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1. Substance abuse programs should have a risk management plan that addresses the needs of clients who are suicidal. This plan should include:
A. All clients in substance abuse treatment should be screened for suicidality.
B. The facility should meet all public health and safety codes.
C. Personal safety for clients and staff should be addressed in policies and procedures.
D. All of the above.
2. Crisis services, either as a component in the treatment program or through arrangement with other agencies, should be available:
A. 24 hours a day
B. From 8AM until 8PM
C. From 6AM until 6PM
D. From 5AM until midnight
3. Screening for suicidality is not the job of a substance abuse counselor.
A. True
B. False
4. Once someone enters treatment, they are significantly less likely to have suicidal thoughts or behavior.
A. True
B. False
5. If the counselor does not ask about suicidal thoughts or behaviors, the program and the counselor will not be legally at risk if the patient attempts suicide or dies from suicide.
A. True
B. False
6. At a minimum, all programs providing substance abuse treatment to clients should be:
A. Level 1
B. Level 2
C. Level 3
D. Level 4
7. All of the following attributes may be found in Level 2 programs, except for:
A. The program has at least one staff member with an advanced mental health degree who is specifically skilled in providing suicide prevention and intervention services and in providing clinical supervision to other program staff working with clients with suicidal thoughts and behaviors.
B. Clinical staff can perform comprehensive suicide assessments in-house that determine level of risk, treatment needs, and necessity for legal constraint on the client.
C. The program has the capability to continue substance abuse treatment services for clients with suicidal thoughts and behaviors while monitoring those clients for suicidal symptoms and an exacerbation of psychiatric symptoms of depression, anxiety, or other co-occurring disorders.
D. The program has formalized ongoing relationships with mental health professionals trained in suicide intervention to address emergency needs.
8. Programs that offer substance abuse treatment and have the capacity to provide services to acutely suicidal clients, and are administratively linking to hospitals and inpatient psychiatric services, are:
A. Level 1
B. Level 2
C. Level 3
D. Level 4
9. If implementing a Level 1 or Level 2 program, and screening for suicide is part of the program’s routine protocol, all of the following should be reviewed, except for:
A. Are there specific questions to explore with clients with suicidal thoughts and behaviors?
B. Is there an individual or work group assigned to monitor and evaluate policies and procedures?
C. Has training been completed for all staff?
D. Is training specific to each staff member’s role?
10. Which of the following are typically the “go-to” staff when a counselor suspects that a client is suicidal?
A. Administrators
B. Clinical supervisor
C. Frontline staff
D. Support staff
11. Standard of care is defined as:
A. The degree of care which a reasonably prudent person or professional should exercise in the same or similar circumstances.
B. The duty to exercise that degree of skill and care ordinarily employed in similar circumstances by the average clinical practitioners.
C. The duty to make reasonable and appropriate decisions using sound clinical judgment.
D. All of the above.
12. All of the following are failures in assessment, except for:
A. Failure to consider the impact of an intense substance abuse treatment environment on a client’s suicidality.
B. Failure to gather information.
C. Failure to recognize warning signs or risk factors as they emerge in treatment.
D. Failure to obtain records from other sources that would have indicated a significant risk of suicidality.
13. It is essential to properly document:
A. Warning signs, risk factors, and protective factors and steps taken to address these signs.
B. Consultation or supervision that was obtained.
C. Referrals that were considered and/or made and the client’s response to the referral.
D. All of the above.
14. Programs may be held responsible for meeting standards of care and may also be responsible for the actions of counselors employed by the program when those counselors or other professional staff do not adhere to professional standard of practice, commit a violation of law, or when the program does not provide adequate support to counselors or other professional staff.
A. True
B. False
15. Most substance abuse counselors have the skills to conduct an assessment for suicide risk.
A. True
B. False
16. It is important that substance abuse counselors, with oversight from their administrators, practice within the scope of their professional competencies and skills, as transcending the limits of acceptable practice creates malpractice liability for counselors and for their agency.
A. True
B. False
17. Generally, there is no duty to warn family members if a client is suicidal, unless that behavior threatens to harm another person.
A. True
B. False
18. A single full-day training session is preferable to shorter training sessions extending over several weeks for developing skills in working with clients who are suicidal in substance abuse treatment.
A. True
B. False
19. Most clients experiencing suicidal thoughts and behaviors are in an acute crisis and warrant crisis management.
A. True
B. False
20. Which of the following is a kind of crisis that can occur in a program?
A. Active suicidality on the part of a client.
B. Aggressiveness, violence, threats of violence towards others.
C. Special protective issues for children and adolescents at risk for endangerment or abuse.
D. All of the above.
21. Program policies should specifically state that it is not the counselor’s role to make a final determination of whether the client is at acute or imminent risk for suicide.
A. True
B. False
22. Having both the client and counselor sign the Commitment to Treatment Statement helps promote engagement in treatment.
A. True
B. False
23. The goal of agency policy for managing clients who are acutely suicidal is to:
A. Give enough direction to clinicians and clinical supervisors to guide them in crisis situations.
B. Anticipate every kind of crisis situation related to suicidal thoughts and behaviors.
C. Both (A) and (B).
D. None of the above.
24. Every serious adverse event should result in a debriefing and postvention that considers:
A. How the event unfolded.
B. How the specific action steps facilitated or hindered resolution of the crisis.
C. How policy worked or didn’t work to address the crisis.
D. All of the above.
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