Deliberate Practice in Assessing Self-Directed Violence

Deliberate practice exercises help trainees gain competence in evaluating clients' risk for suicidality and other self-harming behaviors in a variety of contexts while honing their own therapeutic styles.

These exercises present role-playing scenarios in which two trainees act as a client and a therapist, switching back and forth under the guidance of a supervisor. The therapist improvises appropriate and authentic responses to client statements organized into three difficulty levels--beginner, intermediate, and advanced.

The first 10 exercises review skills that can be incorporated into any approach to assess self-directed violence (SDV), such as exploring the deeper meaning behind statements that indicate a desire to engage in SDV, asking scaling questions to assess the likelihood of acting on these desires, collaborative safety planning, and communicating with clients about the therapist's ethical and legal responsibilities to report SDV and seek involuntary hospitalization if necessary. Two comprehensive exercises follow in which trainees integrate these skills into a transcribed session and mock therapy sessions.

Step-by-step instructions guide participants through the exercises, identify criteria for mastering the skills, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.