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

When a client expresses beliefs of government surveillance and agitation, what should the therapist's initial response include?

1. Explore the client's reasoning behind their beliefs

2. Conduct a risk assessment for harm to self or others

3. Refer the client to a psychiatrist for evaluation

4. Establish rapport to assess underlying issues further

The correct answer is: Conduct a risk assessment for harm to self or others

In situations where a client expresses beliefs of government surveillance and agitation, it is essential for the therapist to initially conduct a risk assessment for harm to self or others. This response is crucial because it prioritizes the safety and well-being of the client and those around them. Beliefs about government surveillance can stem from paranoia or delusion, which may be indicative of underlying mental health conditions that put the client at risk of self-harm or harm to others. By assessing risk as the first step, the therapist can determine the level of concern and make informed decisions about the appropriate course of action. This includes evaluating the client's access to means of harm and their intent, which is vital in ensuring safety. Only after establishing that there is no immediate risk of harm can the therapist explore other avenues, such as discussing the content of the client’s beliefs or building rapport to better understand the issues at hand. Prioritizing safety helps create a foundation for effective treatment moving forward.