LPC Crisis Intervention Strategies 2 — Questions and Answers
Question 1: The primary goal of psychological first aid (PFA) during a crisis is to:
- Conduct a comprehensive mental health assessment
- Promote safety, calm, connectedness, self-efficacy, and hope (Correct answer)
- Prescribe medications to reduce acute distress
- Process the trauma narrative in depth immediately after the event
Correct answer: Promote safety, calm, connectedness, self-efficacy, and hope
PFA focuses on five core elements: safety, calming, connectedness, self-efficacy, and hope to support immediate recovery in the aftermath of a disaster or crisis.
Psychological First Aid (PFA), developed by the National Child Traumatic Stress Network and the National Center for PTSD, is an evidence-informed approach designed to help survivors of disaster, terrorism, and other traumatic events. Its core actions include making contact, providing safety and comfort, stabilizing overwhelmed survivors, gathering information about needs, offering practical assistance, connecting people with social supports, and providing information on coping.
Question 2: The ABC-X Model of family crisis, developed by Hill, identifies which of the following as the 'X' factor?
- The stressor event itself
- The resources available to the family
- The family's perception of the event
- The resulting crisis (Correct answer)
Correct answer: The resulting crisis
In Hill's ABC-X Model, X represents the actual crisis or degree of family disruption resulting from the interaction of the stressor (A), resources (B), and perception (C).
Hill's ABC-X Model posits that A (stressor event) interacts with B (family's resources) and C (the family's perception of the event) to produce X (the crisis). The model highlights that a stressor does not automatically cause a crisis — the family's available resources and how they interpret the event are equally important determinants of crisis severity.
Question 3: When conducting a lethality assessment, the acronym IS PATH WARM was developed by the American Association of Suicidology to represent:
- Stages of grief following a suicide loss
- Warning signs of suicide risk (Correct answer)
- Steps for crisis de-escalation
- Categories of suicidal behavior
Correct answer: Warning signs of suicide risk
IS PATH WARM stands for Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, and Mood changes — all warning signs of suicide.
IS PATH WARM is a mnemonic developed by the American Association of Suicidology to help people recognize suicide warning signs: Ideation (threatening to hurt/kill), Substance abuse (increased use), Purposelessness (no reason for living), Anxiety (agitation/sleep disturbance), Trapped (feeling no way out), Hopelessness, Withdrawal (from friends/family/society), Anger (uncontrolled rage), Recklessness (risky acts), and Mood changes (dramatic shifts).
Question 4: Debriefing models like Critical Incident Stress Debriefing (CISD) are primarily designed for use with:
- Individual trauma survivors in outpatient settings
- Emergency responders and groups exposed to occupational trauma (Correct answer)
- Children following natural disasters
- Survivors of domestic violence
Correct answer: Emergency responders and groups exposed to occupational trauma
CISD was originally developed by Mitchell for use with emergency service personnel (firefighters, police, paramedics) following critical incident exposure.
Critical Incident Stress Debriefing (CISD) is a structured group intervention developed for emergency responders who have experienced traumatic incidents on the job. It is intended to mitigate the impact of traumatic stress and prevent the development of PTSD. The model has been adapted for other populations, but its evidence base and original application are primarily with occupational groups.
Question 5: A client in crisis states, 'I have a plan, I have a gun at home, and I intend to use it tonight.' The counselor's immediate intervention should include:
- Scheduling a follow-up appointment for tomorrow
- Exploring the client's childhood experiences related to the plan
- Activating an emergency safety plan and initiating a 911 call or psychiatric hold (Correct answer)
- Providing cognitive restructuring techniques to challenge the plan
Correct answer: Activating an emergency safety plan and initiating a 911 call or psychiatric hold
When a client discloses a specific, imminent suicide plan with means and intent, the counselor must take immediate action to ensure safety, including activating emergency services.
A client who reveals a specific plan (gun), access to means (gun at home), and stated intent (use it tonight) represents an imminent suicide risk. The counselor is ethically and legally obligated to act — this means activating emergency services (911), initiating an involuntary psychiatric hold if appropriate, or accompanying the client to an emergency room. Exploring history or providing cognitive techniques is not appropriate when life is in immediate danger.
Question 6: The Collaborative Assessment and Management of Suicidality (CAMS) model was developed primarily to:
- Provide a quick screener for suicidality in primary care
- Engage the client as a collaborative partner in assessing and managing their own suicidal risk (Correct answer)
- Train emergency room physicians in triage
- Standardize DSM-5 suicide specifier documentation
Correct answer: Engage the client as a collaborative partner in assessing and managing their own suicidal risk
CAMS positions the client as an active collaborator in assessing and managing their suicidal risk, emphasizing shared decision-making and the therapeutic alliance.
Developed by David Jobes, CAMS is a therapeutic framework and assessment approach used with suicidal clients. Rather than viewing suicidality as something done to a client (e.g., forced hospitalization), CAMS invites the client to sit side-by-side with the clinician, jointly completing the Suicide Status Form (SSF) to understand suicidal drivers and develop a collaborative treatment plan. Research supports CAMS for reducing suicidal ideation and distress.
LPC Crisis Intervention Strategies 2
The primary goal of psychological first aid (PFA) during a crisis is to: