Topic 1: Initial Assessment in Counseling {by 10/15}
Based on the text readings and lecture recording due this week consider the following two discussion points: (1) Share your understanding on why it is important to get an accurate understanding of the client’s problems early in therapy (i.e., intake/early sessions). (2) Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety provoking. Share a few of your initial concerns when (not if) you are confronted with a suicidal client. (Keep in mind, you will learn a lot more about responding to suicidal clients in future classes and on your practicum/internship.)
(3 – Prepare for Class [do not blog]) You will notice on my website (Class Lectures & Recordings) a short video “Assessment Review Introduction,” “Assessment Review Reflection Questions” template, and five assessments. Please review these questions and the assessments before class. You do not have to complete these assessments before class, but you can if you want. In class, we will complete these assessments and discuss them based on the reflection questions.
Your original post should be posted by 10/15. Post your two replies no later than 10/17. *Please remember to click the “reply” button when posting a reply. This makes it easier for the reader to follow the blog postings.
Oct 12, 2026 @ 22:12:22
The early intake assessments or sessions are extremely valuable in the continued structure of care for the client. The most important I think, is to hear and understand the story from the client’s perspective. It tells you where the client is at, if they’re ready for help, or if they’re in denial. What the client says in the first hour of seeing them gives you a lot more information about your next steps and how to treat them. You also aren’t just building a rapport about the client, you’re building a rapport with the client. The client is assessing you as much as you are assessing the client.
In these first initial sessions, you’re finding out things like the five Ps. The presenting problem (current issue), predisposing factors (historical genetics or situations), precipitating factors (trigger of current event), perpetuating factors (what’s keeping it going), but also the protective factors (current coping skills/supports). You’re assessing how much this situation impacts the client’s life. If they’re being consistently retriggered into the situation, and if there’s protective factors that can be put into place to get the client to a safer space mentally. As you assess what the problems are, mentally you’re organizing and ranking the severity, so you can work most detrimental to least.
If a client is suffering from depression, suicidal ideation, abuse, those things require higher attention in that moment. You as a clinician need to be able to pick up on the cues or statements indicating this thought. The first session(s) are primarily exploration. Getting to know the client, getting to know their background, digging into their biopsychosocial side of their lives. Learning about what they think the problems are. It’s important to know where the client is at in their own treatment before you push them into insight. If you’re pushing them into insight on things that they don’t think are a problem, you may hit a wall. Unless in my opinion, they have an active or passive plan to harm themselves due to the situation they’re in. Getting them skills, tools, and into a safe environment to keep them alive it’s something you need to know about immediately to act.
Those first sessions your client could either be in denial, accepting they need help, thereby force, et cetera et cetera. Every client’s reason for therapy is a little bit different. But it’s important that we know how to ask the questions to get to the information we need. How to c get a difficult client talking, or how to support a vulnerable client. The better we do it our assessments, the more effective treatment can be down the line.
(2) Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety provoking. Share a few of your initial concerns when (not if) you are confronted with a suicidal client. (Keep in mind, you will learn a lot more about responding to suicidal clients in future classes and on your practicum/internship.)
I think one of my biggest fears with a suicidal client, is wondering if I said the wrong thing. I worry that I’m if I’m with the client and I can’t help them, and they end up either having an attempt or success, I will wonder if it’s my fault. And I have anxiety that it’s because I said something wrong in session that led them to that final decision.
I worry about the gray area of suicidal clients and reporting to get them help. If I know a client has a gun, and that’s their method of going out, but they don’t have an active plan, just a plan as a “in case” I worry about what I’ll say or do in that situation.
I know that I’m a person who desperately wants other people to see their own worth. I worry that I’ll waiver from clinical talk, to personal Support. And end up anxious about trying to fix the problem over listening to the problem.
I also have a lot of anxieties around the topic of suicide feeling too personal. I think that is one of my top triggers that will happen in sessions. I get very uncomfortable when people say “you don’t know what it’s like”, if it’s over something I do know what it’s like. I know I need skills to better compartmentalize my own experiences, but suicide is not something that’s taken lightly, nor should it be. And without giving too many details, it’s almost too close to home for me. To be honest I really don’t know how I’ll respond to a client who is suicidal, and I can only hope that how I’ve prepped it in my head is how it comes out live action.
Oct 17, 2026 @ 16:24:04
Hi Olivia! I really liked how you included the five Ps in your discussion! I think they are so important because they allow us to learn so much about the client while also helping us recognize areas where we may need to dig a little deeper. I also really liked your point about not just building rapport about the client, but actually building rapport with them. That is an important distinction, especially during the early sessions. I would also love to learn more about how to approach clients who are in denial/may not be ready to accept help.
