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Using the Triage Assessment Form

Using the Triage Assessment Form

The case of Alexa, a 17-year-old Hispanic female who ran away from home, will be discussed in this paper. Alexa suffers from depression and attempted suicide once before by taking her father’s prescription medication after being returned home by the police to flee. She is enraged at her parents and does not feel wanted at school or at home. Alexa’s mother discovered a bottle of vodka and a bottle of pills in her daughter’s room just weeks after her first suicide attempt. Alexa skipped school twice in the last week, and she refuses to tell her parents where she was or what she was doing. Alexa will be given the Triage Assessment Form (TAF) by the crisis worker. The TAF is a quick and efficient tool that collects real-time data on what is going on with a client (James & Gilliland, 2017). This evaluation covers three domains: affective, behavioral, and cognitive. These three domains are assigned numeric values and categorized into a specific response modes to assist the crisis worker in determining the client’s current functioning level. The numerical ratings inform crisis workers about the extent and type of intervention that will be required (James & Gilliland, 2017).

Client Assessment of Priority

The affective domain is the first section of the Triage Assessment form. This domain is divided into three categories: anger/hostility, anxiety/fear, and sadness/melancholy. The learner gave Alexa a 2 for anger/hostility because she stated that she is angry with her parents because she believes they are too strict and does not like it when they discuss school with her. Needs frustration, such as interpersonal issues with her parents, can be the precursor to other negative emotions, behaviors, or thoughts that plunge the client deeper into crisis (James & Gilliland, 2017). Because Alexa does not exhibit Anxiety symptoms, there was no rating on this section. The learner gave Alexa a 1 in the sadness/melancholy section because she suffers from depression and has attempted suicide. Alexa received an 8 on the affective severity scale due to the gravity of the negative effects she is experiencing, such as suicidal ideation and substance abuse.

The behavioral domain was the next section in which Alexa was evaluated. This domain is divided into three sections: approach, avoidance, and immobility. Alexa received a 3 for approach because she ran away and skipped school because she felt unwanted or ineffective. Alexa received a 2 for avoidance because she skipped school, withdrew from therapy, and ran away from her parents and home. Alexa received a 1 for immobility because her depression has caused her to see suicide as a way out of her life’s circumstances. Alexa received a behavioral severity rating of 10 (severe impairment) because her behavior is erratic and harmful to herself.

The cognitive domain was the final section Alexa assessed. This section is divided into four subsections: physical, psychological, social relationships, and moral/spiritual. Each section enables the crisis worker to determine whether a transgression, threat, or loss has occurred. Alexa received a 2 for threat in the first category, physical, because she puts herself at risk of losing water, safety, and shelter when she runs away from home. Alexa received a 1 in the psychological category because she has attempted suicide in the past, is depressed, and employs maladaptive coping mechanisms such as prescription pills and medication. Alexa received a 3 in the social relationships category because her relationship with her parents is unstable. She has also expressed feelings of worthlessness and rage about living with her parents. There was no mention of moral or spiritual beliefs, so nothing was rated in the moral/spiritual category. Alexa received a 10 on the cognitive severity scale due to the risk to her well-being and the unpredictability of what she may or may not do. Alexa’s total score was 28, indicating that she may be heading in the wrong direction. At this point, the crisis worker must provide effective direction as well as a secure and safe environment to ensure that Alexa does not escalate into a fatal situation (James & Gilliland, 2017).

Techniques and Skills for Diagnosis

The ABCs of Assessing Crisis Intervention are a diagnostic skill or technique that can be used in Alexa’s case. The client’s subjective point of view and the crisis worker’s objective point of view is used to determine the severity of the crisis. The ABCs of Assessing Crisis Intervention is an objective evaluation of the client’s affective, behavioral, and cognitive state (James & Gilliland, 2017). The first category, affective state, investigates whether the client’s equilibrium is abnormal or impaired. During this portion of the assessment, the crisis worker may address the following questions: Does the emotional response match the severity of the situational crisis? Is the client denying the situation or attempting to avoid involvement? Do people usually exhibit this type of behavior in similar situations? James and Gilliland (2017).

The crisis worker then focuses on doing, acting out, behaving, taking active steps, and other psychomotor activities in the next category, behavioral functioning. In this step, the crisis worker may ask questions such as, “What could you do to regain control of the situation?” What have you done in the past to regain control in similar situations? James and Gilliland (2017). The final category in which clients are evaluated is their cognitive state. The crisis worker will assess the client’s thinking patterns in this step, aiming to answer questions such as: How realistic are the client’s thoughts about the crisis? How long has the client been contemplating a crisis? James and Gilliland (2017).

Observations, open-ended questions, closed-ended questions, clarifying, and reflecting experience are counseling skills that are implemented through the use of the Triage Assessment form and while working with Alexa. Offering and providing support and resources and stabilizing the client is critical in crisis work. Active listening, reassurance, unconditional positive regard, and acceptance are also important abilities (Cherry, 2020).

Considerations for Development and Culture in Crisis Assessment and Intervention

The characteristics of Alexa’s crisis state are related to her developmental stage. According to Erik Erikson’s theory of psychosocial development, Alexa is currently in the identity vs. role confusion stage. This is the stage at which teens explore their independence and develop a sense of self (Cherry, 2019). In Alexa’s case, she is having a major and life-altering reaction to her parents’ control over her. This is demonstrated by her rage at her parents’ strictness, her parents’ questions about school or life in general, and her having a curfew. Teen behavior can be unpredictable and rash when they are trying to find their identity (Cherry, 2019).

