In CBT practice, how should suicide risk be managed as part of a stepped approach?

• A. Only document risk in the chart without action.
• B. Ignore risk if the client denies current intent.
• C. Screen for intent and plan, assess access to means, create a safety plan, involve crisis resources if needed.
• D. Refuse to involve caregivers due to confidentiality.

Answer: (C)

Managing suicide risk in CBT practice means taking a proactive, stepped approach that moves from assessment to concrete safety actions. The essential move is to screen for intent and plan, since knowing whether there is a current aim or a specific plan directly informs how urgent the response is. Assessing access to means is crucial because it identifies practical risks that can be mitigated immediately. From there, a collaborative safety plan helps the client build coping strategies, identify support networks, and set steps to reduce risk if warning signs reappear. When needed, involving crisis resources ensures the person has timely access to higher levels of support, which is especially important if danger is imminent or the client cannot keep themselves safe. This approach respects safety as the priority while keeping therapy collaborative and structured, allowing ongoing care to continue in a controlled way.

Other options miss the mark because they skip or downplay action. Merely documenting risk without any safety steps leaves the client vulnerable. Ignoring risk when there’s no stated intent ignores the possibility of future escalation. And confidentiality has limits in high-risk situations—safety and appropriate crisis intervention take precedence to protect the person, often involving crisis resources or additional supports as needed.