Crisis Intervention and Risk Management
What to know
Crisis work prioritizes safety, stabilization, and connection to care. Know suicide risk assessment: ideation, intent, plan, means, prior attempts, protective factors, and access to lethal means. Understand risk and protective factors, the difference between risk assessment and prediction, and the value of structured tools as adjuncts, not substitutes for clinical judgment. Know violence risk assessment, de-escalation, safety planning (e.g., Stanley-Brown), lethal-means counseling, and when to escalate to emergency services or hospitalization. Understand crisis response phases, trauma-informed approaches, and follow-up contact after a crisis. Recognize that asking about suicide does not increase risk.
Traps in questions
- Relying on a single score or a "no" answer to rule out risk.
- Missing means restriction as the most concrete safety intervention.
- Failing to document the assessment, rationale, and safety plan.
- Escalating to hospitalization reflexively without considering least-restrictive options and collaboration.
- Ignoring protective factors and cultural context.
Rule of thumb
Assess, plan, restrict means, document, and follow up. When risk is imminent, act to ensure safety; when it is elevated but not imminent, build a collaborative safety plan and increase contact.
Worked example: A client reports passive ideation, no plan, strong social support, and no firearm access. Response: complete a structured assessment, co-create a safety plan, counsel on means safety, schedule a follow-up within days, and document the reasoning.