When working with culturally diverse people, keep in mind that culture influences how a crisis is perceived by both the client and the crisis worker. Considerations and strategies for working with diverse populations in crisis intervention include developing self-awareness of one’s own cultural biases, staying current with current events in other cultures, building cultural competence, conveying respect, developing a list of community resources, and identifying the various meanings of pain and suffering relevant to the norms of diverse cultural groups (National Association of School Psychologists, n.d.). This case study makes no mention of cultural, diversity, or gender issues, but becoming more culturally competent can assist the counselor or crisis worker in selecting the most appropriate approach and treatment. In this case, the crisis worker would provide Alexa with support and a safe place to share her experience. Due to Alexa’s high risk, the worker would ensure her physical safety and possibly place her in a psychiatric inpatient facility.


Cherry, K. (2020, May 30). How crisis counseling can help people cope with trauma. Retrieved from

Cherry, K. (2019, December 7). Identity vs. role confusion in psychosocial stage 5. Retrieved from

James, R. K., & Gilliland, B. E. (2017). Crisis Intervention Strategies (8th ed.). Boston: Cengage Learning.

Myer, R. & Conte, C. (2006). Assessment for crisis intervention. Journal of Clinical Psychology, 62(8), 59–70. Intervention

National Association of School Psychologists. (n.d.). Culturally competent crisis response.Retrieved from podcasts/diversity-and-social-justice/cultural-competence/culturally-competent-crisis- response


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Using the Triage Assessment Form

After reading the case examples in the Myer and Conte (2006) article, you have a better understanding of how to use one type of assessment tool. A Microsoft Word copy of the Triage Assessment Form (TAF) is included in the assignment Resources. The most current version of this form is also shown in your James and Gilliland (2013) text, pages 63–65. Use the form to analyze Jordan, described below. You can save the form as you have completed it as an MS Word document or as a PDF document, and attach the form to your written paper as an appendix.

Using the Triage Assessment Form

Using the Triage Assessment Form

Rate the client in each of the three domains (Affective, Behavioral, and Cognitive) using the Severity Scale included with each domain on the Triage Assessment Form (TAF) and total the scores. Describe, in detail, the rationale for your ratings, including your judgment about how intense and directive the treatment should be based on the total score. In your discussion of the rationale, summarize diagnostic skills and techniques that can be used to screen for addiction, aggression, and danger to self and others, as you note these risks in your client. Similarly, a possible co-occurring mental disorder (such as substance abuse) may become apparent during a crisis, disaster, or another trauma-causing event that ties in with your assessment during the client’s crisis. Note this as well in your rationale.

Project Objectives

To successfully complete this project, you will be expected to:

Summarize diagnostic skills and techniques used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, disaster, or other trauma-causing events.

Evaluate key elements of the crisis, disaster, or trauma-causing event including the nature of the crisis and associated risks, including client and counselor safety

Discuss developmental and cultural considerations in crisis assessment and intervention

Exhibit proficiency in effective, credible academic writing, and critical thinking skills.

Note: A template for your APA formatted paper is included in the assignment Resources. Please use the template to present the assignment criteria in an organized way. The headings guide you to the criteria, and the details that are included describe what is necessary to complete the assignment to a Distinguished degree.



Jordan arrives at counseling saying that her husband, Jake, left the house earlier that day in an agitated mood and with his rifle, and tearfully discloses concerns about her safety and his. She states that her friend, who has been worried about her for some time, insisted that she see a counselor. Jordan says she was surprised at Jake’s abrupt departure because she was unaware of any plans he had to go hunting, and if he was not going hunting, why he would take his gun out. She recalls that she and Jake had fought the previous night over his drinking. Jordan reports that she asked Jake to stop drinking so much, and in response, he threatened her and slammed a few doors. She recalls that Jake said he liked being a little drunk and pushed her back against the kitchen counter at one point. When Jake went back into a spare bedroom to sleep that night, Jordan found numerous beer bottles in the den and a large empty whiskey bottle in front of his truck. Jordan states that it was not unusual for Jake to put his rifle in his truck when he planned to go hunting, but when he had done so today, he had still been quite angry about her accusation that he was drinking too much. After he left, Jordan reports that she began shaking. She felt fear for her own safety, so she called her friend who insisted that she speak to a counselor. While Jordan was on her way to counseling, her husband called her. He seemed calm, asked about her day, and said nothing about the previous night or his abrupt departure. Jordan states that this switch in mood from extreme aggression to a pleasant tone “seems weird.” Jordan asks for help in dealing with her husband’s odd behaviors. She fears for her own safety and the safety of her husband but is unwilling to call the police. As she speaks, she is agitated and continually looks over at the doorway, as though expecting it to burst open.

Project Requirements

Content: Prepare a comprehensive paper that includes all elements described.

Components: The paper must include a title page, abstract, and reference list.

Written communication: Develop accurate written communication and thoughts that convey the overall goals of the project and do not detract from the overall message.

APA formatting: Resources and citations must be formatted according to APA (6th Edition) style and formatting.

Number of pages: The body of the paper should fall within 3–5 pages of text, plus 3 pages of the Triage Assessment Form, excluding the title page and reference list.

A number of resources: Minimum of 4 current resources, published within the last 12 years, and you may include your text as one.

Font and font size: Times New Roman, 12-point.

Submit the completed paper and form to the assignment area.

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