I mentioned in my own post that one of my biggest concerns when working with a suicidal client would be saying the wrong thing or unintentionally making the situation worse. However, I didn’t even think about the gray areas you mentioned! I can only imagine how difficult it would be to navigate those situations, especially as a new counselor who is still learning. Lastly, I appreciate your openness and vulnerability in sharing your personal experiences and concerns. That takes a lot of courage, and I am so lucky to have you as part of our cohort!
Oct 17, 2026 @ 21:20:46
Hi Olivia,
first & foremost, thank you for your thoughtful and thorough response to the questions we were asked. I think you have demonstrated a thorough understanding of your own processes, intention, and mechanisms of actions through which you’d like to apply a therapeutic modality to a patient. I think that you also take a great deal of care and compassion when approaching different difficult subjects, especially that which are, for lack of a better figure of speech, very close to home. I think these are both exceedingly admirable and demonstrate just how much dedication you have towards the craft! Thank you so much for your vulnerability, honesty, earnestness, and transparency, as well as your feedback on my own comments- I look forward to working and studying alongside you in the future!
– Lorcán
Oct 17, 2026 @ 23:01:50
Hi Olivia,
I liked how you went right in with the 5 P’s. I didnt even think of approaching it from that perspective, I looked at it in a more this is what they are struggling with such as past or current known mental health diagnosis and considered it from their how physical or mental health and risk of suicide or selfharm should take priority, Breaking it down as you did makes it alot easier to conceptualize and undertand more of the importance on why knowing/doing a proper intake and learning what you can about them in early sessions is so important, Another thing you brought up was the part about their level of acceptance for change, in mine i did bring up that slightly but not as well as you did in the part about how they could be in denial again I took a different but similar approach connection but focused on if they are ready to put in the work versus them being in denial of whatever problems they are facing which then connects to what is the word oh yes level of insight goes with this, I am not totally sure if the two necessariyly go together since I imagine a person could be of some awreness but just deciding to refute it because they dont want to admit it but internally and physically know about it or if that would mean they lack insight. You brought up alot of good points on insight and knowing when to push or not push. It was informative to read your perspective and I wish I had read yours before I wrote mine but thought it was important I not look at anyone elses before I submitted my own, It was good introspection you did and how you considered more than just the problem but how presenting rapport is not just the basics of why it is contextually important to know their history but you went beyond that and added alot of thoughts outside the basic way I thought of the assignments purpose and expected response we were to give for our post.
Now onto the second part and my response to what you wrote in your blog/discussion post. You bring up your fear of saying the wrong thing and how it could in your mind leave you wondering if a persons suicide (attempt or completion) is somehow your fault or if you could of done something more, I want to say this to you, we are human, in the end what another person does we cannot control, and as long as we do what we can and try to help them and follow the ethics and protocols you cannot fault yourself for the actions of you client. Knowing whether or not someone decides to take their life because you dont think you did enough or because you said the wrong thing, is not a burden you should place onyourself as long as you did what you could and took the legal and practical steps that you could do in your position and covered your bases, it would not be your fault . We cannot save everyone from themesleves or be there to stop them from taking their own life, but we can support and help them while we are working with them, that is all we can do, we are not god and we cannot take away their pain or totally prevent their death but we can help support them in getting to a better place in life or in helping them get stronger mentally. The connection we have to others and eachother and our clients and them to us and them to those around them and to other living things is what grounds us but sometimes even an amazing therapist and extremly caring well meaning individual can only do so much as we are human. In this field it is likely that in your career one client will be lost so even with that known statistic do your best with what you can and do not place that burden or thought of what if drown you.
Oct 14, 2026 @ 16:09:58
Oct 14, 2026 @ 23:02:55
Hello Aleesha,
I really like how you pointed out how important it is to look into the severity of a situation. Helping your client feel safe and grounded is vital especially if you’re working crisis work. How that bond is made early in session, also in the future can affect how likely the client is to share dangerous thoughts with you in the future. Showing them early that you are a safe person to share these things with is important.
I also resonate with your sense of urgency to fix a clients suicidal ideation. I think it is going to be interesting to learn how to 1) hear more on how to clinically speak and think in that situation of learning someone is suicidal. and 2) how to not try and save them. We cannot keep someone alive, but we can give them tools to help them see life from a different angle.
Fantastic reflection!
