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Why are we concerned for this person's safety?

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Why are we concerned for this person's safety?

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What do you think your automatic response would have been like to this client?

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What do you think your automatic response would have been like to this client?

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Summarize how the situation was handled.

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Summarize how the situation was handled.

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Would you have done anything differently? 

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Would you have done anything differently? 

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Why are we concerned for this person's safety?

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Why are we concerned for this person's safety?

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We are concerned for this person's safety because she is at home alone having suicidal thoughts with a plan of how she would do it.

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We are concerned for Claytons safety because they have suicidal thoughts and a history of suicidal ideations. 

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We are concerned for Claytons safety because they have suicidal thoughts and a history of suicidal ideations. 

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Clayton has chronic pain from liver and hopelessness.

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-She's alone
-Has the means, method, and plan: She was drinking and has a history of trauma (sexual abuse) from her childhood that has been causing her to have disruptive thoughts. Also, there are pills in the house that she was curious about using as a means.

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Made the comment of not wanting to be alive anymore. Rob is super stressed out. He is coming to the end of his treatment.
our concern is that he could potentially complete suicide. due to his previous statements.

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Our automatic response would have been to go to our supervisor for assistance or  complete an SI assessment with Clayton. 

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Our automatic response would have been to go to our supervisor for assistance or  complete an SI assessment with Clayton. 

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Our automatic response would be to listen, do grounding techniques and set the shame inside. The automatic response would also depend on if this was your client or not because if it is your client you know what will work in the situation.

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-Empathize and validate
-Concerned about safety-would want to get her somewhere she would be safe, would've called 911 before calling a family member

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The counselor talked with Clayton calmly to obtain more information. Once the counselor was aware that Clayton had a gun and SI they brought in their supervisor to assure that the right action was taking place. The counselor talked with Clayton about taking the gun out of the house. Clayton, the counselor, and supervisor called Claytons daughter to arrange for the gun to be removed. The counselor also asked that Clayton sister calls them when the gun is removed from the home. 

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The counselor talked with Clayton calmly to obtain more information. Once the counselor was aware that Clayton had a gun and SI they brought in their supervisor to assure that the right action was taking place. The counselor talked with Clayton about taking the gun out of the house. Clayton, the counselor, and supervisor called Claytons daughter to arrange for the gun to be removed. The counselor also asked that Clayton sister calls them when the gun is removed from the home. 

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Our automatic response would be to talk about the statement that he made and question why Rob was thinking that way, but asking certain open ended questions to make sure that he didn't feel like he was being grilled.

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She has a chronic Hx of SMI , Multiple suicide attempts, extensive use of sub abuse, continual relapse, bipolar do, not a strong support system, struggling to adhere to medication recommendations.

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The client called the counselor after having had some drinks and having racing suicidal thoughts. The counselor went through the safety plan they had worked out together, which included calling him and talking through the hope box. Next, the counselor wanted to ensure her physical safety so he talked through a plan to contact the closest family member being her mother, and if she wasn't contacted then 911 would be called.

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In the group setting they all jumped on him and felt that he was ganged up on. The counselor just went over what had happened and questioned Rob. She could've shown more compassion and empathy. She was more of grilling him and more direct, but in this situation it does not seem to have work as well with this particular client.

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She needs more help with medication management, support system that can help her with getting her needs met, supervised and structured support with medical, cognitive, spiritual, etc.. treatment for her whole self.

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Rena was suicidal so she called her therapist, she had started drinking and was alone. She had a plan for how she would kill herself and this pain was stemming from the shame she felt as she was abused by her uncle from the age of 8 to her teenage years and this trauma is not totally resolved yet. Her therapist had a tool called the hope box that they created awhile back. Her therapist asked her to pull out her hope box which had a picture of her family and this calmed her down a bit. After she was calmed the therapist talked with her about contacting her mother to get her to safety. Rena didn't want to upset her mother that she was feeling suicidal and drinking but she agreed for the therapist to call and have her mother bring her to the ER.

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I would possibly do a SI assessment on Clayton if that was an option. 

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I would possibly do a SI assessment on Clayton if that was an option. 

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ER, DR to keep inpatient treatment, counselor and clinical supervisor got involved and set up a tx plan with her that would be sustainable for her long term mental health, sub abuse- residential care program is the conclusion, involved the brother Walter, educated family on her needs, gave the family case management svcs. Angela then went to res. care. Follow up- she stayed sober longer than she ever has, went to 1/2 house, attends counseling, one episode, but it was managed w med change. She now is working her program, and feeling supported with her family and her res tx setting.

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Would've contacted 911 first, before contacting family member if at all.

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Why are we concerned for this person's safety?

Being suicidal involves the person's suicidal ideation, plan, means, and timeframe, as well as an evaluation of protective and risk factors for suicidal completion. Rob has indicated suicidal ideation by saying he feels like he would be "better off dead", and he has supported these statements by alluding to risk factors like family difficulties and depression or addiction struggles.

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What do you think your automatic response would have been like to this client?

All of us agreed that we would be uncomfortable and cautious about the fact that Rob shared these feelings with the group. We want to make sure that both he and the group are safe. This is an outpatient therapy where Rob or other group members could hurt themselves afterwards. Rob has alluded to difficulties with group relationships, and we do not know who could be triggered by conversations about dying. We felt that it would be important to talk to Rob privately before addressing the group, but wanted to make sure that we could postpone group intervention safely.

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Summarize how the situation was handled.

The therapist acknowledged Rob's comments in the group and followed up with Rob in a private session. The therapist went back to the group with Rob after their private session, and the group was able to process Rob's statement and their own feelings. The therapist updated Rob's treatment plan with the incident.

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We would have been more emphatic and asked opened questions and not been as direct as the counselor was to Rob. We would also ask more of a guiding questions then just asking him why he was talking about completing suicide.

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Getting her family involved sooner, and educating them with the resources they needed to help support Angela.

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Would you have done anything differently?

Again, we felt like it would be appropriate to talk to Rob privately before talking with the group, and were particularly concerned about Rob's comfort and group safety.

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Would we have done anything differently?

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Would we have done anything differently?

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Maybe not mention calling the police and maybe contact the husband if he is listed as contact she agrees to