Counseling and the Triage Assessment Form

Abstract

Triage assessment is valuable in managing psychological patients since it helps identify crucial psychological factors causing risks to the patient’s safety. A 7-year-old girl named Alexa is identified in the following paper who shows signs of stress and anxiety with a previously exhibited intention of committing suicide. She is a Hispanic girl who feels unwelcome and unwanted at home and school. She argues much when her parents assert that getting engaged in school activities diverts her mind from uninvited thoughts of killing herself. With the help of triage assessment, the problems identified in the affective domain are anger, a feeling of worthlessness, and suicidal intention. The behavioral domain shows avoidance behavior. The cognitive domain shows a loss of safety, self-concept, personal integrity, and complicated social relationships. Her total score is between 14 to 17. Diagnostic skills, techniques, and developmental and cultural considerations for her intervention are suggested in the last sections of the paper.

Counseling: Using the Triage Assessment Form

Crisis Event

Alexa, 17-year-old, is a Hispanic female that shows signs of anger, depression, and worthlessness and is unwelcome at home and school. She attended counseling sessions for the past eight years but withdrew, feeling that it was useless and that time should be spent with her friends instead. She also attempted suicide by taking her father’s pills. Her mother also found a bottle of vodka with some pills in her room one day, which are more problematic signs of her condition.

Affective Domain

· Anger/Hostility: It is considered a primary effect with a rating of as she shows signs of anger periodically with her parents. She gets easily irritable and complains about strict curfew times and being insistent about engaging in school activities.

· Feeling of worthlessness: It is considered a secondary effect with a rating of 2. After withdrawing from counseling sessions, Alexa felt valueless at home and school; however, this feeling seemed to curb when she was with her beau and her friends. Still, this change is troublesome as she seems to be engaged in drinking and taking the wrong pills, as found by her mother in her room.

· Suicidal intention: It is considered a tertiary effect with a rating of 3; however, the riskiest one. Since she has attempted suicide once and did not attempt it again even after having withdrawn from counseling sessions, it does not seem to be a high threat.

Affective Severity Scale

The number that most closely corresponds with the client’s reaction to the crisis is highlighted below:

No Impairment

Minimal Impairment

Low Impairment

Moderate Impairment

Marked Impairment

Severe Impairment

Behavioral Domain

Avoidance behavior is predominantly used and deemed primary, with a rating of 1. Alexa avoided counseling sessions, perceiving them as useless; thus, a withdrawal outcome is observed. Alexa also avoids school activities as she feels she is unwanted in school. She also avoids her beau despite mentioning that they are close to each other but without serious intimacy. She is repellant to her parents’ questions involving curfew time and repeated inquiries.

Behavioral Severity Scale

The number that most closely corresponds with the client’s reaction to the crisis is highlighted below:

No Impairment

Minimal Impairment

Low Impairment

Moderate Impairment

Marked Impairment

Severe Impairment

Cognitive Domain

· Physical transgression with loss of safety is evident in Alexa’s case. The threat to Alexa’s safety is prominent since she found a bottle of vodka and some pills in her room. Moreover, her attempt to suicide is another clear sign of the same transgression. For this cognitive domain, its rating is 1.

· Psychological transgression is seen with a loss of self-concept and threats to emotional well-being. Alexa feels unwelcomed, unwanted at school, and worthless at home. The assigned rating is 2.

· Social relationships with her friends seem fine as she skipped school and might have gone out with her friends, who might not be good company as she seems to indulge in drinking and pills. Her statement about her beau also appears fine if her intimacy factor is disregarded. However, social relations at school and home are not working well. The assigned rating is 2 for this, too, as it is equally important.

· Moral transgression with loss of personal integrity seems to be fading. Alexa showed slight impairment while controlling herself in front of her parents and was easily agitated when they contently asked her to engage in school activities. The state of her soundness is somewhat lost. Its rating could be 3.

Cognitive Severity Scale

The number most closely corresponds with the client’s reaction to the crisis is highlighted below.

No Impairment

Minimal Impairment

Low Impairment

Moderate Impairment

Marked Impairment

Severe Impairment

Domain Severity Scale Summary

Affective: 6-7

Cognitive: 4-5

Behavioral: 4-5

Total: 14-17

Triage Assessment of the Client

With the domain severity scale summary, Alexa seems to require code C mental health intervention since she has a history of suicidal intention and depicts a high risk for self-harm (Victorian Government Department of Health, 2010, p. 42). Bottles of vodka and pills show that she is psychologically unstable with mood instability. Feelings of worthlessness and showing anger numerous times need mental health responses within the next eight hours (Victorian Government Department of Health, 2010, p. 42).

Diagnostic Skills and Techniques

Crisis assessment and treatment teams (CATT) are suggested for code C patients. As the case of Alexa is critical since she is a teenager, suicide intention could be repeated. Female adolescents tend to show higher signs of suicide attempts that are a high risk to their mental health (Nguyen Thi Khanh et al., 2020). Further, her slow self-esteem and loss of personal integrity indicate harm-based measures that are negative-risk factors asking for quick intervention (O’Beagloich et al., 2020). Alexa’s more historical details are required about what triggered the psychological instability that led her to rake counseling sessions, from which she has now withdrawn. However, her poor relationships at school and with her parents are associated with her depression, including low mood, avoiding engaging in social activities, and progressing toward harmful activities like drinking and taking unprescribed pills.