Licensed Clinical Social Worker (LCSW) Therapist Development Center Practice Exam

A client reveals plans to end their life within 48 hours. What is the social worker's most critical responsibility?

1. Honor the client's decision for self-determination

2. Conduct a mental status exam immediately

3. Discuss options for voluntary hospitalization

4. Respect the client’s confidentiality

The correct answer is: Discuss options for voluntary hospitalization

In situations where a client expresses intentions to end their life within a short timeframe, the social worker's most critical responsibility is to ensure the safety and well-being of the client. This is paramount, as the risk of suicide is significantly heightened when a plan is verbalized, especially with a specific timeline. Therefore, discussing options for voluntary hospitalization becomes essential as it allows the client to receive immediate psychiatric evaluation and care in a safe environment. Voluntary hospitalization can help the client stabilize and begin to address the underlying issues contributing to their suicidal thoughts. While honoring self-determination is important in therapeutic practice, the imperative to act in the best interest of the client's safety supersedes that principle when a clear risk to life is presented. Conducting a mental status exam is indeed important for assessing a client's mental health condition, but it may not immediately address the urgent safety concerns that arise in this scenario. Similarly, while respecting confidentiality is a key ethical principle, the safety of the client must come first, as breaching confidentiality may be necessary to prevent harm. Choosing to discuss hospitalization directly addresses the risk and offers a proactive solution, recognizing the immediate need for intervention and support.