Chapter Risk Assessment and Intervention: Suicide and Homicide

Chapter 1. Overview of Crisis Intervention……………………................... ………1

Objectives………………..………………………………………………….1

Multiple Choice Questions………………………………………………….1

Extended Response Questions………………………………………………5
Chapter 2. Safety and Self-Care in Crisis Situations….…………………………... 6

Objectives………………..………………………………………………….6

Multiple Choice Questions………………………………………………….6

Extended Response Questions………………………………………………10

Objectives………………..………………………………………………….11

Multiple Choice Questions…………………………………………………..11

Extended Response Questions……………………………………………….14

Chapter 4. Essential Crisis Intervention Skills………………………………………16

Objectives………………..…………………………………………………..16

Multiple Choice Questions…………………………………………………..16

Extended Response Questions……………………………………………….24

Chapter 5. Risk Assessment and Intervention: Suicide and Homicide……………...26

Multiple Choice Questions………………………………………………......26

Extended Response Questions……………………………………………….30
Chapter 6. Understanding and Treating Substance Use Disorders with

Clients in Crisis…….………………………………………………………………...32

Objectives………………..…………………………………………………..32

Multiple Choice Questions…………………………………………………..32

Extended Response Questions……………………………………………….35
Chapter 7. Intimate Partner Violence…………………………...…………………....37

Objectives………………..…………………………………………………...37

Multiple Choice Questions…………………………………………………...37

Extended Response Questions………………………………………………..41

Objectives………………..…………………………………………………..42

Multiple Choice Questions…………………………………………………..42

Extended Response Questions……………………………………………….46

Objectives………………..…………………………………………………..47

Multiple Choice Questions………………………………………………….47 Extended Response Questions………………………………………………51
Chapter 10. Emergency Preparedness and Response in the Community

and Workplace………………………………………………………………………52

Objectives…………………………………………………………………...52

Multiple Choice Questions………………………………………………….52

Extended Response Questions………………………………………………56
Chapter 11. Emergency Preparedness and Response in Schools

and Universities..……………………………………………………………………57

Objectives………………..………………………………………………….57

Multiple Choice Questions………………………………………………….57

Extended Response Questions………………………………………………61
Chapter 12. Grief and Loss…………………….……………………………………62

Objectives………………..………………………………………………….62

Multiple Choice Questions………………………………………………….62

Extended Response Questions………………………………………………66

Objectives………………..………………………………………………… 67

Multiple Choice Questions………………………………………………….67

Extended Response Questions………………………………………………72

Objectives………………..………………………………………………….73

Multiple Choice Questions………………………………………………….73

Extended Response Questions………………………………………………75

ANSWER KEY……………………………………………………………………..76
Answer Key For Chapters 1 and 2…………………………………………………..76

Answer Key For Chapters 3………………………………………………………...77

Answer Key For Chapters 4………………………………………………………...78

Answer Key For Chapters 5………………………………………………………...79

Answer Key For Chapters 6 and 7…………………………………………………..80

Answer Key For Chapters 8………………………………………………………....81

Answer Key For Chapters 9 and 10………………………………………………....82

Answer Key For Chapters 11……………………………………………………......83

Answer Key For Chapters 12 and 13………………………………………………...84

Answer Key For Chapters 14…………………………………………………………85

• 
  identify and define a crisis situation.
  
• 
  understand the basic theoretical underpinnings of crisis intervention.
  
• 
  understand how crisis can play a role in family dynamics and affect individuals.
  
• 
  recognize specific elements of stress and how it contributes to crisis.
  
• 
  understand how different crises can be developmental in nature and have links to unique ecological determinants.
  
• 
  understand that most crisis situations consist of key concepts such as stress, trauma, coping, and adaptation.
  
• 
  understand how people can be resilient in crisis situations and how that resiliency plays a role in treatment.
  
• 
  understand the various roles of mental health workers.
  
• 
  discuss the realities of working in crisis situations.
  

1. 
   Crises are
   

1. 
   traumatic events.
   
2. 
   any events that cause trauma reactions.
   
3. 
   events that cause subjective distress.
   
4. 
   None of the above.
   

2. 
   According to authors such as James (2008) and Slaikeu (1994), a crisis
   

1. 
   is a perception or experience.
   
2. 
   is an event.
   
3. 
   is a situation.
   
4. 
   always leads to a negative outcome.
   