-Olivia Griffin
Oct 17, 2026 @ 21:28:31
Aleesha,
Thanks for your honest reflection. I think we all find these kinds of matters to be somewhat anxiety-inducing on a base level, and I believe that it is a very natural and innate response to want to be able to immediately resolve such situations to make ourselves and the individual in question feel safer and more secure. I also thank you for your candor regarding your fears surrounding patients who may potentially attempt to conceal suicidal ideation; That can be a particularly sensitive situation, both in terms of how we think about administering therapy, but also in terms of how we rationalize that outcome within ourselves. I’m sure we’ll learn how to best navigate these sorts of challenges in the future.
fair play,
– Lorcán
Oct 17, 2026 @ 23:46:24
Hi Aleesha,
I really liked how you describe the negatives and positives in a therapist in understanding a client. It was a great point how if we understand a client there is more likely to have a better outcome in therapy compared to having a negative outcome and not understanding from the beginning. It makes a point how we have to truly understand our client to see results and consistency throughout their therapeutic journey. I also understand your concern with false negatives. I also have some concerns about that. It is hard to not be able to fix everything right away as it can build up anxiety, it is good though that we are being aware of these concerns early on. Great Post!
Oct 19, 2026 @ 09:03:11
Hi Aleesha, I agree that having an accurate understanding of a client’s problems is important because it can affect the direction of treatment and the results. I think it is important for therapists to understand not only what the client is struggling with but also how the problem affects their everyday life. I also like your point about assessing for substance use and medical conditions because these factors may contribute to what the client is experiencing. When it comes to suicide risk, I agree that it is important to assess the client carefully so that important warning signs are not missed. As a beginning counselor, I think one of the biggest challenges would be making sure I understand the client’s level of risk while remaining calm and supportive. Seeking supervision when needed would also help me make better decisions and protect the client’s safety.
Oct 14, 2026 @ 16:56:18
Oct 16, 2026 @ 23:57:13
Hi Ang!
I love how you pointed out the importance of a client-centered approach from the very beginning of therapy. The client knows themselves better than we do and it is crucial to keep that in mind when conceptualizing their case. Like you said, this approach will result in better outcomes because it enhances the therapeutic relationship and increases client motivation to come to therapy and explore with the therapist.
The anxiety of providing a false negative when it comes to suicidality is so relatable! I believe as we learn more about assessing suicidality and gain experience that anxiety will decrease, but it is truly a great responsibility to uphold!
Oct 19, 2026 @ 09:02:15
Hi Angelina, I agree with your point about how understanding a client’s concerns early can help build trust and encourage them to continue with counseling. I think when clients feel that their therapist is really listening and trying to understand them without judging, they may feel more comfortable opening up about things they find difficult to discuss. I also like your point about identifying the factors that may affect the client’s treatment. Every client has different experiences, so taking the time to understand their situation can help the therapist provide the right support. I also think assessing for suicide risk early is important because it allows the therapist to recognize safety concerns and respond appropriately.
Oct 19, 2026 @ 17:05:48
Hi Ang!! I think it is great how you brought up the fact that as a helper we inspire the client ton continuing evolving the therapeutic relationship, but what matters is us laying the foundation for it. I really liked how you referenced the book for this portion as well. I like how you used the phrase “paves the path” as this is a great visualization for curating rapport and building that relationship between client and counselor from the initial interview and beyond. Bringing in your real life experience and involvement in adventure therapy gave me a perspective and insight I have not ever considered on the topic of suicide from the counselor perspective, thank you!
Oct 14, 2026 @ 21:45:11
Oct 15, 2026 @ 17:38:17
Hello Lorcan,
First off, thank you for your vulnerably in sharing your experiences with your personal experiences. It is a point I very much agree with as a major concern. I also agree that this thought of emotional or psychological response is a very real fear and concern. But as you said we will learn more. As we were learning about how to help those who are struggling, its a good opportunity for us as learners to not just learn how to support others, but find way to support our selves.
I also like your point of creating a therapeutic alliance, I think that your rapport with your client from the start is very important. And beneficial for your client to know right off the bat the type of therapist you will be from the start (i.e, blunt, calm, cozy, firm, etc). A question that arose is: I am interested in how you might in the future work through if you think your client and you are not a good match?
Thank you again for sharing, you are doing amazing!
-Olivia G
Oct 17, 2026 @ 23:30:23
Hi Lorcan,
In your post you mentioned how knowing their problems and doing proper intake and rapport in early sessions is helpful to know triggers or what behaviors to expect, which is sound logic but also think need to keep in mind we can only discover so much in first few sessions or intake, some problems may be hidden and may not be talked about or covered well into the therapeutic relationship, Triggers and behaviors can also change how they present and in severity so yes it is important to discover them early but also to be aware that we might not fully grasp what behaviors or triggers they are experiencing it is sometimes to easy to assume that if someone yells they are angry or crying means sad and maybe that a certain event reminder triggers a response in someone those are all good things to be aware of but also to keep perspective that sometimes clients can be very good at hiding or what is the word, I suppose putting up a front or masking. We cannot always know what the other person across from us is masking or if purposely or unpurposfully responding in a certain way for a specific reaction or if their display is genuine, which I suppose is also where rapport comes in an knowing past diagnosis and gathering information come in which you did discuss rapport and the 5 P’s but I felt it is may be important to also keep those things in mind not only in the intake or first few sessions but as a continually developing concept of the client and who what and how they are and present. We are always changing knowing or not as our are clients.
