Crisis Intervention - Chapter 4

A good strategy for a middle risk client regarding suicide is: Support comments No suicide contract Family suicide watch All of the above

All of the above

Clients who are a danger to others may: Be delusional Have impulse control problems Feel controlled by outside forces All of the above

All of the above

Norman Farberow

An American pioneer in the field of suicidology. Created the first suicide prevention center and hotline in Los Angeles.

The Mental Health Exam (Categories)

Appearance Attitude Behavior Speech Mood and Affect Thought Process/Content Perception Cognition Insight Judgement

Delusions

Beliefs and thoughts often observed in individuals who are suffering from psychotic episodes due to schizophrenia, dementia, a manic episode, or substance intoxication. These beliefs have no basis in reality.

High-Risk Suicidal

Clients who have a plan, the means, and the intent to complete suicide; they cannot be talked out of harming themselves.

Middle-Risk Suicidal

Clients who have been thinking about suicide and feel depressed. These clients probably still have some hope, but they might also have a suicide plan. A no-suicide contract works as well for such persons as does a suicide watch.

Low-Risk Suicidal

Clients who have pondered but never attempted suicide. These clients have adequate support systems and can usually be treated as outpatients.

Homicidal Ideation

Common psychiatric term for thoughts about homicide which range from vague ideas of revenge to detailed and fully formulated plans without the act itself.

Involuntary Hospitalization

Detaining clients against their will in a psychiatric facility for evaluation and observation when they have been deemed a danger to themselves or others, or are gravely disabled because of a mental disorder.

T/F: Hospitilizing a high-risk client is avoided at all costs.

False

T/F: If you ask someone if they are thinking of suicide, you run the risk of encouraging them to complete the act.

False

T/F: Individuals who engage in self-mutilative behavior are always at high risk for completing suicide.

False

T/F: Individuals who have been contemplating suicide never tell anyone about their thoughts.

False

T/F: Suicidal people never leave hints that they are thinking of suicide.

False

T/F: Suicide is always an insane act.

False

T/F: Suicide is always compulsive.

False

Hallucinations

False sensory perceptions. Indicative of severe illness; when these are present, a doctor should be consulted.

The most common methods of self-mutilation behaviors include all of the following EXCEPT: Cutting Carving Hanging Biting oneself

Hanging

The top five methods of NSSI include:

- Cutting/carving one's skin - Picking at a wound - Hitting oneself - Scraping one's skin to draw blood - Biting oneself

Potential Violence Against Others (Risk Factors)

- Poor impulse control - Feeling of being controlled by outside forces - History of violence - Thoughts of committing harm - Belief that others wish to harm him/her - Being under the influence of drugs

Plan

A blueprint for action that clients have devised for killing themselves.

No-Suicide Contract

A formal written or verbal contract between the client and the crisis worker in which the client makes a commitment to speak to the counselor before harming themselves. Effective intervention for low- and middle-risk clients.

Suicide Assessment

A process in which the crisis worker asks a series of directive questions to ascertain the seriousness of a client's suicidal intent and ideation.

Psychotic Decompensation

A state in which the client is out of touch with reality and shows symptoms such as delusions and hallucinations.

Mental Status Exam

A structured way of observing and interviewing clients to assess for possible psychotic states.

Gravely Disabled

A term used to describe individuals who are unable to care for their own personal needs such as food, shelter, and clothing due to a mental disorder.

A client who says, "I am going to kill myself and there is nothing you can do to stop me" is probably:

High-Risk Suicidal

Nonsuicidal Self-Injury/Self-Mutilative Behavior

Intentionally causing tissue damage to oneself without desiring to kill oneself.

Which of the following is NOT a category of the Mental Status Exam? Appearance Perception Behavior None of the above

None of the above

Suicide Watch

Observation by family or friends of those who are at middle risk of hurting themselves. Someone stays by the client's side 24 hours a day to ensure that the person does no harm to himself or herself. Suicide watches are also conducted in psychiatric facilities for high-risk clients.

Means

The actual physical implement, pills, or action that a suicidal person uses to kill themselves.

Suicidal Ideation

The cognition component of suicide, the thinking involved.

T/F: A no-suicide contract is a good idea for a middle-risk client.

True

T/F: Family members may be included when conducting a suicide watch.

True

T/F: Farberow's work with suicide began with World War II veterans.

True

T/F: It is common for depressed individuals to think about death.

True

T/F: The World Health Organization estimated that about one million individuals complete a suicidal act each year in the world.

True

T/F: The suicidal client will feel relieved to openly discuss his or her feelings.

True

Typical warning signs of suicide include all of the following EXCEPT: Giving things away Putting things in order Vegetative depression Increased drug use

Vegetative depression

Emergency Psychiatry

When services are provided in an emergency setting such as a hospital to people with serious suicide attempts, life threatening substance abuse conditions, vegetative depression, psychosis, violence, or other rapid changes in behavior.