. L. (2014). Suicide prevention in social work education: How prepared are social work students?. Journal of Social Work Education, 50(2), 349-364.

The following are the original discussion posts:

Colleague #1 (The King of Zando)

Week 3 Discussion

COLLAPSE

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Identify elements of Dr. Sommers-Flanagan’s suicide risk assessment.

Elements discussed during Dr. Sommers-Flanagan’s suicide risk assessment with his client Tommi included, cultural check-in, cognitive triad assessment, assessment of physical symptoms, assessment of social relationships, directly asking the question, asking about exceptions, and asking about the plan. 

Describe any personal emotional responses you would have to Tommi’s revelations and reflect on reasons you might experience these emotions.

In Sommers-Flanagan (2014), Tommi reveals that she has had some thoughts about suicide on and off and has even disclose that she has come up with a couple of plans for it to occur.  She contemplated hanging her self and writing on the walls everything that ever hurt her, for her parents to see. As a response to Tommi’s revelation, I would feel a heavy weight of sadness cloud my thoughts. The reason rest on wanting to be of help for someone, and sometimes wanting to accomplish this task means empathy for what someone else is experiencing or in this situation contemplating. 

Describe the elements of safety planning that you would put in place as Tommi’s social worker in the first week and in the first months.

A safety plan acts as protection from individuals causing harm or danger to themselves and others. Stanley & Brown (2012) makes use of a safety plan resulting in 5 steps and lastly constructing a safe environment. I would continue to assess Tommi for possible warning signs, help her discover internal coping strategies like “singing” as this has helped her to not ponder the thought of suicide. In addition I would consult with Tommi about social situations and people that would distract her from suicidal ideation. I would also provide her with an emergency contact list for when she needs to reach out to someone; this also includes professional contacts as well. Lastly, together we can come up with ideas for making her environment more safe.

Identify a suicide risk assessment tool you would use at future sessions to identify changes in her risk level. Explain why you would use this tool.

A suicide risk assessment tool that I would use in a future session would be the Cultural Assessment of Risk for Suicide (CARS). Tommi discloses that she is native alaskan. While working with her it is important to consider cultural competence and it’s benefit towards proper safety planning. The CARS is the first to operationalize a systematic model that accounts for cultural competency across multiple cultural identities in suicide risk assessment efforts (Chu, Floyd, Diep, Pardoners, Goldblum, Bongar, 2013). According to Chu et al., (2013), one of the benefits is its ability to be used in several compacities  such as screening, prevention and suicide management. By utilizing CARS  it might provide greater insight for identifying extra risk factors than an average assessment tool would. The CARS provides substantial advancement in the field of culture and suicide and provides a viable method of assessing for the variegated ways in which cultural variation is manifested in suicide risk (Chu, 2013).

Explain any adjustments or enhancements that might be helpful given Tommi’s cultural background. Support your ideas with scholarly resources.

The greatest benefit of this assessment is that it accounts for culture and minority. An enhancement to this assessment should be more tailored to the youth considering Tommi is a teen. This might provide better insight for assessment. Chu (2013) discusses future research needed to expand on CARS in areas such as age. 

References:

Chu, J., Floyd, R., Diep, H., Pardo, S., Goldblum, P., & Bongar, B. (2013). A tool for the culturally competent assessment of suicide: the Cultural Assessment of Risk for Suicide (CARS) measure. Psychological Assessment, 25(2), 424–434. https://doi-org.ezp.waldenulibrary.org/10.1037/a0031264

Sommers-Flanagan, J., & Sommers-Flanagan, R (Producers). (2014). Clinical interviewing: Intake, assessment and therapeutic alliance [Video file]

Stanley, B., & Brown, G. K. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice, 19(2), 256–264. https://doi-org.ezp.waldenulibrary.org/10.1016/j.cbpra.2011.01.001

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Colleague #2 (Azz Crap Zak)

WK 3 Discussion

COLLAPSE

Top of Form

Identify elements of Dr. Sommers-Flanagan’s suicide risk assessment.