In regards to part two of your blog post about self-disclosure, I think depending on the client it can be very helpful for them to know whether or not their clinician has faced similar problems or experienced what they have. What I mean by this is that sometimes it helps us to feel connected and understood if we know someone else has had the same challenge we have faced. For instance when I found out my therapist had not had any suicidal thoughts before I at first felt dejected like how can this person know how to help me if they havent also had to try so hard not to kill themselves or how can they actually understand what it is like to feel this way. But I realized later that is was okay they havent felt this way because they were still trying to understand and help me even though they themselves never went thought it. However, I dont think it would be necessarily helpful for them to find out if you yourself as the clinical have or haven’t had suicidal thoughts or hospitalizations while they are being assessed in the moment, I believe that there may be a better time or more appropriate time for self-disclosure of such things that would still be helpful for the client but would have to be careful and cautions on when and. how brought it up, such as if they are having difficulty accepting their thoughts such as thinking they are the only ones or if they feel it is a sin or makes them a bad person for even thinking about it, could be helpful with rapport that they know you have struggled to but at same time could be a double edged sword where could be beneficial for them or make them close up, so probably more likely helpful disclosure after you have a good rapport with them, though if they ask point blank at the beginning then I feel honesty should be your way to go, while also maybe considering why they would want to know.
Oct 14, 2026 @ 22:53:46
Getting a thorough background of a client not only allows you to understand their culture and worldview better, but it allows for further understanding of potential stressors in their lives. Especially witht the prevelance of culture bound syndromes, we do not want to be assessing anybody for the incorrect diagnosis, a potentially harmful process. Quickly getting an understandong of the clients problems allow us to begin work, and when people see results-even small ones- they feel motivated to engage in the work of therapy.
With a client in active crisis, I do not want to waste critical time on general intake and potentially cause greater harm by reminding them of their struggles. My main worry is not making things worse trying to understand, rather than harm prevention. I am also worried about seeiming dismissive or overly concerned, even though it is better to prevent loss of life. Finally, I am concerned that placing someone on critical watch or into a ward may cause severe and ongoing trust issues and harm regarding therapists if they were not truly that severe.
Oct 17, 2026 @ 16:34:41
Hi Gemma! I liked how you brought up the importance of understanding a client’s cultural background and worldview. That is such an important part of the assessment process because we need to recognize how someone’s background and experiences may influence their symptoms and how they approach therapy. I also agree that getting an accurate understanding early on can help prevent misdiagnosis and allow us to develop a more appropriate treatment plan.
You brought up an interesting concern about how taking additional safety measures could potentially affect the client’s trust in their therapist. I hadn’t really considered how an intervention meant to protect someone could also impact the therapeutic relationship moving forward. I mentioned in my own post that I would be worried about saying the wrong thing or unintentionally making the situation worse, so I definitely relate to your concerns. I think finding that balance between protecting the client’s safety and maintaining their trust will be one of the more challenging things for us to learn as new counselors!
Oct 17, 2026 @ 23:20:13
Hi Gemma! Your first few statements are very prevalent. A client’s culture, worldview, and potential stressors are major factors in accurately understanding a client. These point us, as therapists, to a greater knowledge and understanding of the major problems the client is facing in their life. For example, a pessimistic worldview may indicate many things, but the treatment plan may include encouraging the client to see the world more optimistically (more so realistically). I love your last statement in your first paragraph because small, progressive results are so important to the client, and that is part of the therapeutic process; small steps of the client becoming more adaptable, adjusted, and alive (not surviving).
Also, I understand your concern about balancing an intake while a client is in crisis. This is when give-and-take comes into play, and it may take a few more sessions to get the full intake, but being attuned to what the client needs is paramount. I also see your concern about potentially admitting a client whom you may call into a psychiatric facility. This is definitely tricky, and there’s no easy answer. It may cause trust issues and harm to the therapeutic alliance, but through the therapist’s and client’s cooperation, each party can understand one another’s concerns more profoundly.
Oct 14, 2026 @ 22:54:57
Hello Lorcan,
First off, thank you for your vulnerably in sharing your experiences with your personal experiences. It is a point I very much agree with as a major concern. I also agree that this thought of emotional or psychological response is a very real fear and concern. But as you said we will learn more. As we were learning about how to help those who are struggling, its a good opportunity for us as learners to not just learn how to support others, but find way to support our selves.
