Case Study
Patient Demographic: Client Age: 25 Sex: Male Gender: Male Sexuality: Heterosexual Ethnicity: Caucasian Relationship Status: Single Counseling Setting: Counseling Clinic Type of Counseling: Individual Presenting Problem: Depression and Suicidal Ideation Diagnosis: Major Depressive Disorder, Recurrent, Mild (F33.0)
Mental Status Exam: Mental Status Exam: The client appears to not have bathed recently because his hair is greasy and unkempt. The client has food stains on his clothing; however, he is dressed appropriately for the season. His motor movements are within normal limits. He is engaged in therapy, but he appears anxious as evidenced by hesitating before speaking and by his hand wringing. The client reports suicidal ideation with no plan or intent. The client reports a depressed mood more often than not and difficulty enjoying most activities. The client is oriented to person, place, time, and situation. The client reports that his appetite has increased lately and that he is experiencing hyperso
Presenting Problem: You are a resident in counseling practicing in a private practice agency. During the initial counseling session, the 25-year-old single male client reports feeling depressed and hopeless. He has difficulty enjoying activities that he has enjoyed in the past and feels unsatisfied with most areas of his life. The client identifies that he is not happy at work and wants to make a career change. The client verbalizes feeling sad more often than not, and that this has been going on for about 2 years. The client decided to start counseling when he began experiencing suicidal thoughts. The client reports no plan or intent to attempt suicide but is concerned about his own well-being.
Other Contexts:    mnia. Family History: The client reports that he has two younger brothers who are 19 and 22 years old. His parents divorced when he was 10 years old, and he grew up living with his mother but maintained a strong consistent relationship with his father. The client reports no history of trauma, neglect, physical abuse, sexual abuse, or emotional abuse. The client denies drug or alcohol use, although he reports that his father previously was an active alcoholic

Question: Due to the client’s reported suicidal ideation, which of the following would be an appropriate intervention regarding management of suicide risk?
(A): Create a safety plan.
(B): Encourage the client to stay with his girlfriend so he is not alone.
(C): Coordinate for placement in a psychiatric hospital to safely address the crisis.
(D): Provide psychoeducation on cognitive reframing in order to manage depressive symptoms.

Correct Answer: Create a safety plan.
Explanation: A safety plan would be the best first intervention because suicidal ideation is present, but without an intent or plan. A safety plan provides options for coping with negative thoughts and lists the people that the client can contact for support. Cognitive reframing will be beneficial in treating depression and at times suicidal thoughts, but this would not be taught quickly and effectively enough to assist the client in the first session. Encouragement to stay with his girlfriend may provide safety and/or be part of the safety plan, but it will not guide the client on how to manage his thoughts in the way that the safety plan would. Placement in a psychiatric hospital is not always necessary when someone has suicidal thoughts, and this may enhance the client’s anxiety. Further questioning and assessments can be used to ensure that someone is at low risk for suicide and if they are lower risk, they can likely be stabilized in the community with a safety plan. Therefore, the correct answer is (B)
Competency: treatment planning