3. 
   __________ was an early influence in the field of crisis intervention.
   

1. 
   The Great Atlantic Hurricane of 1944
   
2. 
   The Cocoanut Grove Nightclub fire of 1942
   
3. 
   Hiroshima and Nagasaki being bombed with nuclear weapons in 1945
   
4. 
   Orson Wells’ broadcast of “The War of the Worlds” in 1938
   

4. 
   Early contributors to the field of crisis intervention include all of the following EXCEPT
   

1. 
   Gerald Caplan.
   
2. 
   Gerald Corey.
   
3. 
   Erich Lindemann.
   
4. 
   Reuben Hill.
   

5. 
   The study of crisis intervention began during World War II in response to
   

1. 
   soldiers returning from the war effort with PTSD diagnoses.
   
2. 
   family reactions when loved ones left home to participate in war efforts.
   
3. 
   family reactions when soldiers returned from service and resumed their civilian lives.
   
4. 
   families grieving for loved ones who died in combat.
   

6. 
   A cluster of symptoms including somatic distress, feelings of guilt, hostility, disorganization, and behavior changes experienced by the surviving family members of nearly 500 individuals who died in a tragic event in the 1940s was labeled “acute grief.” A disorder that is described in the DSM that seems to parallel acute grief is
   

1. 
   acute stress disorder.
   
2. 
   posttraumatic stress disorder.
   
3. 
   adjustment disorder.
   
4. 
   bereavement.
   

7. 
   According to Erich Lindemann, a psychiatrist and researcher who described acute grief, treatment for acute grief
   

1. 
   should be provided only by psychiatrists who may prescribe medication.
   
2. 
   may be provided by psychiatrists (MDs) or psychologists (PhDs) but not counselors or social workers.
   
3. 
   may be provided by paraprofessionals and helpers other than psychiatrists.
   
4. 
   is not necessary.
   

8. 
   According to Raphael (2000), the full impact of trauma frequently is felt
   

1. 
   within 48 hours of a crisis event, during the “fight or flight” period of adjustment.
   
2. 
   two to four weeks after a crisis event during the period of adjustment known as “picking up the pieces.”
   
3. 
   a considerable time after the crisis event during the “disillusionment” period of adjustment.
   
4. 
   after individuals or families have completed the “rebuilding” period of adjustment and can reflect on the events of the crisis in totality.
   

9. 
   According to Hill’s ABC-X model of crises,
   

1. 
   a crisis is caused by a stressor event.
   
2. 
   as long as there are resources to meet the demands of a stressor event, there will not be a crisis.
   
3. 
   “A” represents an antecedent event, “B” represents behavioral resources, “C” represents the crisis, and “X represents treatment or intervention.
   
4. 
   a crisis is the outcome of an interaction between a stressor event, resources, and cognitive processes involving perception and meaning.
   

10. 
    According to the Double ABC-X Model proposed by McCubbin and Patterson (1982), long-term change following a crisis event
    

1. 
   would most likely be negative.
   
2. 
   would most likely be positive.
   
3. 
   is not likely.
   
4. 
   may be positive or negative.
   

11. 
    Stressors that may lead to crises
    

1. 
   generally are unforeseen.
   
2. 
   may be normal, developmental phenomena.
   
3. 
   typically originate outside the individual or family.
   
4. 
   most often are traumatic.
   

12. 
    The effects of a stressor or crisis event may be mediated by
    

1. 
   tangible resources such as food, clothing, and shelter.
   
2. 
   intangible resources such as self-esteem and problem-solving ability.
   
3. 
   external resources such as social support or government aid.
   
4. 
   All of the above.
   

13. 
    Which of the following statements about coping is FALSE?
    

1. 
   Denial may be a useful short-term coping strategy.
   
2. 
   Coping often involves “fight or flight” responses.
   
3. 
   Using defense mechanisms should not be considered coping.
   
4. 
   Coping involves both cognitive and behavioral responses.
   

14. 
    According to Boss (2002), stress is mediated by internal and external contextual variables. Internal contextual variables include
    

1. 
   factors over which the individual or family has no control, such as heredity.
   
2. 
   normative, developmental factors.
   
3. 
   factors such as culture.
   
4. 
   factors or dimensions that may be controlled or changed.
   

15. 
    According to Selye (1956), there are two types of stress,
    

1. 
   affective and cognitive.
   
2. 
   biological and environmental.
   
3. 
   internal and external.
   
