A client reports thoughts of harming others. What immediate step is essential?

• A. Document the thoughts and plan for follow-up
• B. Conduct a risk assessment and ensure safety planning; obtain emergency precautions if imminent danger
• C. Ignore unless the client acts
• D. Refer to law enforcement immediately

Answer: (B)

When someone reports thoughts of harming others, the priority is to ensure safety through immediate risk assessment and planning. The clinician must quickly determine how real and imminent the threat is by evaluating factors such as intent, plan, means, and time frame, as well as protective factors and supports. If the danger is imminent, implement safety precautions right away—this may involve removing access to means, enacting a safety plan with the client, and, if necessary, contacting emergency services or crisis resources to prevent harm. Document the assessment and the steps taken, and seek supervision as needed to ensure appropriate action and follow-up. This approach addresses the harm risk directly and acts to prevent harm now, rather than waiting for the client to act or deferring action to later.