Reflect on how the type of interaction with a client (i.e. seeing a client, listening to a client on the phone, or reading a written file) might impact your crisis response.
Please no plagiarism and make sure you are able to access all resource on your own before you bid. One of the references must come from James, R. K., & Gilliland, B. E. (2017). I have put in bold the classmates that you will need to respond to according to the instructions of the instructor. Please follow the instructions to get full credit for the discussion. I had the written format and I included my discussion. I need this completed by 10/13/18 at 8pm.
Respond to at least two of your colleagues. Be sure to select at least one colleague who had a different type of format/interaction than the one you were assigned. For example, if you were assigned the written transcript, respond to a colleague who watched the video or listened to the audio recording. Respond in the following ways:
- Discuss the similarities and differences in the risk factors and safety plan ideas you and your colleague identified.
- Reflect on how the type of interaction with a client (i.e. seeing a client, listening to a client on the phone, or reading a written file) might impact your crisis response.
My Discussion Post
1. Type of interaction: written transcript
2. Risk factors for the client: depression, irritability, despair, mental health conditions.
3. Things I would like to know about the client: presence of any suicide warning signals in her behavior. Warning signs to look for include, withdrawing from activities, isolating from family and friends, sleeping too much or too little, hopelessness for the future, loss of interest and rage. Having gone through the written transcript, I have gathered that Sue is at risk of committing suicide as a result of depression and possible mental illness. In her safety plan for intervention, I will therefore include the following: warning signs, preferred internal coping strategies, social contacts that may distract her from the crisis, family members or friends who may offer help, ways to make her environment safer and conducive for positive thoughts, help her recognize the reasons to go on living and professionals to contact in case of a crisis. Here is an example of a safety plan template that I would use for Sue’s intervention.
4. Patient Safety Plan
Warning signs for development of a crisis- behavior, moods and thoughts
Internal coping strategies- physical exercise and activities and relaxation
People and social settings that provide distraction- children, movie theatres and church
People whom I can seek help from-psychologist and counsellors
Professionals or agencies to contact during crisis-clinicians, local urgent care services and suicide prevention lifeline phone.
Making the environment safe
References
James, R. K., & Gilliland, B. E. (2017). Crisis Intervention Strategies. Mason, OH: Cengage Learning US.
Classmate K. Bre
The type of interaction that I reviewed was the video.
Risk Factors
Several risk factors were identified during the session with the client. I observed this individual to present with symptoms of Post Traumatic Stress Disorder. He seems to be replaying a number of traumatic events that he has experienced (Physical and Emotional abuse from his father, surviving an explosion that his friends died from). He also uses alcohol as a way to cope and to go to sleep. This individual also expressed losing his identity. He expresses that he is supposed to be providing for his family. However, he has no job and is dependent on his wife to provide as she is the only one working as a nurse. I found it interesting that he referred to himself as “the babysitter” instead of a stay at home father or something similar. The individual also expressed that he has no significant supportive relationships. He has no friends no support. He doesn’t identify his wife as support due to them fighting and arguing.
According to James and Gilliland(2017), Robert identifies with a number of “Characteristics of People who Commit Suicide”. He is enduring unendurable psychological pain (traumatic events), he has expressed affective characteristics (hopelessness with his work situation), and relational characteristic (The individual is communicating that his contemplating ending his life or believing that everyone will be better off without him). Another risk factor is the availability to a firearm.
Missing Information
I think that I would like to know more about how the traumatic events of his past are currently affecting him on a day to day basis. I would also want to know how long have Robert and his wife had issues. I would also want to know more specifics of his plan. When would he plan to do it? Is there a specific event that would push him closer to completing the act of suicide?
Safety Plan
I think it would be important for Robert to address his access to his firearm. I think it would also be important for Robert to identify key individuals he can talk with when he feels like committing suicide. I would also be interested if Robert would discuss with his son and his wife how he feels about them being better off without him. I think it would be important to provide Robert the suicide prevention hotline. I would also be inclined to get him connected to a veterans support group to assist Robert in gaining some natural supports.
James, R. K., & Gilliland, B. E. (2017). Crisis Intervention Strategies (8th ed.). Boston, MA: Cengage.
Classmate E. Sch
Audio Case Study
Robert, a military veteran, is seeking counseling in response to a recent fight with his significant other. Most of his unit died after driving over an explosive, leaving him to feel guilty about surviving without them. He also has a history of being abused as a child, and is concerned about his growing tendencies toward violence. He notes that he is still in possession of a gun, but denies any intention to use it on himself. Robert also reports drinking a case of beer each night to subdue his emotions enough to sleep, and feels as though spending copious amounts of money on beer makes him a burden to his family. Accordingly, his counselor is beginning to collect information regarding whether he is at risk for suicidal behavior (Laureate Education, 2018).
Suicide Risk Factors
Based on his traumatic military experiences, his symptoms, and their duration, it is possible that Robert might be suffering from posttraumatic stress disorder (James & Gilliand, 2017). Posttraumatic stress disorder is a risk factor for suicide, as is substance abuse (May & Klonsky, 2016). In addition, he discusses wondering whether the pain he is experiencing is worth continuing to live (Laureate Education, 2018). In reality, suicidal thoughts like this are also a risk factor for eventual attempts and death (Ballard et al., 2016). Other risk factors present in Robert’s case include childhood abuse, isolation, feeling guilty, burdensomeness, and possessing a gun (James & Gilliand, 2017). Hence, the information that is available in the audio interview is indicative of a high risk for suicide. However, there is still some risk information that must be gathered.