I also like your point of creating a therapeutic alliance, I think that your rapport with your client from the start is very important. And beneficial for your client to know right off the bat the type of therapist you will be from the start (i.e, blunt, calm, cozy, firm, etc). A question that arose is: I am interested in how you might in the future work through if you think your client and you are not a good match?
Thank you again for sharing, you are doing amazing!
-Olivia G
Oct 15, 2026 @ 07:59:24
Oct 17, 2026 @ 13:22:34
Hi Sara! I like how you emphasized that gaining information from the client early on can allow the therapist to learn more about their background, behaviors, and experiences, as these may influence the treatment plan. Information that may not seem immediately relevant to the client’s treatment goals at the time may later turn out to be a factor, so it’s important to gather as much information as possible in those early sessions.
In terms of the second question, I think you bring up some really great points. I would also be afraid of accidentally saying something that could offend or upset the client, possibly making the situation worse. Gauging suicidality is definitely difficult to approach, especially as a beginning therapist. I also mentioned in my response how my biggest concern would be making a lapse in judgment that leads to the client attempting suicide. I agree that while this judgment can be difficult to make, it is definitely important to be overly cautious when a client seems to be at imminent risk of suicide. This emphasizes the importance of practice and supervision in helping beginning therapists develop their skills and gain competence in handling these situations.
Oct 17, 2026 @ 21:44:45
I agree that getting an accurate understanding of a client’s problems early in therapy is important because it helps the counselor understand the client’s needs and develop an appropriate treatment plan. I also agree with your concerns about working with a suicidal client, especially as a beginning counselor. I think it can be intimidating to ask those questions because you want to make sure the client feels supported while also taking their concerns seriously. I think learning how to stay calm and ask direct questions will be important, along with knowing when to seek supervision. It is important to remember that we do not have to know everything as beginning counselors, but we do need to be willing to learn and make sure our clients are safe.
Oct 19, 2026 @ 17:10:57
Hi Sara! I see how you emphasized seeing the client as more than their problems and as individuals. Like you said, through collecting information on their background, behaviors, and experiences allows us to do so, which these are all crucial moments within the initial intake interview. In addition, I like how you mentioned it helping us guide treatment. We do not want to give just the same 3 step program or medication to every client. If anything, this could be harmful and the same shoe does not fit everyone. So being intentional in those initial intakes and gathering key identifying information can do nothing but support the future of the working relationship, and as you said, prevent information from being overlooked.
Oct 15, 2026 @ 08:51:44
I think it is important to get an accurate understanding of a client’s problems early in therapy because it helps the therapist understand what the client is struggling with and what they need help with. Without a clear understanding, it can be easy to make assumptions or focus on symptoms without understanding the bigger picture. The intake process allows the therapist to learn about the client’s background, current concerns, history, and how their problems are affecting their daily life. This also helps the therapist identify potential diagnoses, assess any safety concerns, and develop a treatment plan that fits the client’s individual needs. I also think it is important to build trust and rapport during these early sessions so the client feels comfortable opening up and sharing information they may find difficult to talk about. Having a strong understanding early on can help create a better foundation for the therapeutic relationship and make treatment more effective.
As a beginning therapist, one of my biggest concerns when working with a suicidal client would be making sure I understand the seriousness of their situation and can help keep them safe. I would worry about asking the right questions and making sure I do not overlook any warning signs or minimize what the client is experiencing. I might also feel anxious about how to respond if a client tells me they have a plan or intend to act on their thoughts. Another concern would be knowing how to balance building trust with taking the necessary steps to protect the client. I would want the client to feel heard and understood rather than judged or afraid to be honest with me. At the same time, I would need to recognize when a situation requires additional support or immediate intervention. Although I know I will learn more about suicide assessment and intervention in future classes and during my practicum, I think it is important to recognize my limitations as a beginning therapist, consult with a supervisor, and prioritize the client’s safety.
Oct 17, 2026 @ 21:32:43
Hi Alyssa M!
You make a good point that the initial intake appointment gives the client a chance to not only gain rapport with the helper, but also to adequately describe their experiences, feelings, and cognitions. It also gives a chance for an beginning to exploration, allowing the helper to probe and restate to fully understand the client. I think your concerns about encountering suicidality in clients can be minimized by explaining confidentiality limits during intake to set realistic expectations about being a mandated reporter while also being trustworthy.
Oct 17, 2026 @ 22:53:38
Hi Alyssa M!
You brought up a great point about getting a broader perspective- knowing a client’s cultural mindset and wider viewpoints not only deepen the therapeutic alliance, but they also establish some understanding of how the client sees the world and operates in it.
I too am worried about the impact reporting suicidal intent could cause. Although we discuss confidentiality and reporting mandates with clients, reporting could prevent bodily harm, but harm the relationship. I am interested how to repair the relationship after this occurs, but good call on wanting supervision.
