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Read the following vignette: Ralph is a 28-year-old white male who self-referred to the intake office today. You are being told he needs to see someone immediately and so you make room for him in your schedule. Before meeting with him, you review his intake paperwork including an intake questionnaire. He reported that he recently got back from deployment, but there are no additional details about his rank or nature of deployment. On the question of whether he is currently suicidal, he wrote that he planned on hanging himself but that he owns a gun and has also considered using that. Ralph further reported having made suicidal plans in the past, but never acting on them. He describes his distress as an 8 on a scale of 1 to 10. There is no indication on the intake as to why. He does report a substance dependence history (alcohol) and has been divorced in the last year. He is in an AA support group but has never been to individual therapy before. There is no report of sleep or appetite concerns. Using what you have learned in class about suicide assessment and in the readings, summarize your initial impressions of Ralph. Your summary assessment should reflect on what stands out to you regarding desire, capability, intent, buffers, risk formulation, recommendations for safety planning, and recommendations for next steps. Remember, you are reviewing this paperwork and about to work into an initial session with Ralph so really be thoughtful about how you would move forward.
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