CCMH558 – Suicide Risk Intake Assessment Transcript

Counselor is an African American male in his mid to late thirties.

Client is a White female in her mid to late thirties.

Counselor – So tell me what’s bringing you into counseling today?

Client – I’ve just been feeling really, really overwhelmed lately.

Client – Something happened on campus last week and I haven’t felt like myself ever since.

Counselor – Okay. So tell me what you mean by overwhelmed.

Client – Well, just I’ve been having a hard time focusing and I’ve been having a really hard time sleeping. My emotions are all over the place, sometimes I’ll cry for no reason. I’m really jumpy. You know, like, I catch myself looking over my shoulder a lot and every little sound kinda sets me off.

Counselor – I noticed that you’re shifting in your chair a lot and you’re kind of wringing your hands and I’m wondering, how you’re feeling right now?

Client – Not great. I’ve just, I mean, I kinda feel, I don’t know, frightened or sad, or kind of like I’m watching everything from really far away, kinda like things aren’t really real around me anymore, you know?

Counselor – Okay. Do you feel comfortable with me as a counselor and things like that? I’m not really comfortable with, I’m not really comfortable talking to strangers, let alone counselors.

Client –  And then especially after last week, I’m not typically comfortable talking to men.

Counselor – Okay. With me being a male, do you feel comfortable talking to me or would you rather me get someone else?

Client –  I’m just not so sure how you’ll be able to understand where I’m coming from.

Counselor – Okay. Well, I have some training in working with diverse clients and so hopefully I can be able to relate to you. And one of the things with counseling is that there is confidentiality with a few exceptions. One of those exceptions is if you are thinking about harming yourself or are actively suicidal. And so hopefully that makes you feel a little bit more comfortable in our relationship together. So I’m gonna do a quick assessment and so I’m gonna ask you a couple of questions and I just want you to be as truthful as possible and things like that. So tell me, do you have any previous psychological diagnoses or anything like that?

Client – No. I saw a counselor for a while when I was back in high school, but I haven’t been diagnosed with anything.

Counselor – Okay. And what about any family history of psychiatric diagnoses or anything like that?

Client – There’s some depression in the family, especially, yeah, I mean, with my brother.

Counselor – Okay. Tell me about that.

Client – Well, I mean, he was always a weird little kid but he was diagnosed in a pretty straightforward way. I mean, we were able to get him into counseling and therapy early, but his was different than mine. You know, I was just a teenager going through some stuff though and his was different.

Counselor – Okay. Is there been any suicidal behavior in the family? Has anyone completed suicide or had any suicide attempts? Attempts?

Client –   Yes, but no suicides.

Counselor – Okay. And so tell me, do you have any thoughts about harming yourself or anything like that?

Client – Sometimes, especially since last week.

Counselor – Tell me what happened last week.

Client –  I was finishing class, and it was my late night class. I’ve been taking classes at night after work and I didn’t…

Client –  I don’t really know the details of what happened. Campus security doesn’t usually have the cameras on in that dark part of the quad, but I was attacked from behind and I was assaulted and I still don’t know who it was.

Counselor – You sound really scared and really kind of afraid right now. It seems like that is affecting you in multiple areas of your life right now.

Client –  Yeah. Yeah, it’s getting in the way of everything.

Counselor – Okay. And so I’m wondering, you mentioned that you kind of have some thoughts about harming yourself. Have you thought about attempting suicide?

Client –  Thinking about it and thinking about doing it or different things, you know, like, it seems like it would be a good idea. It seems like it would be really, really easy. When I can’t sleep I have sleeping pills, they’re right there. I know how easy it would be. And sometimes it just seems like the best option would just be go to sleep and not wake up again.

Counselor – So you have a plan and that would be to.

Client –  I mean, if I were to go through with such a thing.

Counselor – Okay. So like on a scale of one to 10, one being, not at all and 10 being definitely gonna do it. Where would you say that your intent is right now?

Client –  I would say that, depending on whether or not I am distracted and whether or not I have had a nightmare maybe a seven.

Counselor – Okay. So I’m really worried about your safety right now. So one of the things that I’m worried about is You said that your kind of intend is kinda high now. So I’m wondering what are some reasons to live? Tell me about some reasons that you have to wake up tomorrow.

Client –  I don’t want to hurt anyone whom might care for me. I mean, you never know how that’s gonna hurt people. I remember how I felt when that kid in my class killed himself when he was in high school. And I just, I don’t want to do that to people, you know. My mom loves me, my roommate would be really scared. I’m certain that my friends from work would be worried about me. But I don’t really, I don’t really know why me being in the world would make it more important for me to be there.

Counselor – So I hear that you’re worried about the impact that completing suicide would have on like your family, your friends, your coworkers, and things like that. But you still may be a little bit hesitant or you still kind of have those suicidal thoughts surrounding you.

Client –  It just seems like it would be the easiest fix.

Counselor – Okay. I’m wondering if you have any other, maybe, factors to live, maybe some children or anything like that, a beloved pet, just something to wake up to in the morning?

Client –  I do have a cat who would be very upset if anything happened to me. And I know, I know that my mom, even though that we’re not close, like we used to be, I know that my mom, she wouldn’t be the same.