Part 1 case scenario.
I have a 22-year-old African American refereed by a friend of the father. The client experienced a significant loss of the mother at the age of eighteen years. He was doing his final exam and ready to join college when his mother passed away from a hit and run. The client says his brother, and he came home from school, and the father was at the door telling them the sad news. He pushed away his grief and sat his exams and joined the medical school a year later. Six months into medical school, he started feeling frustrated and missing his mother’s presence. He was angry at the driver who hit his mother and left her for dead. He says he has trouble sleeping and will sometimes wonder and end up waking in a bar in the morning. He dropped out of school and has moved back with his father. The client has found himself in the wee hours of the night at the place of her mother’s accident and has found himself wishing he would join her. Clients’ depressive symptoms, including social withdrawal and decreased appetite, continue to develop. He has recently survived a terrible car crash where he was driving under the influence and explaining it. He stated, “even if I died, my family would not miss me because of the troubles I have taken them through.” His brother is done with college, has a good job, and in a good stable relationship that makes him feel like a failure. He is ashamed of what he has become, and he thinks his father is ashamed of him too. The client admits that he has tried to stop drinking and push away the dark thoughts, but it is difficult. He reveals that he thinks his family is better off without him and his struggles.
Part two
Some specific behaviors lead to the creation of risk assessment. One of the warning behaviors is suicidal thoughts and actions. A history of suicide attempts is the most significant sign that there is a need for risk assessment. Acts of recklessness and feeling worthless are also a cause for need assessment. Such behaviors like reckless driving and driving under the influence is a behavior that an individual may cause harm to themselves and those around them. Substance abuse and depressive behaviors like staying in isolation all the time. Violence towards other people as a defense mechanism in an individual is also a reason that could lead to the creation of risk assessment. Relation difficulties, even with the people closest to an individual, should be a reason for risk assessment. Such behaviors create psychological problems that make an individual worthless and like they are not wanted, which puts them at risk to harm or take away their own lives.
Part three
As a counselor during risk assessment, I will aim to establish any variable, treatable risks, high-risk suicide factors which advice of the client’s safety, and treatment needs. Through and sound analysis of risks and management is the basis of clinical decisions. Achievement of beneficial outcome and reducing the risk requires a careful judgment of the compromise between different clinical factors. To ensure correct risks assessment I would ask direct questions to establish the background and actual mental state of the client. Some of the questions I would ask would be related to the client’s mood. For instance, if they have had suicidal thoughts before or during the session. If yes, I would ask how often they have suicidal thoughts under what circumstance do they have these negative thoughts to establish the triggers. I would ask if they tried to harm themselves and why they think their lives are not worth living. Other questions would include what they think they could do to make things better and who they think could help them improve to get better. Establishing their medical history like any other psychological disorder can help since patients suffering from multiple disorders are at a higher rate of harming themselves.
Basing on the client’s answers, I would then start establishing a plan to help them get better. Where a risk is identified, the counselor should address the immediate risks, manage the risk, and prevent future risk by considering context opportunity means and motivation. First, I would help the client identify the risks, and I would document them. Secondly, we would develop a management plan based on the risks identified. Informing those around a person who is at risk of harming themselves is crucial. Therefore, if necessary, I would involve family or caregivers to help in this process. I would then move to the implementation stage, where the client puts into practice the management plans. We would then evaluate every plan assessing the success and failures, if any, and trying to improve on the plan. Depending on the client’s needs, I could consult with the family together with the client to help evaluate and review the set management plans. All through this process, I would be documenting the details of the sessions for reference and tracking of the client’s progress. Also, documentation may help a client in case they move services. Documentation is also a clinical requirement when assessing risk.
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