Suicide risk assessment frameworks and crisis intervention steps for the practicing clinical counselor.
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- What is Gerald Caplan's definition of a psychological crisis?
- A state that occurs when a person faces an obstacle to important life goals that seems insurmountable through their usual coping methods.
- About how long does an acute crisis state typically last before some resolution occurs?
- About 4 to 6 weeks.
- What is passive suicidal ideation?
- Thoughts of wanting to be dead or not wanting to wake up, without a plan or intent to act.
- What is active suicidal ideation?
- Thoughts of wanting to kill oneself, with some degree of intent to act on the thoughts.
- In risk assessment, what does the 'plan' component refer to?
- Whether the person has worked out a specific method, time, and place for suicide.
- In risk assessment, what does 'intent' refer to?
- How determined the person is to act on suicidal thoughts and end their life.
- Why is assessing access to lethal means a critical step in suicide risk assessment?
- Because ready access to a lethal method greatly increases the chance an attempt will be fatal.
- What is the single strongest predictor of future suicide?
- A prior suicide attempt.
- What is the main purpose of the SAD PERSONS scale?
- To give clinicians a quick, structured checklist of risk factors for estimating suicide risk.
- Give an example of a protective factor against suicide.
- Strong social support, such as close family or friend connections.
- How do religious or cultural beliefs commonly function as a protective factor?
- They can create moral objections to suicide that discourage a person from acting on suicidal thoughts.
- What is means restriction counseling?
- Working with a suicidal person and their support network to limit access to lethal methods, such as firearms or excess medication.
- What is a safety planning intervention?
- A collaboratively written, prioritized list of coping strategies and supports a person can use during a suicidal crisis.
- Why do most modern clinicians favor a safety plan over a traditional no-suicide contract?
- A safety plan gives concrete coping steps, while a no-suicide contract only extracts a promise and has no evidence of preventing suicide.
- What are chronic (distal) risk factors for suicide?
- Longstanding vulnerabilities, such as a history of mental illness or past trauma, that raise baseline risk over time.