I just need responses to these two discussion post that are attached.

Respond to the following:

• Provide      suggestions to manage the emotional responses your colleague identified.
• Explain why      consideration of culture is important when working with diverse clients.

                                                      Posted By Karis Robinson

Overall, the interview of suicide risk with Tommi was very impressive. It was clear that Sommers-Flanagan was understanding, empathetic, and was reassuring Tommi that her feelings were normal (2014). One aspect of the interview that was interesting was the cultural check. Sommers-Flanagan did a great job at asking questions about the clients background if they did not understand (2014). The interview had a cognitive triad assessment. This covered how the client felt about themselves, the world, and the future. Sommers-flanagan also did a great job at asking direct questions about a touchy subject such as suicide,and was genuine and allowed the client to feel comfortable enough to talk (2014). When Sommers-Flanagan asked about a plan to commit suicide, and the client shared her plan, Sommer-Flanagan used empathy and reminded her of reasons to live (2014). It was surprising that she would shoot herself because often times, when women commit suicide, they would not use a gun. 

Safety planning is key when working with a suicidal client. When working with a suicidal client it is important that the ideas for the safety plan come from the client. This is to ensue they are capable and willing to do what is on the safety plan. This worker would meet with the client weekly, ask how they are doing, and do a mental status exam every week (Sommers-Flanagan, 2014). 

Due to the clients cultural background, it is important to think about how this may factor into her suicide plans. The Cultural Theory and Model of suicide could definitely be used in this case (Chu et al., 2013). This was developed to see the cultural differences in the major risk factors over four different minority groups (Chu et al., 2013). The Cultural Assessment of Risk for Sucide also will assess cultural factors that are not in a typical suicide risk assessment (Chu et al., 2013). 

                                                Posted by Leticia Cortez

Identify and discuss elements of Dr. Sommers-Flanagan’s suicide risk assessment.

Dr. Sommers-Flanagan’s engage in culturally chick- with Tommi to implement cultural sensitivity. Throughout the initial assessment, he focused on asking questions related to her cognitive thoughts of self and future. Then, he transitioned to physical and social symptoms; if sleep or eating habits have changed, or friends and current environments. Dr. Sommers-Flanagan then transitioned into asking more direct questions towards thoughts of death/ suicide, her thoughts other than suicide, and her plan to end life. He attempted to balance the interview between the negative thoughts and the positive thoughts. 

Describe the elements of safety planning that you would put in place as Tommi’s social worker in the first week and the first months.

Developing a plan of safe care with Tommi and her family will give everyone in Tommi’s immediate environment to have the same awareness of the intensity of her thoughts and what they need to know to be prepared. Other elements to include is removing the items or removing her from the area of harm (CPI). Tommi has mentioned she would use in the home for harm, the bullets, the guns, the ropes, and anything that can be used to create hanging-like items. Discussing identifiers (behaviors, topics, etc.) that can trigger death and suicide thoughts (CPI). Within the first-month using family therapy to discuss behaviors and progress and a bi-weekly assessment for suicide thoughts to assure feelings are decreasing and not increasing.  This would allow a better opportunity for saving a life and/or preventing a death (CPI).

Identify a suicide risk assessment tool you would use at future sessions to identify changes in her risk level. Explain why you would use this tool.

The Columbia-Suicide Severity Rating Scale (C-SSRS) is an assessment tool I would use because it is available to be given in 103 languages and has been created for multiple settings whether it is hospital, clinic, or officers (CPI). It has been used at “intakes, every visit since the last session, when a client is insignificant stressors, when appropriate, day programs, ACT team, residential settings, as an agency or state policy”(CPI). The is a direct approach to the suicide assessment that has been created to be flexible and straight to the point, using terminology that is understandable to most clients. 

Explain any adjustments or enhancements that might be helpful given Tommi’s cultural background. Support your ideas with scholarly resources.

An enhancement to use in the case of Tommi is Elders’ resilience by implementing a “cultural-grounding intervention to promote resilience through connection, self-esteem, and cultural identity/values” (O’Keefe, Haroz, Goklish, Ivanich, Cwik, & Barlow, 2019). In the session, Tommi had a positive happy response when spelling out her tribe’s name. The use of cultural tradition and prevention interventions by the use of Elders of tribes teaching youth about their language, cultural knowledge, stories, and concentration on respect and sacredness of life (O’Keefe, Haroz, Goklish, Ivanich, Cwik, & Barlow, 2019). Implementing these talks and encouragements would help Tommi reconnect with her tribe and rebuild their memories of her tribe in Alaska.