MFT Crisis Intervention 4 — Questions and Answers
Question 1: Which client statement is the STRONGEST indicator of imminent suicide risk?
- 'I've been feeling really down for several months now.'
- 'I sometimes wonder what it would be like if I weren't here.'
- 'I have pills saved up and plan to take them tonight.' (Correct answer)
- 'I've thought about suicide but I would never actually do it.'
Correct answer: 'I have pills saved up and plan to take them tonight.'
A specific plan with a set time frame indicates imminent risk because the client has moved from ideation to preparation and intent.
Question 2: A family presents to crisis services after an unexpected death by suicide of a family member. The therapist's role during this initial session is BEST described as:
- Conducting a formal grief assessment using a validated instrument
- Providing psychoeducation about suicide contagion, safety, and support resources (Correct answer)
- Exploring unresolved family-of-origin conflicts that may have contributed
- Determining whether surviving members were complicit in the death
Correct answer: Providing psychoeducation about suicide contagion, safety, and support resources
Postvention with suicide loss survivors focuses on psychoeducation, safety planning for contagion risk, and connecting the family to ongoing support.
Question 3: A therapist working in a school setting learns a student disclosed to a peer that they want to die. The peer comes to the counselor. The therapist should FIRST:
- Reassure the peer that the statement was probably not serious
- Immediately meet with the student who made the disclosure and assess risk (Correct answer)
- Notify the student's parents without speaking to the student first
- Document the incident and wait to see if further reports emerge
Correct answer: Immediately meet with the student who made the disclosure and assess risk
Direct assessment of the at-risk student is the immediate ethical and clinical obligation before any other action.
Question 4: Which intervention is MOST consistent with a trauma-informed approach to crisis care?
- Confronting the client's denial to break through resistance quickly
- Emphasizing safety, trustworthiness, choice, collaboration, and empowerment (Correct answer)
- Using paradoxical directives to challenge maladaptive crisis cognitions
- Prioritizing symptom reduction through rapid exposure to traumatic material
Correct answer: Emphasizing safety, trustworthiness, choice, collaboration, and empowerment
SAMHSA's six trauma-informed principles—safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity—guide trauma-informed crisis care.
Question 5: A therapist who routinely responds to traumatic crises and begins experiencing symptoms mirroring those of their clients is MOST likely experiencing:
- Burnout from high administrative workload
- Secondary traumatic stress (vicarious traumatization) (Correct answer)
- Compassion satisfaction
- Countertransference rooted in unresolved attachment issues
Correct answer: Secondary traumatic stress (vicarious traumatization)
Secondary traumatic stress (vicarious traumatization) involves absorbing the traumatic material of clients, producing PTSD-like symptoms in the helper.
Question 6: When a therapist hospitalizes a client involuntarily, which legal standard MUST typically be met?
- The client has a diagnosable DSM disorder and has missed appointments
- The client poses an imminent danger to self or others and lacks capacity for voluntary care (Correct answer)
- A family member has requested hospitalization and signed a consent form
- The client has a history of prior hospitalizations within the past year
Correct answer: The client poses an imminent danger to self or others and lacks capacity for voluntary care
Involuntary hospitalization (civil commitment) requires evidence of imminent danger and typically that the client cannot adequately care for themselves or refuses voluntary treatment.
Question 7: A couple presents in crisis following the revelation of an affair. Which approach is MOST appropriate in the initial session?
- Focus immediately on the betraying partner's childhood attachment wounds
- Stabilize safety and emotional regulation before exploring the affair's causes (Correct answer)
- Encourage the betrayed partner to express maximum anger to achieve catharsis
- Assign homework to rebuild trust before addressing the immediate emotional pain
Correct answer: Stabilize safety and emotional regulation before exploring the affair's causes
Crisis stabilization and affect regulation must precede exploratory work; jumping to causes escalates dysregulation in the acute phase.
MFT Crisis Intervention 4
Which client statement is the STRONGEST indicator of imminent suicide risk?