Duty to Protect, Suicide Risk, and Violence Risk Management
This domain tests risk assessment, intervention, and documentation when a client may harm themselves or another person. Nevada questions often probe whether you know when confidentiality may yield to safety.
Core rules
- Conduct a structured risk assessment using validated tools, collateral information when appropriate, and clinical judgment. Distinguish ideation, intent, plan, means, and protective factors.
- For suicide risk, use the least restrictive effective intervention: safety planning, means restriction, increased contact, consultation, emergency evaluation, or hospitalization when risk is imminent.
- For violence risk, identify the intended victim, the client’s access to weapons, history of violence, and immediacy. Nevada’s confidentiality framework permits disclosure when necessary to prevent serious harm; warning the victim, notifying law enforcement, or arranging emergency evaluation may be appropriate. Do not rely on a single formula.
- Document the assessment, rationale, consultations, actions taken, and follow-up. If you disclose, disclose only what is necessary.
Worked example
A client states, “When my brother gets out next week, I’m going to shoot him.” The psychologist assesses intent, plan, means, and history; finds a specific victim and access to a firearm; arranges emergency evaluation, notifies law enforcement, and warns the brother. The file records the risk factors and each action.
Traps
Assuming a duty to warn always requires warning the victim; promising secrecy after a threat; relying on no-suicide contracts; failing to document consultation; disclosing more than necessary.