In the suicide risk assessment video, Dr. Sommers-Flanagan starts off by employing cultural competence and encourages Tommi to let him know of any cultural influences that might warrant a different perspective (Sommers-Flanagan & Sommers-Flanagan, 2014). He then proceeds to provide Tommi with a psychoeducation concerning cognitions and behaviors as well as physical and social implications. During this conversation, Tommi discloses feeling hopeless, which is a conspicuous indicator of probable suicidal behavior (Morrison, 2014; Sommers-Flanagan & Sommers-Flanagan, 2014) Next, he is forthright in asking Tommi about any existing suicidal ideations or plans she might have. While discussing this topic, Dr. Sommers-Flanagan skillfully attempts to elicit strengths by asking her about what she is doing or thinking when suicide is not governing her thoughts (Sommers-Flanagan & Sommers-Flanagan, 2014). 

 

Describe any personal emotional responses you would have to Tommi’s revelations and reflect on reasons you might experience these emotions.

It was shocking to hear Tommi disclose her various plans as to how she would commit suicide. Also, it was very chilling to hear about how she planned to write down everything that hurt her on her walls for her parents to read after she was dead (Sommers-Flanagan & Sommers-Flanagan, 2014). This prompted personal feelings of frustration, because, in my mind, there are countless other ways to address mistreatment and unhealthy relationships with parents. However, I know that thinking this way is not productive and professionals must meet their clients where they are. 

 

Describe the elements of safety planning that you would put in place as Tommi’s social worker in the first week and in the first months.

To reduce the risk and hopefully prevent suicide in Tommi’s situation, I would implement the Safety Planning Intervention that focuses on identifying suicidal ideations, encouraging individual coping strategies, contacting supports, and eliminating access to anything that could provoke suicidal behavior (Stanley & Brown, 2012). This plan would be created collaboratively with Tommi to ensure that it is specific to her cognitions, coping strategies, and sources of support. It is important to promote Tommi’s personal coping mechanisms so that they can be utilized if she is alone, feeling suicidal, and feels as though she has no one to talk to about what is going on. In addition, I would recommend that Tommi try to engage in poetry and singing when she begins to feel symptoms consistent with suicide to relax her mind. 

 

Identify a suicide risk assessment tool you would use at future sessions to identify changes in her risk level. Explain why you would use this tool.

The suicide risk assessment I would use is the Cultural Assessment of Risk for Suicide (CARS). This tool takes into considerations factors such as cultural beliefs about suicide, cultural influence as to how an individual might express suicidal ideations, stress/anxiety resulting from cultural affiliation, and social relationship dynamics (Chu et al., 2013). Using this tool would ideally reveal some of the influences from her Native Alaskan culture, especially concerning the contentious relationship between Tommi and her parents and how this has contributed to her risk of suicide. In addition, this tool uses a 6 point likert scale with 52 items that can be reassessed at a later time to evaluate progress or lack thereof (Chu et al., 2013). 

 

Explain any adjustments or enhancements that might be helpful given Tommi’s cultural background. Support your ideas with scholarly resources.

Ivanich and Teasdale (2018) found that the American Indian/Alaskan Native adolescent population is more prone to depression when compared to other cultural and ethnic populations, which is linked with increased suicidal ideations. In addition, this population was found to have more exposure to suicidal behavior from family and friends that has led to an increase in suicidal thought (Ivanich & Teasdale, 2018). With this in mind, I would tailor my approach with Tommi in a way that emanates sensitivity regarding the possibility that she may have been exposed to suicide in the past. Also, given the higher rates of depression found among this population, I would research evidence-based depression screening tools and intervention strategies that are specific to the American Indian/Alaskan Native population.

Chu, J., Floyd, R., Diep, H., Pardo, S., Goldblum, P., & Bongar, B. (2013). A tool for the culturally competent assessment of suicide: The Cultural Assessment of Risk for Suicide (CARS) Measure. Psychological Assessment, 25(2), 424–434. 

Ivanich, J., & Teasdale, B. (2018). Suicide Ideation among Adolescent American Indians: An Application of General Strain Theory. Deviant Behavior, 39(6), 702–715.

Morrison, J. (2014). Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). New York, NY: Guilford Press.

Sommers-Flanagan, J., & Sommers-Flanagan, R. (Producers). (2014). Clinical interviewing: Intake, assessment and therapeutic alliance [Video file].

Stanley, B., & Brown, G. K. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk. Cognitive and Behavioral Practice, 19(2), 256–264. 

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