When someone seeks treatment after trauma, counselors must complete a risk assessment


When someone seeks treatment after trauma, counselors must complete a risk assessment, even when clients may not be demonstrating behaviors that seem high risk.

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Assess risk for the client in the following case study using the Suicide Risk Assessment Form, which is based on the Suicide Assessment Five-step Evaluation and Triage from SAMHSA in this week’s learning activities. Use full sentences and appropriate grammar.

Katina is a 37-year-old heterosexual female of Serbian and Italian descent. She met Jonathan when she was in college, and they have had an on-and-off-again relationship over the past 15 years. During that time, they have had four children together, ages 4 to 13. She and Jonathan are currently working on their relationship and live together in the family home. 

Katina states that she has experienced mental health problems since adolescence, and recently receiving a diagnosis of anxiety and depression. She reports having been abused during her childhood by a family friend, who was imprisoned briefly as a result, but never received counseling for it. When younger, Katina took party drugs to cope with her anxiety and depression but feels now that she has grown out of the habit.

Katina describes her long relationship with Jonathan as turbulent and dysfunctional. The abuse started as name calling; he would call her “fat,” “ugly,” and a “loser” if he felt he wasn’t getting his way or if he objected to her spending money. They had a joint bank account where Katina deposited her salary. If she didn’t pay bills and get household necessities immediately, Jonathan would clean out the account. As time went by, Jonathan’s abuse became physical. He frequently spat on Katina, pulled her hair, dragged her through the house, smashed her head into the wall, and threw drinks over her, on many occasions in front of the children. Throughout the relationship, she has experienced negative, controlling interference from Jonathan’s family, including verbal and physical abuse in the presence of the children as well.

Yesterday, Katina was attempting to pay bills and noticed that there was not enough money to cover the household expenses. When she brought it up to her husband, he told her she was just trying to get extra money out of him and called her a “mooch” and “too dumb to add 2+2.” As Jonathan approached her, their eldest child stepped in to shield her. The husband then struck the eldest child and they continued in a physical altercation. Per Katina’s report, the child has bruises and a black eye, but the police were not called, and she has not told anyone else about this occurrence. 

Katina describes feeling guilty that she got her children involved in this situation. She explains that she wants everything to just go away. She describes feeling that, if she were not here any longer, everyone in her life would be much happier. Katina explains that she has these feelings often but never thought about acting on them until now. She explains that her child stepping in “pushed me to the edge.”

Katina explains that, when she was driving yesterday, she thought about how free it would feel if she were to just keep driving off the bridge. She said that she has had the thought several times since. She expresses being unsure if she is trying to end her life but admits that “it might just be for the best.”

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