Certified Advanced Alcohol and Drug Counselor (CAADC) Practice Exam

What is the appropriate initial response to a patient indicating suicidal thoughts without a plan?

1. Call 911 immediately

2. Work on a no-suicide agreement with the patient

3. Try some self-disclosure to build rapport

4. Contact the client’s support network

The correct answer is: Work on a no-suicide agreement with the patient

In situations where a patient expresses suicidal thoughts but does not have a specific plan, developing a no-suicide agreement can be an appropriate initial response. This approach helps to create a collaborative and supportive therapeutic environment where the patient feels heard and understood. A no-suicide agreement is a tool that can establish a commitment from the patient to avoid self-harm and encourages open communication about their feelings. This enhances the therapeutic alliance and provides a foundation for further exploration of the underlying issues contributing to the suicidal thoughts. Creating a no-suicide agreement is also an opportunity for clinicians to assess the level of risk and the patient's perception of their safety. This process can lead to a deeper discussion about coping strategies, support systems, and alternative methods for managing distress. By using this approach, practitioners can foster trust and enable patients to take an active role in their safety plan while ensuring that the clinician has a framework to monitor and address the patient's ongoing risk. Considering the other options, immediately calling 911 may be an appropriate action in situations where a specific plan exists or there is imminent danger. However, since the patient does not have a plan, such an immediate response could unnecessarily escalate the situation. Self-disclosure by the counselor might be helpful at times to build rapport but might not