Wk 6 Discussion – Assessing Risk During Intake
When meeting with a client for the first time, a counselor typically asks some standard questions to gather information about the presenting issues and complete the biopsychosocial assessment. When engaging in crisis response, sometimes an intake moves so quickly or is so chaotic that the counselor may not gather as much information as they would have liked. Respond to the following questions after watching “Suicide Risk Intake Assessment.”
Respond to the following in a minimum of 175 words:
• What are some additional questions that the counselor could ask this client?
• What cultural factors might influence the professional counseling relationship between counselor and client in this scenario?
• After the client’s phone call intervention, what should be the next steps? How should the counselor follow up with this client?
Respond to the following classmates in a minimum of 175 words:
SW classmate response
The counselor could ask the client many questions. One issue I noticed was the client’s fear of talking to strangers, counselors, and men. This counselor is all three. I think he should ask if she is feeling ok with him doing the intake at all. He could inform her that going forward, she can have a female counselor if that would be helpful. He could tell the client that if he takes the intake today, she can schedule with a female counselor as soon as possible and he will pass along the intake information. He should ask her how she feels about this. Then, the male counselor should wait for the client’s response. Other questions the counselor could ask are about her social history, education history, and any past trauma.
The counselor needs to be aware of cultural factors that could influence the professional counseling relationship. He is a black male in his early 30’s (?) and the client is a white female in her late 20’s (?). Perhaps their similar age or difference in race could be an issue. The counselor will need to be cognizant of this and look for indications they are not connecting. In addition, the client has made it known she is apprehensive talking to a man, and that she is “not so sure if (he will) be able to understand where I’m coming from.” Therefore, the male counselor will need to get a female colleague to take his place or build rapport quickly and ask the client if she is comfortable with him. Offering to get another counselor will show cultural humility and validate the client’s feelings (Buse et al., 2013). This offer itself may build rapport, indicating to the client that he is sensitive to her feelings and recognizes they are important.
After the phone call intervention, the counselor should present a safety plan. Together, the counselor and client should explore strengths and reasons to stay alive and put them on the safety plan (Kanel, 2018). The counselor should follow up with the client by providing his work cell and presenting a list of resources she can use to call for support or help should she find herself escalating. The client should be scheduled for frequent counseling appointments, twice a week to start. During these appointments, the client and counselor can re-visit the safety plan, see what resources such as police or campus administration are involved, and support and validate the client with counseling interventions such as reframing and building coping skills.
Buse, N. A., Burker, E. J., & Bernacchio, C. (2013). Cultural variation in resilience as a response to traumatic experience. Journal of Rehabilitation, 79(2), 15-23. Multicultural competency, individualism vs collectivitsm, spirituality, cultural perceptions of resiliency.
Kanel, K. (2018). An Overview of Crisis Intervention. In (Ed.), A guide to crisis intervention (6th ed.). Cengage Learning. https://bibliu.com/app/#/view/books/9780357088531/epub/OEBPS/11_9781337566414_ch1.html
LK Classmate response
One of the aspects of the entire interview which I observed is that the overall line of questioning was very clinical, and had very few attending behaviors and bonding attempts. While the counselor did ask some very good questions to get definitive answers, very few of those answers explored how the client may be able to walk back from her suicidal ideation, but instead defined it. When the client was first asked what brought her into counseling, she specified that an event had happened last week which was making her feel overwhelmed. However, instead of asking about the event (which would have been an indication of interest and care in why she was there), the counselor asked the client to define what overwhelmed meant to her, which can be hard with no context. Asking about the event may have given an easier segue into her definition of overwhelmed, and given the counselor context about why the client feels uneasy about speaking to strangers and men in particular. In addition, when the client mentioned being uncomfortable talking to strangers, especially men, there was another opportunity to ask if there was any way the counselor could make her more comfortable, or if her level of comfortability was important enough to switch counselors. While the counselor did ask if she would be comfortable talking to someone else, again, it felt almost clinical and with no understanding of her fear of men or strangers, and no investigation, the counselor just kind of reported his own diversity in clientele and then moved forward. There was a definitive lack of bonding in the beginning of the interview which just made the entire process awkward, and almost robotic. “The primary purpose of using the basic attending skills is to gain a clear understanding of the internal experience of the crisis as the client sees it. The focus should be on the client’s feelings and thoughts about his or her situation” (Kanel, 2018, p. 68). I feel as though there was no understanding of the client’s thoughts or feelings until nearly halfway through the intake session. Overall, structurally, I simply feel like this session was stilted and very rushed, which can lead to disharmony in the therapeutic relationship.
Culturally, this is a black male counseling a white, sexually assaulted female. One of the things she states is that she does not think that he will be able to understand where she is coming from. Before declaring diversity, if he would have asked for clarification on that statement, he might have a more culturally informed response. Again, this would be easier had they talked about the incident which led her to counseling before this point, but asking for clarification allows her to talk about her feelings on men and strangers, and gives her the opportunity to talk about how she feels, which gives him the insight into how she is acting, and insight into her view on culture. Cultural humility creates cultural competence, and learning about a client’s culture requires them to be honest and open about what they have experienced (Kanel, 2018).
While the phone call is a good prevention measure, the next steps the client should take is to schedule another appointment so that he and the client can get better acquainted and perhaps explore the positive aspects of her live and the traumatic event. The validation statements which help with dignity and embarrassment (Kanel, 2018) should be focused on, and the client should know that her counselor is on her side. Lastly, ensuring that the client has a safety plan and emergency contacts in case she feels like truly following through with her suicidal ideation is critical.
References
Kanel, K. (2018). A guide to crisis intervention, (6th ed.). Cengage
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Wk 6 Discussion – Risk Assessment During Intake
When a counselor initially meets with a client, he or she will normally ask certain basic questions to gather information about the current concerns and complete the biopsychosocial assessment. When responding to a crisis, an intake may proceed so quickly or be so chaotic that the counselor does not acquire as much information as they would have desired. After watching “Suicide Risk Intake Assessment,” answer the following questions.
In a minimum of 175 words, respond to the following:
• What more questions could the counselor ask this client?
• In this case, what cultural elements might influence the professional counseling relationship between counselor and client?
• What should be the next steps following the client’s phone call intervention?
