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

When faced with a client who shows signs of depression and hopelessness, what should the therapist prioritize?

1. Explore job history and ambient support

2. Assess the risk of self-harm or suicidality

3. Teach coping mechanisms for employment stress

4. Encourage social integration techniques

The correct answer is: Assess the risk of self-harm or suicidality

Prioritizing the assessment of the risk of self-harm or suicidality is crucial when working with a client exhibiting signs of depression and hopelessness. This is because individuals who experience these emotions may be at a heightened risk of harming themselves or contemplating suicide. In a therapeutic context, it's essential to create a safe environment where the therapist can gauge the severity of the client’s symptoms, understand the thoughts and feelings that may be leading to these behaviors, and determine the level of immediate risk. Being vigilant about potential self-harm allows the therapist to intervene appropriately and ensure the client's safety. This assessment may involve asking direct questions about suicidal ideation, intent, and any previous attempts at self-harm. Moreover, it facilitates the development of a safety plan and can guide the therapeutic direction, whether it involves further treatment, hospitalization, or crisis intervention, which is vital when mental health is at stake. In contrast, while exploring job history, teaching coping mechanisms, or encouraging social integration could be beneficial aspects of overall mental health treatment, they do not take precedence over immediate safety concerns. If a client's life is at risk, addressing those concerns must come first before delving into other areas of their life.