4. 
   distress and eustress.
   

16. 
    According to Boss (2002), __________ is a continuous variable, whereas __________ is a dichotomous variable.
    

1. 
   distress; eustress
   
2. 
   stress; crisis
   
3. 
   organization; disequilibrium
   
4. 
   coping; adaptation
   

17. 
    Which of the following statements with regard to trauma is TRUE?
    

1. 
   Traumatic events almost always involve actual death or serious injury.
   
2. 
   People experiencing traumatic events respond with intense feelings of fear and helplessness.
   
3. 
   Most people who experience traumatic events develop acute stress disorder or post-traumatic stress disorder.
   
4. 
   All of the above.
   

18. 
    A behavioral or cognitive action that is taken in an effort to manage stress is
    

1. 
   a coping strategy.
   
2. 
   a defense mechanism.
   
3. 
   adaptation.
   
4. 
   a resource.
   

19. 
    __________ is NOT a category of coping described by Lazarus (1993).
    

1. 
   Problem-focused coping
   
2. 
   Solution-focused coping
   
3. 
   Emotion-focused coping
   
4. 
   Avoidance
   

20. 
    Following a stressor or crisis event, the degree to which functioning has changed over an extended period of time is called
    

1. 
   adaptation.
   
2. 
   resilience.
   
3. 
   coping.
   
4. 
   None of the above.
   

21. 
    __________ does NOT have a positive association with resilience.
    

1. 
   Attachment
   
2. 
   Mastery
   
3. 
   Cognitive skills
   
4. 
   Affective arousal
   

22. 
    Compared to psychologists and psychiatrists, professional counselors
    

1. 
   are less trained and less prepared to provide crisis intervention.
   
2. 
   work from a prevention point of view.
   
3. 
   would not be likely to diagnose mental or emotional disorders.
   
4. 
   are less effective advocates because they have Masters’ degrees rather than doctoral degrees.
   

23. 
    Within the mental health community, paraprofessionals
    

1. 
   include counselors.
   
2. 
   are not permitted to provide crisis intervention because they are not licensed.
   
3. 
   may provide an outlet for clients to talk and feel less isolated.
   
4. 
   None of the above.
   

24. 
    Which of the following statements is TRUE? Crisis intervention
    

1. 
   usually occurs between counselors and clients who have no previous relationship.
   
2. 
   may be a scheduled component of other forms of counseling.
   
3. 
   is similar to other forms of counseling in its purpose, setting, time, and design.
   
4. 
   may take place within an established ongoing counseling relationship.
   

25. 
    The procedures for working with clients in crisis begin with
    

1. 
   establishing equilibrium.
   
2. 
   assessment.
   
3. 
   debriefing.
   
4. 
   defusing.
   

1. 
   How does disequilibrium play a role in crisis situations?
   
2. 
   You are a counselor at a local mental health agency. You have just read the intake of a male client that you will see next week. His presenting problem is that he witnessed his brother being shot and killed. According to the ABC-X model, what might you anticipate while working with this client?
   
3. 
   In the scenario presented in question #2, describe what you might consider to be the provoking stressor events and how those might be described by the client.
   
4. 
   Again, in the scenario presented in question #2, describe some of the resources that might be needed while working with this client.
   
5. 
   In a debate between developmental crisis and situational crisis. Take the side of developmental crises. Make a case for how developmental crises are more difficult to treat than situational crises. Provide specific examples to support your case.
   
6. 
   In a debate between developmental crisis and situational crisis. Take the side of situational crises. Make a case for how situational crises are more difficult to treat than developmental crises. Provide specific examples to support your case.
   
7. 
   Discuss how stress and trauma are key concepts related to crisis. Provide specific examples of how clients might experience these concepts.
   
8. 
   Discuss how coping, adaption, and resilience are key concepts related to crisis. Provide specific examples of how clients might experience these concepts.
   
9. 
   Discuss how crisis intervention is different from other forms of counseling. Provide specific examples in your discussion.
   
10. 
    You are in charge of a crisis response team. Your team has been called out to work with individuals and families in the aftermath of a major hurricane. On your team, you have access to professional counselors, psychiatrists, psychologists, social workers, and an assortment of paraprofessionals. Briefly describe how you would use each of these mental health workers in this situation and how you might hope they could collaborate together.
    

1. 
   Explain safety and security concerns related to counseling practice particulary regarding crisis situations
   
2. 
   Describe