You are the on-call crisis psychologist for Mercy Hospital. Cassandra Smith is a 21-year-old black female who has been brought in to the crisis center in handcuffs and leg chains. She appears disheveled, she is talking to herself, and has bruises all over her face and body.

You are told by the officers who bring Cassandra in that she is being detained for a fight with her boyfriend. There is indication that she may have killed him, but it is not confirmed. Throughout the interview, she is unable to directly answer your questions and often smiles when talking about important negative information. She indicates that she was not born in the U.S., and when living in another country she often saw her mother get physically and sexually abused by her father and grandfather, and she also indicates she thinks this happened to her too. She also states that her father was an alcoholic and her brother has struggled with heroin addiction.

When you ask about suicidal ideation, she denies any thoughts, but when asked about homicidal ideation she states that she “feels like killing someone, to see how it feels to take someone’s life.” She doesn’t know who, but wants it to be a family member for all the “stuff they put her through.” When asked about her sleep, she indicates nightmares in which she begins to sweat and curls up in a ball when she thinks about her father.

Throughout the entire interview, the police officers are standing over her and listening. They refuse to leave because she is in custody. About 30 minutes into the interview, Cassandra wants to stop and go home. When the officers indicate that she cannot leave, she becomes verbally abusive and starts to yell and curse at them.