Clinic

Question 1

Suicide Risk Assessment

Answer 1

Suicide Risk Assessment
Prompt Questions:

Are you thinking of suicide?
Have you thought about Suicide in the last two months?
Have you ever attempted to kill yourself?
If the caller answers “yes” to any of these questions, please complete the following risk assessment.

Risk Assessment:
SUICIDAL DESIRE

Suicidal Ideation

killing self and others

Psychological pain

Hopelessness

Helplessness

Perceived burden on others

Feeling trapped

Feeling intolerably alone
SUICIDAL CAPABILITY

History of suicide attempts

Exposure to someone else’s death by suicide

HIstory of/current violence to others

Available means of killingself/other

Currently intoxicated

Substance abuse

Accute symptoms of mental illness, for example:

Recent dramatic mood change
Out of touch with reality

Extreme agitation/rage, for example:

Increased anxiety
Decreased sleep

SUICIDAL INTENT

Attempt in progress

Plant to kill self/other

method unknown

Preparatory behavious

Expressed intent to die
BUFFERS/CONNECTEDNESS

Immediate supports

Social supports

Planning for the future

Engagement with helper

Telephone worker

Ambivalence for living/dying

Core values/beliefs

Sense of purpose

Question 2

Informed Consent

Answer 2

1. I am a trainee
2. I am supervised by faculty
3. We are being videotaped; this is about me, and evaluating my skills, helping me to be a better counsellor
4. In counselling, people often bring in some kind of concern, or difficulty. I will work with you to try and develop and meet goals to explore and come to a greater understanding of your concern. You have the right to know and understand any particular approach used. You have the right to refuse any particular treatment, and you have the right to end counselling at any time.
5. There are risks and benefits to counselling. The benefit is the possibility of increased sense of well being, confidence, and relief from symptoms and patterns. The risk is that this process can involve bringing up difficult feelings.
6. Confidentiality: everything we talk about is kept strictly confidential with five exceptions:
   1) My supervisors and 5 colleagues will dicuss your case to help serve you better.
   2) If you reveal that you will harm yourself or another person
   3) If I learn of potential abuse of a child or vulnerable adult, I must report it to the authorities.
   4) If I am subpoenad by the court.