Suicide Assessment Cases MSW by Tiffany Tumminaro https://padlet.com/ttumminaro/lope4sa9vj7hlc5x en-us 2020-09-14 14:14:00 UTC 2020-09-15 00:24:11 UTC hello@padlet.com Why are we concerned for this person's safety? ttumminaro https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048445 2020-09-14 14:14:00 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048445 What do you think your automatic response would have been like to this client? ttumminaro https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048455 2020-09-14 14:14:00 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048455 Summarize how the situation was handled. ttumminaro https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048463 2020-09-14 14:14:00 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048463 Would you have done anything differently? ttumminaro https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048496 2020-09-14 14:14:00 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/744048496 Why are we concerned for this person's safety? bmaksimovic01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746096559 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. ]]> 2020-09-15 00:01:30 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746096559 We are concerned for Claytons safety because they have suicidal thoughts and a history of suicidal ideations. tamrakuester https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746099821 Clayton has chronic pain from liver and hopelessness. ]]> 2020-09-15 00:03:41 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746099821 zlewis01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746101700 -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. ]]> 2020-09-15 00:04:44 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746101700 livihandelman https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746102492 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. ]]> 2020-09-15 00:05:14 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746102492 Our automatic response to this client bmaksimovic01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746105609 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. ]]> 2020-09-15 00:07:17 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746105609 Our automatic response would have been to go to our supervisor for assistance or complete an SI assessment with Clayton. tamrakuester https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746106105 2020-09-15 00:07:34 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746106105 zlewis01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746107700 -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]]> 2020-09-15 00:08:36 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746107700 question 2 livihandelman https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746108810 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. ]]> 2020-09-15 00:09:13 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746108810 eklco01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746111043 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. ]]> 2020-09-15 00:10:30 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746111043 zlewis01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746113351 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. ]]> 2020-09-15 00:11:51 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746113351 Rob 1 melrosemyself https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746113993 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.
]]> 2020-09-15 00:12:11 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746113993 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. tamrakuester https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746115001 2020-09-15 00:12:48 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746115001 eklco01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746115143 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.]]> 2020-09-15 00:12:53 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746115143 Question 3 livihandelman https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746115376 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. ]]> 2020-09-15 00:13:00 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746115376 Summary of the Situation bmaksimovic01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746116201 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.]]> 2020-09-15 00:13:32 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746116201 I would possibly do a SI assessment on Clayton if that was an option. tamrakuester https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746117858 2020-09-15 00:14:24 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746117858 eklco01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746119044 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.]]> 2020-09-15 00:15:05 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746119044 zlewis01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746119668 Would've contacted 911 first, before contacting family member if at all. ]]> 2020-09-15 00:15:24 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746119668 melrosemyself https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746120945 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. ]]> 2020-09-15 00:16:04 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746120945 melrosemyself https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746125664 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.
]]> 2020-09-15 00:18:24 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746125664 question 4 livihandelman https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746126901 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. ]]> 2020-09-15 00:19:03 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746126901 eklco01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746128088 Getting her family involved sooner, and educating them with the resources they needed to help support Angela. ]]> 2020-09-15 00:19:38 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746128088 melrosemyself https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746128255 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. 

]]> 2020-09-15 00:19:43 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746128255 Would we have done anything differently? bmaksimovic01 https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746131993 Maybe not mention calling the police and maybe contact the husband if he is listed as contact she agrees to]]> 2020-09-15 00:20:29 UTC https://padlet.com/ttumminaro/lope4sa9vj7hlc5x/wish/746131993