Clinical Consultation & Escalations (Associate Handbook)

This section covers when and how associates escalate concerns and get support.

When to consult

• Consult with Katherine if there is clinical uncertainty, ethical concerns, boundary concerns) -It is understood that associates are also consulting with their private supervisors and may or may no need supervision with Katherine for clinical uncertainty.
• Urgent concerns and escalation pathway (who to contact, when) #Suicidal intent or planning: -Do suicidal assessment and document in Jane -If the client is deemed to be high risk for acute suicidality: call 911 and report to Katherine immediately -If the client is not acutely suicidal and low risk then: -Establish safety plan with the client -Obtain a contract of no harm with the client -Report the suicidal concerns/assessment to Katherine
• Safety concerns documentation expectations (what to record, where)
• Transfer/discharge considerations (how to involve owner/admin)
• Office/building emergencies (facilities contacts): see ../Policies_and_Expectations/If_Something_Breaks_or_Supplies_Run_Out.md and ../Policies_and_Expectations/Building_Emergencies_Reliance_Properties_Contacts.md #Associate personal safety concerns: -If you feel unsafe with a client, report immediately to Katherine -Acute sense of lack of safety: end session and report to Katherine -General but not immediate lack of safety: escalate to Katherine as soon as possible -If it is an emergency situation, call 911 and report to Katherine as soon as possible.

Procedures to add next (placeholders)

• Escalation pathway (non-urgent vs urgent)
• “If I’m worried about safety” checklist (what to do first, who to contact)

New drafts (owner to finalize)

• ./Routine_Supervision_Consultation.md
• ./Peer_Consultation.md
• ./Session_Structure_Minimum_Standard.md
• ./Urgent_Concerns_Escalation_Pathway.md
• ./Non_Urgent_Escalation_Pathway.md
• ./Safety_Checklist_What_To_Do_First.md
• ./Safety_Plan_Template.md
• ./Suicide_Assessment_Checklist.md
• ./No_Harm_Contract_Template.md
• ./Referral_and_Transfer_Process.md