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May 8, 2023 16 mins

[Content advisory: This episode includes discussion of client suicidality. If you or someone you know is considering suicide, call 988.]

Exams have been criticized for how they treat information about a client's culture. Resisting stereotyping is an important clinical and test-taking skill, but race weighs more heavily on mental health licensing exams than you might expect.

This question comes from Preparing for the 2019 California Clinical Social Work Law & Ethics Exam. You can find the 2023 edition here.

A therapist is deeply concerned about her young adult client from Central America, who has been gradually weaning herself off of mood stabilizing medication. The client’s doctor advised against the change, and the client has begun exhibiting risk-taking behavior including high-stakes gambling, experimentation with psychedelic drugs, and running barefoot on a freeway. In session, the client says she is planning her suicide, and that she has bought a gun. The therapist should:

  1. Assess the client’s history.
  2. Move toward hospitalization.
  3. Contact the client’s physician.
  4. Understand the suicidality as a side effect of discontinuing the medication.

Intro/outro music: "Swampy Lands" by Adam Saban, licensed via Soundstripe.

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