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

When a client expresses suicidal ideation but lacks a clear plan, what is the best initial response?

1. Break confidentiality and inform parents

2. Assess the client's immediate risk more comprehensively

3. Encourage finding healthier coping strategies

4. Report the situation to authorities immediately

The correct answer is: Assess the client's immediate risk more comprehensively

When a client expresses suicidal ideation, even without a clear plan, the priority is to assess the immediate risk more comprehensively. This involves engaging in a thorough evaluation of the client's feelings, thoughts, circumstances, and potential triggers that could contribute to their suicidal thoughts. Understanding the intensity of the ideation, the presence of any intent, and the factors contributing to their current mental state is crucial in determining the appropriate level of intervention. This response aligns with best practices in mental health care, where safety is paramount. A comprehensive risk assessment allows the therapist to gather necessary information to inform next steps, whether that involves developing a safety plan, connecting the client to supportive resources, or determining if further intervention, such as hospitalization, is warranted. Providing a well-rounded assessment also establishes a therapeutic alliance, showing clients that their feelings are taken seriously and fostering an environment where they feel safe to share more about their experiences. This approach is more effective and ethically sound than simply breaking confidentiality or reporting to authorities, which may not address the immediate need for understanding and support.