Oct 17, 2026 @ 23:40:57
Hi Alyssa! I totally agree with your first statements about truly understanding the client instead of making assumptions. With time and practice, beginning therapists become more aware of the true concerns in the client’s life. Also, there are always provisional diagnoses if we didn’t accurately diagnose during intake. Furthermore, I like how you mentioned rapport in supporting therapists in accurately understanding clients. Building therapeutic rapport is so important to the client’s likelihood of returning and feeling open and honest with the therapist.
I understand your concerns about your worries if a client brings up suicidal ideation. Thankfully, beginning therapists typically have supervisors whom they can go to for advice, who have worked with clients with suicidal ideation or tendencies. Also, I totally agree with wanting the client to feel heard and understood and being honest rather than feeling judged or fearful. Therapeutic rapport, nonverbals, tone of voice, empathy, and open-ended questions are some of the many factors therapists can include in potentially cultivating the client to feel heard and understood.
Oct 15, 2026 @ 13:50:21
1/ I think it is important to get an accurate understanding of the client’s problems early in therapy especially during intake because it helps being able to get a clear picture. A better understanding of what the client is going through will help to create an effective treatment plan that will benefit the client to be able to have a successful therapeutic journey. Clients have expectations when coming to therapy they want to be able to keep coming back and seeing improvement if they don’t feel their expectations are met they might not come back. Therefore it’s important to be aware of what they are saying during an intake and even in early sessions. Even if it’s a small situation, as therapists we need to be aware of the situation and see how the situation can affect the client in the beginning rather than finding out later in multiple sessions. Being able to have a strong understanding of the client benefits in success; having not a successful understanding can cause difficulty in the client having a great outcome throughout their therapeutic journey. Building rapport is important as well throughout the early sessions, you want the client to feel as comfortable as they can be with expressing how they are feeling with emotions and thoughts. Along with building rapport it can significantly help the therapeutic relationship. You will be able to see the clients progress and the client really digest their emotions which will make them want to keep coming back as they see the improvement within themselves.
2/ As a beginning therapist being confronted with a suicidal client my initial concerns are assesing the client properly and making sure I ask the right questions but also making sure that the client is comfortable with the questions being asked. I worry about missing a small component as they are describing their thoughts that had significant meaning like warning signs. I would also have concerns about their safety and what their environment at home is like as I would need to gain more insight on their feelings and what their intention is. I know I will be empathic, and prioritize clients safety but It still can worry me if I make the right decisions in the given situation.
Oct 15, 2026 @ 13:53:47
Oct 17, 2026 @ 21:36:03
Hi Kayla,
I like that you connected understanding a client’s presenting problem to planning what assessments should be done. You also make a good point that while it’s nerve wracking to encounter clients who are suicidal, that is why assessments are used! Assessments are a good tool to help measure severity and level of danger when worried that a client is suicidal.
Oct 17, 2026 @ 23:34:27
Hi Kayla,
I really like how you mentioned the 5 p’s for understanding client problems early in therapy. I think that’s an important point to get an accurate understanding of the client and like you said can help with the treatment plan in planning the right steps to take next. I also relate with you on being confronted by a suicidal client as it is nerve racking we will improve with more pratice I think thought it can be challenging in the beginning. Great Post!
Oct 15, 2026 @ 13:54:52
(1) Share your understanding on why it is important to get an accurate understanding of the client’s problems early in therapy (i.e., intake/early sessions).
First, it is important to understand the client’s problems thoroughly within the first few sessions; the severity, frequency, and impact of a problem guide the treatment plan. Through the intake and the exploration stage typical of the first few sessions, therapists can ask questions to get to know the client and understand why they are in therapy. For example, if a client’s presenting problem is the inability to leave their house due to fear and sometimes struggles with low mood, the treatment plan will focus on the agoraphobia, since its severity, frequency, and impact are greater on the client’s life than occasional low mood. However, if the client mentions their infrequent low mood and the therapist focuses on that aspect, the treatment plan would reflect a poor understanding of the client. That treatment plan would not accurately combat the presenting problem.
Also, it is important to thoroughly understand the client’s problems early in the therapy process since a therapist can determine whether counseling can be effective for the client. Sometimes, therapy may not be impactful on a person. This may be due to therapist-client misconnection, the type of modality the therapist is trained in, or lack of factors that would facilitate change. For example, a client comes in and states their presenting problem is feeling detached from their body, a sense of unreality, and a sense of distorted perceptions. If the therapist is not knowledgeable in dissociative disorders, their counseling would probably not be effective for the client, who is exhibiting symptoms of depersonalization. It is not that therapy will not work for this client, but the type of modality and expertise the therapist has may not be efficient to promote change and growth. Also, therapists and clients do not always make a good fit: personality, expectations, and modality dissimilarities may lead the client to either no longer continue therapy or may not impact the client in a desired way.
