Clinical Confidence in Risk Assessments of Suicidal Clients: An Intervention Study.

This paper reports on factors associated with clinician confidence in the assessment of suicide risk and the ability of an educational intervention aimed at improving decision-making in experienced clinicians to influence clinical confidence. Two aspects of clinical confidence were considered: (1) o...

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Published in:Clinical Social Work Journal Vol. 54; no. 1; pp. 32 - 44
Main Authors: Regehr, Cheryl, Birze, Arija
Format: Article
Published: Springer Nature Mar2026
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Mar2026
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      pub: Springer Nature
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        10.1007/s10615-024-00965-8
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        atl: Clinical Confidence in Risk Assessments of Suicidal Clients: An Intervention Study.
      aug:
        au:
          Regehr, Cheryl
          Birze, Arija
        affil:
          https://ror.org/03dbr7087 Factor-Inwentash Faculty of Social Work, University of Toronto, 27 King's College Circle, M5S1A1, Toronto, ON, Canada
          https://ror.org/03v6a2j28 Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
      su:
        Suicide risk factors
        Mental health services
        Psychological burnout
        Hospital care
        Confidence
        Quantitative research
        Suicide
        Psychological stress
        Education of physicians
        Risk assessment
        Digital technology
        Statistical correlation
        Psychology of physicians
        Scale analysis (Psychology)
        T-test (Statistics)
        Research funding
        Questionnaires
        Decision making in clinical medicine
        Physicians' attitudes
        Wearable technology
        Descriptive statistics
        Pre-tests & post-tests
        State-Trait Anxiety Inventory
        Longitudinal method
        Heart beat
        Clinical competence
        Research
        Physiological stress
        Data analysis software
        Patient monitoring
      sug:
        subj:
          Suicide risk factors
          Mental health services
          Psychological burnout
          Hospital care
          Confidence
          Quantitative research
          Suicide
          Psychological stress
          Offices of Mental Health Practitioners (except Physicians)
          Psychiatric and Substance Abuse Hospitals
          Residential Mental Health and Substance Abuse Facilities
          Offices of physicians
          Offices of Physicians (except Mental Health Specialists)
          Education of physicians
          Risk assessment
          Digital technology
          Statistical correlation
          Psychology of physicians
          Scale analysis (Psychology)
          T-test (Statistics)
          Research funding
          Questionnaires
          Decision making in clinical medicine
          Physicians' attitudes
          Wearable technology
          Descriptive statistics
          Pre-tests & post-tests
          State-Trait Anxiety Inventory
          Longitudinal method
          Heart beat
          Clinical competence
          Research
          Physiological stress
          Data analysis software
          Patient monitoring
      keyword:
        Clinical confidence
        Clinical performance
        Decision-making
        Psychology and Cognitive Sciences Psychology Medical and Health Sciences Public Health and Health Services
        Suicide risk assessment
        Clinical confidence
        Clinical performance
        Decision-making
        Psychology and Cognitive Sciences Psychology Medical and Health Sciences Public Health and Health Services
        Suicide risk assessment
      ab: This paper reports on factors associated with clinician confidence in the assessment of suicide risk and the ability of an educational intervention aimed at improving decision-making in experienced clinicians to influence clinical confidence. Two aspects of clinical confidence were considered: (1) outcome-based confidence regarding the ultimate decision whether or not the client required hospitalization due to suicide risk; and (2) process-based confidence regarding clinician performance during an interview. The intervention combined: risk assessment interviews with simulated clients; classroom-based education on decision-making science; practice-based self-monitoring with the aid of wearable technology; and classroom-based group and individual opportunities to engage in discussions regarding clinical decision-making. Results revealed that while there was wide variability in clinician decisions regarding hospitalization, participants were equally confident in their suicide risk assessment process and clinical performance regardless of the final decision. Confidence in clinical decision-making was negatively associated with psychological stress and physiological stress, as well as emotional exhaustion on the Maslach Burnout Inventory (MBI) and positively associated with the personal achievement scale of the MBI. Confidence in clinical performance was negatively associated with psychological stress and both emotional exhaustion and depersonalization on the MBI. Confidence in clinical decision-making did not significantly increase following the educational intervention, however, there were some modest increases in confidence in clinical performance that approached statistical significance. These findings raise new questions regarding clinical confidence, separating different aspects of clinical confidence and investigating further the association between clinical confidence and client outcomes in social work.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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