Missing Information
Since this assessment is based entirely on the audio of an interview, there is no information available about Robert’s appearance and body language. Being able to conduct a visual assessment is critical when working with potentially suicidal clients, as there are a variety of behavioral cues that are indicative of increased risk (James & Gilliand, 2017). A visual assessment could identify agitation, which is predictive of suicidal behavior (Ballard et al., 2016). A counselor could also scan for obvious cutting, burns, hair pulling, and other forms of self-injury, as nonsuicidal self-injurious behavior can predict the transition from suicide ideation to attempts (Nock et al., 2018). In addition, it would be preferable to ask whether Robert has a specific suicide plan. He has shared that he has a gun, which is a suicide risk factor on its own (James & Gilliand, 2017). Essentially, his counselor should collect more information about whether Robert has developed a suicide plan that involves the gun. Ultimately, this information could play a critical role in the development of a safety plan.
Safety Plan
Safety plans provide clients with information about how to recognize crisis situations, how to utilize personal support systems, and how to contact mental health professionals. As a result, safety plans reduce suicide attempts, make hospitalizations less frequent, and increase the frequency of contact with outpatient mental health staff. are associated with a variety of benefits including fewer suicide attempts, fewer hospitalizations, and more frequent contact with outpatient mental health staff. Although suicide plans must be customized to fit the needs of each client, common themes include drawing support from family members, contacting hotlines, and reducing access to lethal means (Zonana, Simberlund, & Christos, 2018). Hence, Robert’s suicide plan could include surrendering his firearm, identifying family members that he could contact, and collecting the contact information for local suicide prevention services.
References
Ballard, E. D., Voort, J. L., Luckenbaugh, D. A., Machado-Vieira, R., Tohen, M., & Zarate, C. A. (2016). Acute risk factors for suicide attempts and death: Prospective findings from the STEP-BD study. Bipolar Disorders, 18, 363-372. doi: 10.1111/bdi.12397
James, R., K., & Gilliand, B. E. (2017). Crisis intervention strategies (8th ed.). Boston, MA: Cengage Learning. Laureate Education (Producer). (2018). Suicide assessment and safety planning [Video file]. Baltimore, MD: Author.
May, A. M., & Klonsky, E. D. (2016). What distinguishes suicide attempts from suicide ideators? A meta-analysis of potential factors. Clinical Psychology Science and Practice, 23(1), 5-20. doi: 10.1111/cpsp.12136
Nock, M. K., Millner, A. J., Gutierrez, P. M., Naifeh, J. A., Stein, M. B., Kessler, R. C., . Ursano, R. J. (2018). Risk factors for the transition from suicide ideation to suicide attempt: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Journal of Abnormal Psychology, 127(2), 139-149. doi: 10.1037/abn0000317
Zonana, J., Simberlund, J., & Christos, P. (2018). The impact of safety plans in an outpatient clinic. Crisis, 39(4), 304-309. doi: 10.1027/0227-5910/a000495
Required Resources
Readings
James, R. K., & Gilliland, B. E. (2017). Crisis intervention strategies (8th ed.). Boston, MA: Cengage Learning.
- Chapter 8, “Crisis of Lethality”
Psychological Trauma: Theory, Research, Practice, and Policy. (Nov 2016). Outcomes from eye movement desensitization and reprocessing in active-duty service members with posttraumatic stress disorder, Vol 8(6).
Note: You will access this article from the Walden Library databases.
Virginia Department of Behavioral Health & Developmental Services. (2018). Retrieved from http://www.dbhds.virginia.gov/
Document: Facility Response Activity Transcript (PDF)
Required Media
Laureate Education (Producer). (2018a). Facilitative response activity [Video file]. Baltimore, MD: Author.
Note: This media is a self-paced interactive piece.
Click here to download the transcript.
Laureate Education (Producer). (2018b). How to accurately assess and help a client [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 37 minutes.
Accessible player –Downloads– Download Video w/CC Download Audio Download Transcript
Laureate Education (Producer). (2018c). Suicide assessment and safety planning [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 16 minutes.
Accessible player –Downloads– Download Video w/CC Download Audio Download Transcript
Optional Resources
American Association of Suicidology. (2018). Retrieved from www.suicidology.org
American Foundation for Suicide Prevention. Retrieved from https://afsp.org/
May, A. M., & Klonsky, E. D. (2016). What distinguishes suicide attempters from suicide ideators? A meta-analysis of potential factors. Clinical Psychology: Science and Practice, 23(1), 5–20. doi:10.1111/cpsp.12136
Shallcross, L. (2010). Confronting the threat of suicide. Counseling Today. Retrieved from http://ct.counseling.org/2010/07/confronting-the-threat-of-suicide
Sommers-Flanagan, J., & Shaw, S. L. (2017). Suicide risk assessment: What psychologists should know. Professional Psychology: Research and Practice, 48(2), 98–106. doi:10.1037/pro0000106