Foremost, understanding the client’s problems is the outcome the client experiences. Research has supported that a therapist attending to a client’s presenting concern correlates with greater effective outcomes. Throughout the intake and early sessions, building rapport is crucial not only in fostering a safe space for the client, but it can be a mechanism for growth. Careful and considerate questions and restatements and attentive nonverbals help aid this process.
(2) Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety provoking. Share a few of your initial concerns when (not if) you are confronted with a suicidal client. (Keep in mind, you will learn a lot more about responding to suicidal clients in future classes and on your practicum/internship.)
My concerns when being confronted with a suicidal client are not assessing the client as having severe enough ideation, not recognizing subtle phrases or nonverbals that may indicate suicidal ideation or intentions, implementing a modality that is not adequate for them, or the client eventually committing suicide. If I interpret the client as being within the mid-range of suicidal ideation or intention and they’re more severe, it may lead to potential action by the client or a wrong treatment plan. Also, certain subtle phrases or nonverbals that clients exhibit indicate their potential suicidal ideation may be difficult to catch. Since these behaviors differ, being able to pick up on the differing phrases and mentioning them to clients may be grueling. Lastly, my biggest concern is if a client declares suicidal ideation and eventually commits suicide. I would feel guilty and think I am an inadequate therapist and that I could have done something to prevent it.
Oct 17, 2026 @ 22:48:41
Hi Ashley! I like the points you make about treatment plans, especially since those first few sessions really impact the therapeutic alliance and prevent early termination. I especially liked how you discuss choosing the correct modality for each client and their presenting problem- a client with severe PTSD might need to learn somatic processing before they could learn why they reacted a certain way to a situation.
I like how you mention nonverbals- suicidal clients with a plan may not discuss their intentions, but they make seem to have randomly higher energy, be giving things away, or start engaging in unusual behavior. Being aware of these nonverbals will not only make us better therapists, but could lead to preventative action occurring.
Oct 15, 2026 @ 14:20:25
(1) From my understanding, it is important to get an accurate and relevant information on a client and their problems, specifically from intake, initial interviews, and throughout the early sessions, because it is the foundation of the therapeutic relationship, create rapport to develop working alliance, and eventually is the basis for influencing treatment moving forward. Rapport is the fuel for the future of the therapeutic relationship. Throughout sessions, the therapeutic relationship may be harmed due to the therapists job to challenge the client. What is important is the repairing of that relationship which can only happen if there is a proper foundation to that relationship between client and counselor formed through the working alliance hence the importance of those first interactions.
(2) I am concerned when confronted with a suicidal client that I will be hesitant due to the anxiety that comes with it. I am concerned that I will not be able to conduct proper therapeutic interventions to effectively and thoroughly support their needs. I am also worried that I would not be able to properly assess the magnitude or degree of their ideations. I am afraid of the false negatives that could be the lack of recognition of suicidal ideation and behaviors when they really do have them and could lead the commitment of suicide. In addition, I worry about walking the line of sensitivity to the topic to serious clinical intervention and in intervention, relying on fixing. As therapists I know we are not supposed to “fix” but in the face of someone with suicidal ideation I think the anxiety I may feel in response to it may cause a default of “fix”.
Oct 17, 2026 @ 00:08:22
Hi Payton!
You bring up a great point that having an accurate understanding of a client’s problem is essential as it is the “foundation” for the rest of therapy. If the foundation is strong and the therapeutic relationship is threatened later on, repairs can be made more easily.
I also have the same worry about the urge to “fix” clients who are suicidal. It is a valid worry to have and is a good sign that we will take the matter seriously. I believe with experience and knowledge we will gain the ability to assess and intervene in such situations properly.
Oct 17, 2026 @ 21:47:01
I like how you explained the importance of building rapport early on and how it can help repair the therapeutic relationship if challenges come up later. I agree that having a strong foundation is important, especially when a counselor needs to challenge a client or discuss difficult topics. I also understand your concerns about working with a suicidal client because it can be intimidating to assess the severity of their thoughts while making sure they feel supported. I think it is important to remember that we cannot fix everything for our clients, even when we really want to help. Instead, we can listen, ask the right questions, and work with them to find the support they need. I think learning how to manage our own anxiety in these situations will be an important part of becoming effective counselors.
