Deliberate Practice in Assessing Self-Directed Violence

Role-play exercises help clinicians overcome discomfort in discussing suicide and self-injury. Participants build expertise through scenarios of increasing complexity that cultivate skills in risk assessment, safety planning, and ethical client dialogue under clear, step-by-step guidance.

To help address the suicide public health crisis, this book presents deliberate practice exercises to reduce clinicians' fears of talking about suicide and self-injury with clients and assessing for risk with skill and empathy.



These exercises present role-playing scenarios in which two trainees act as a client and a therapist, switching back and forth under the guidance of a supervisor. The therapist improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced.



The first 10 exercises review skills that can be incorporated into any approach to assess self-directed violence (SDV), such as exploring the deeper meaning behind statements that indicate a desire to engage in SDV, asking scaling questions to assess the likelihood of acting on these desires, collaborative safety planning, and communicating with clients about the therapist's ethical and legal responsibilities. Two comprehensive exercises follow in which trainees integrate these skills into a transcribed session and mock therapy sessions.



Step-by-step instructions guide participants through the exercises, identify criteria for mastering the skills, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

To demonstrate how deliberate practice can be fully integrated into a professional curriculum, this series features exercises developed and refined within the clinical training curriculum at the Sentio online/hybrid marriage and family therapy (MFT) therapist training program in California, which is where we started developing this series. These exercises, which have been tested at clinical training sites around the world, are used to enhance clinical outcomes within the first hybrid MFT program approved by the California Board of Behavioral Sciences to fully integrate deliberate practice into its entire curriculum. By integrating these models into its hybrid MFT program in California, Sentio University demonstrates that therapist training graduate programs can use deliberate practice to bridge the gap between theory and clinical mastery through repetitive, feedback-informed practice to support the development of modern, outcome-focused clinicians.

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