When a client is having suicidal thoughts, what should be the counselor's primary course of action?

When a client is experiencing suicidal thoughts, the counselor's primary course of action should focus on addressing the degree of risk. This involves a thorough assessment of the client’s current situation, including their level of suicidal ideation, any plans they may have made, the lethality of such plans, and their access to means.

Understanding the risk level is crucial as it guides the counselor in determining the appropriate interventions and necessary steps to ensure the client's safety. Immediate safety concerns must be prioritized, which may include creating a safety plan with the client or considering more intensive interventions such as hospitalization if there is a high risk of imminent harm.

Conducting a full psychological evaluation, while important for understanding the client's overall mental health status, may take more time than is appropriate when urgent safety concerns are present and should not delay immediate risk assessment.

Referring the client to a psychiatrist or providing medication are also important components of the overall treatment plan, but these actions come after the counselor has established the client's level of risk and determined a safety plan. Addressing risk first ensures that the client is safe and secure before proceeding with further treatment options.