Oct 15, 2026 @ 22:58:42
Having knowledge of a client in the initial or early stage in counseling is very important since it offers the therapist or counselor a broad overview of what the client is undergoing and the type of help that may be required. Information regarding the client’s symptoms, relations, background, strengths and goals is gathered in the first few sessions. Misinterpretation of the primary concern of the client by the therapist can result in a mismanagement of treatment. I also believe that the process of assessment needs to continue through the entire session because it may not be easy for the clients to open up during the first session. In other words, the development of a trustful relationship is needed for the therapist to get more information about the client. a good initial assessment is also crucial for identifying urgent issues.
Being a beginner therapist, having to evaluate a client that poses a risk of committing suicide is going to make me fear the task due to the severity of the issue. My primary worry would be my inability to ask all the necessary questions as well as getting to know how threatening the client is. I would have to determine where the line of confidentiality is drawn when it comes to situations where intervention is necessary from other people especially supervisor. It is important for me to stay calm, listen carefully, ask straightforward questions about the client’s well-being and thoughts, and seek supervision in case I am not sure what to do.
Oct 17, 2026 @ 13:09:33
Hi Jude! I really like the point you bring up about how, while it’s important to get as much information as possible from the client in the initial sessions, they may not be fully willing to tell you everything at first. Therefore, it’s important to continue gaining new information from the client and potentially altering the treatment plan as the therapeutic alliance improves.
I also agree with you that asking the necessary questions to gauge suicidality and determining when to break confidentiality will likely be difficult, especially as a beginning therapist. I brought up the importance of practice and supervision in dealing with these situations in my response as well. I like how you specifically mention staying calm, listening carefully, and asking straightforward questions. I think those are great skills and strategies to use when dealing with difficult circumstances like these.
Oct 17, 2026 @ 22:36:04
(1) Share your understanding on why it is important to get an accurate understanding of the client’s problems early in therapy (i.e., intake/early sessions).
My understanding of why it is important to get an accurate understanding on the clients problems early in therapy such as in the intake/early sessions is because it helps you understand why they are seeking treatment and gives you an idea of what should be tackled first. Getting a good grasp of the clients current problems is important because it helps you assess risk, as well as glimpse of how ready or not ready a client is to work on themselves and their problems. Additionally it can be dangerous if you do not get a good understanding of what is going on with the client for example previous suicide attempts or hospitalizations or self harm or trauma and also things like medical problems such as seizures or drug use/abuse knowing about them can get flags raised quicker and have safety plans in place or talked about. Also knowing the family dynamics and how they spend alone or social time is important to their problems for instance what if family members supply drugs or alcohol or are actively mentally ill and could pose a danger to the client or make the client worse by acting as a trigger for them and dangerous or reckless behaviors. Reasons such as that as well as what has a hasn’t worked in managing their problems in past is also good to know so can tailor therapy to them and either continue what has worked or know to not do with the client also past diagnosis are helpful to medical and physical though should do a proper assessment regardless on their diagnosis as past ones could have been given incorrectly or without all the proper information and thus led to them receiving wrong treatment or not given chance to get certain services or referrals. These are some of the reasons based on class and my own experiences and thoughts not just from class directly or textbook etc.
(2) Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety provoking. Share a few of your initial concerns when (not if) you are confronted with a suicidal client. (Keep in mind, you will learn a lot more about responding to suicidal clients in future classes and on your practicum/internship.)
A few of my initial concerns of when being a beginning therapist or on internship/practicum would be that a client could be suicidal but be really good at hiding it, or they may have suicidal ideation but don’t want to share the severity of their thoughts/intentions/planning out of fear of being hospitalized or afraid that I would have to break confidentiality. Additionally another one of my concerns that brings up some anxiety is when assessing for suicide and knowing they have access to a gun, which would be a huge red flag and also maybe something that should be asked during intake regardless of suicidality perhaps now that I think of it, but I digress. My concern with them having a gun would be primarily for future risks and ability of successful completion by the client down the line, as it can be tricky to make sure they don’t have access if you can get it removed, but they could have a back up they don’t tell you about or could lie and say they have someone holding it for them, as far as I know police cannot go into their house and search for and remove a gun especially if it belongs to someone else in the household if it is properly secured and legally obtained. Another thing that would be on my mind and may provoke anxiety is say the client is suicidal actively in the office if they have a weapon on them, since sometimes a person can be suicidal or homicidal I am not sure of the incidence of both, especially if they are court ordered for something like anger, what if they get angry and display suicidal or homicidal thoughts actively while I am trying to assess them. I am not to concerned about how to respond to a suicidal client but I suppose rather the afterwards part such as the before they are hospitalized or if they get to the ER and the psych ward decides they don’t meet the criteria and releases them or doesn’t properly watch them and they leave.
Also what if am not physically their with the person and they are only texting me saying they are having thoughts and I do an assessment but don’t know where they physically are and they hang up before their phone can be pinged by the police etc.