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 If something breaks / supplies run out and Building emergencies — Reliance Properties contacts #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
• Peer consultation
• Session structure — minimum standard
• Urgent concerns escalation pathway
• Non-urgent escalation pathway
• Safety checklist — what to do first
• Safety plan template
• Suicide assessment checklist
• No harm contract template
• Referral and transfer process