Psychology 2

SHMILY

CCMHsuicideassement3.docx

Home >Psychology homework help >Psychology 2

CCMH/558 v3

Suicide Risk Assessment Form

CCMH/558 v3

Page 2 of 2

$C:\Users\djshirey\OneDrive - University of Phoenix\F_Drive\Style Guides\UPX Logos\Horizontal format\UOPX_Sig_Hor_Black_Medium.png$ Suicide Risk Assessment Form

When someone seeks treatment after trauma, counselors must complete a risk assessment, even when clients may not be demonstrating behaviors that seem high risk.

Complete Parts 1 and 2 of this form including references. Submit the completed form for your assignment.

Instructions

Part 1: Suicide Risk Assessment

Assess risk for the client in the case study using the Suicide Risk Assessment Form based on the Suicide Assessment Five-step Evaluation and Triage from SAMHSA in 175–260 words. Use full sentences and appropriate grammar.

Support your assessment with appropriate terminology from the DSM-5.

Part 2: Crisis Intervention and Safety Plan

Describe how you would apply the ABC model of crisis intervention in this situation in 260–350 words.

List the next steps you would take and what might be included in a safety plan for this individual in 50–100 words.

Cite the selected case and any other supporting resources used.

Format your citations and references according to APA guidelines.

Part 1: Suicide Risk Assessment

Step 1: Identify Risk Factors

What risk factors exist for this individual? Which factors can be modified to reduce risk?

Risk Factors	Notes
Precipitants and stressors · Recent trauma, triggering events (real or anticipated), another prior crisis · Medical illness, intoxication · Family or interpersonal turmoil, history of physical or sexual abuse, social isolation · Change in treatment or treatment provider, or discharge from psychiatric hospital	Enter notes here.
History of risk factors · Attempts to die by suicide · Self-injurious behavior · Psychiatric disorders, comorbidity, and mental health treatments · Attempts of family members to die by suicide · Family diagnosed with Axis 1 psychiatric disorders that required hospitalization	Enter notes here.
Key symptoms · Anhedonia · Impulsivity · Hopelessness · Anxiety or panic · Global insomnia · Command hallucinations	Enter notes here.
Lethal Access · Access to firearms or other lethal methods	Enter notes here.

Step 2: Identify Protective Factors

Which factors can be enhanced to protect the patient? Note: These protections may not counteract high risk factors.

Protective Factors

Notes

Internal

· Ability to cope with stress or frustration

· Spiritual beliefs

Enter notes here.

External

· Social supports

· Responsibility to loved ones, children, or pets

· Positive therapeutic relationships

Enter notes here.

Step 3: Conduct Suicide Inquiry

Has this individual had any ideations, plans, behaviors, or intentions to die by suicide? To what extent does the patient intend to carry out their plan? How lethal or self-injurious do they think their plan would be? What are their reasons to live or die?

Ask About	Notes
Ideations · Frequency, intensity, and duration of suicidal thoughts and ideations in: a. the last 48 hours b. the past month c. the worst ever	Enter notes here.
Plan · Time · Place · Lethality of their method · Availability of their method · Ways they have prepared for death	Enter notes here.
Behavior · History of attempts (and aborted attempts) to die by suicide · Rehearsal behaviors for suicide vs. non-suicidal self-injurious actions	Enter notes here.
Intent · Extent to which the patient expects to carry out the plan · Extent to which the patient believes it to be lethal versus self-injurious	Enter notes here.
Special Considerations · For youth and parents/guardians of minors: ask about evidence of suicidal thoughts, plans, or behaviors as well as changes in mood, behaviors, or dispositions · When indicated, or for character disordered or paranoid males dealing with loss or humiliation: ask about 4 areas above and conduct homicide inquiry	Enter notes here, if applicable.

Step 4: Determine Risk Level / Intervention

After using your best judgment to assess the patient in Steps 1-3, what risk level do you think they are demonstrating?

Risk Level	Risk Factor	Protective Factor	Suicidality	Possible Interventions
High	Psychiatric diagnoses with severe symptoms or acute precipitating event	Protective factors not relevant	Potentially lethal suicide attempt or persistent ideation with strong intent or suicide rehearsal	· Admission generally indicated unless a significant change reduces risk. · Take suicide precautions.
Moderate	Multiple risk factors	Few protective factors	Suicidal ideation with plan, but no intent or behavior	· Admission may be necessary depending on risk factors. · Develop crisis plan. · Give emergency and crisis numbers.
Low	Modifiable risk factors	Strong protective factors	Thoughts of death, no plan, intent, or behavior	· Outpatient referral, symptom reduction. · Give emergency and crisis numbers.

Step 5: Document

1. What do you think is the patient’s risk level? Justify your reasoning for this determination.

Enter your response.

2. What intervention do you recommend that addresses the current risks? What is your plan for treatment? What can you and the client do to reduce these risks (e.g., medication, setting, psychotherapy, interventions, contact with significant others, consultation)?

Enter your response.

3. Provide firearms instructions, if relevant.

Enter your response, or N/A if not applicable.

4. What is the follow-up plan? In the case of youths, what roles should the parent/guardian have?

Enter your response.

Part 2: Crisis Intervention and Safety Plan

Crisis Intervention

Enter your response.

Safety Plan

Enter your response.

References

Enter your references for both Parts 1 and 2 in APA format.

Psychology 2

Suicide Risk Assessment Form

Instructions

Part 1: Suicide Risk Assessment

Part 2: Crisis Intervention and Safety Plan

Part 1: Suicide Risk Assessment

Step 1: Identify Risk Factors

What risk factors exist for this individual? Which factors can be modified to reduce risk?

Step 2: Identify Protective Factors

Which factors can be enhanced to protect the patient? Note: These protections may not counteract high risk factors.

Step 3: Conduct Suicide Inquiry

Has this individual had any ideations, plans, behaviors, or intentions to die by suicide? To what extent does the patient intend to carry out their plan? How lethal or self-injurious do they think their plan would be? What are their reasons to live or die?

Step 4: Determine Risk Level / Intervention

After using your best judgment to assess the patient in Steps 1-3, what risk level do you think they are demonstrating?

Step 5: Document

1. What do you think is the patient’s risk level? Justify your reasoning for this determination.

2. What intervention do you recommend that addresses the current risks? What is your plan for treatment? What can you and the client do to reduce these risks (e.g., medication, setting, psychotherapy, interventions, contact with significant others, consultation)?

3. Provide firearms instructions, if relevant.

4. What is the follow-up plan? In the case of youths, what roles should the parent/guardian have?

Part 2: Crisis Intervention and Safety Plan

Crisis Intervention

Safety Plan

References

image1.png

$C:\Users\djshirey\OneDrive - University of Phoenix\F_Drive\Style Guides\UPX Logos\Horizontal format\UOPX_Sig_Hor_Black_Medium.png$ Suicide Risk Assessment Form