Lesson 10 - Ending Reviews With Clear Action Plans
1. Introduction
A mental health review should not end simply because the available time has run out. It should end with a shared understanding of what has been discussed, what will happen next and who is responsible for each action.
Reviews often cover several interconnected areas, including symptoms, risks, medication, relationships, education, employment, daily routines and progress towards treatment goals. Without a clear ending, the person may leave feeling uncertain about what they are expected to do. Members of the clinical team may also make different assumptions about which actions have been agreed.
A clear action plan turns discussion into purposeful activity. It supports continuity of care, promotes independence and makes it easier to review progress at the next appointment. It is also an important clinical safety measure because it identifies what should happen if the person’s mental health deteriorates or risks increase.
For case workers, ending reviews effectively is not about making decisions outside their competence. It involves summarising the discussion, agreeing realistic actions, checking understanding, documenting the plan and escalating matters that require senior clinical input.
This lesson builds on previous learning about preparing for reviews, assessing progress, setting goals, collaborative problem solving and supporting independence.
2. Learning Outcomes
By the end of this lesson, learners should be able to:
Explain why every review should end with a clear and collaboratively agreed action plan.
Summarise the main points of a review accurately and concisely.
Develop specific, realistic and appropriately prioritised actions with the person.
Clarify responsibility, timescales and arrangements for follow-up.
check that the person understands and agrees with the plan.
Include appropriate safety-netting and recognise when concerns must be escalated to a senior clinician.
3. The Lecture
The Purpose of the Final Part of a Review
The final few minutes of a review are clinically important. This is the point at which the practitioner brings together what has been discussed and converts it into a practical plan.
A good ending should answer six questions:
What have we understood about the current situation?
What are we trying to improve?
What has been agreed?
Who will do each action?
When will the actions happen or be reviewed?
What should happen if the situation becomes worse?
If these questions remain unanswered, the review may have provided an opportunity to talk, but it may not have produced a meaningful next step.
A clear ending also provides emotional containment. Reviews can involve difficult subjects, including distress, conflict, self-harm, trauma or setbacks. Abruptly ending after discussing these issues can leave the person feeling unsettled. A calm summary and a clear plan help the person move from exploration towards a sense of direction.
Signal That the Review Is Coming to an End
Practitioners should not allow the ending to arrive as a surprise. Approximately five to ten minutes before the scheduled end, explain that you would like to begin bringing the discussion together.
For example:
“We have about ten minutes left. It would be helpful to summarise what we have discussed and agree what the next steps should be.”
This provides an opportunity for the person to raise anything important that has not yet been discussed. It also helps maintain professional boundaries around time without making the ending feel abrupt or dismissive.
If a significant new concern is introduced at this point, acknowledge it rather than ignoring it. Decide whether it can be addressed briefly, should be recorded for a further appointment or requires immediate escalation.
For example:
“That sounds important, and I do not want to rush through it. I would like to clarify whether there are any immediate safety concerns today, and then we can agree how it should be followed up properly.”
Summarising the Review
A summary should identify the main themes rather than repeat the entire conversation. It should usually include:
What has improved.
What remains difficult.
Any important changes since the previous review.
Progress towards existing goals.
Current strengths and protective factors.
Any significant risk or safeguarding concerns.
The priorities that appear to have emerged.
A useful summary might be:
“You have been attending college more consistently and your sleep has improved since you started using a regular evening routine. Mornings remain difficult, particularly after a poor night’s sleep, and anxiety is still affecting your attendance on Mondays. You would like the immediate plan to focus on preparing for Monday mornings rather than introducing several new goals at once.”
This summary is concise, balanced and connected to the person’s priorities. It recognises progress as well as ongoing difficulty.
Avoid summaries that focus only on problems. A strengths-based summary helps the person recognise what is already working and identifies resources that can support further progress.
Check the Accuracy of the Summary
A practitioner’s interpretation may not fully reflect the person’s experience. The summary should therefore be offered for confirmation rather than presented as a final judgement.
Useful questions include:
“Does that sound like a fair summary?”
“Have I missed anything important?”
“Is there anything you would describe differently?”
“Of everything we have discussed, what feels most important to you?”
If the person disagrees, explore the difference respectfully. They may have a different priority, may not feel ready for a proposed change or may believe that an important concern has been overlooked.
An action plan is less likely to be followed if it is based on the practitioner’s priorities without the person’s agreement.
Move From Discussion to Action
A review may identify several concerns, but not every concern needs to become an immediate action. Trying to address everything at once can result in an overwhelming plan that is difficult to follow.
Begin by agreeing the main priority. You might ask:
“What would make the greatest difference before we next meet?”
“Which of these difficulties feels most manageable to work on first?”
“What is one realistic step you could take this week?”
“What support would make that step easier?”
The role of the case worker is to help the person translate a broad aim into a practical next step.
For example, “improve my mental health” is an important aspiration, but it is not yet an action. More specific actions might include:
Getting out of bed by 10.00 am on three weekdays.
Taking a ten-minute walk twice before the next review.
Contacting the college support worker by Friday.
Practising one grounding exercise when anxiety begins to increase.
Completing a sleep diary for one week.
Attending the next planned appointment.
The action should be meaningful to the person and proportionate to their current capacity.
Make Actions Specific and Observable
Clear actions describe what will actually be done. Vague plans such as “try harder”, “be more positive” or “improve motivation” are difficult to understand and impossible to review fairly.
A well-defined action should usually identify:
The activity.
The person responsible.
The expected timescale.
Any support required.
How progress will be recognised.
For example:
“Ali will contact the college wellbeing service by email before Friday. The case worker will send Ali the correct contact details today. Progress will be reviewed at the next appointment in two weeks.”
This is clearer than:
“Ali will get some support from college.”
Specificity should not become rigidity. Mental health can fluctuate, and plans may need to be adapted. The aim is to create enough clarity to support action while recognising that difficulties may arise.
Keep the Plan Realistic
An action can appear straightforward to a practitioner but feel extremely difficult to someone experiencing depression, anxiety, executive functioning difficulties, trauma symptoms or emotional dysregulation.
The plan should reflect the person’s current functioning rather than the level of functioning everyone hopes they will eventually achieve.
If someone is rarely leaving their bedroom, agreeing that they will attend several community activities within a week may be unrealistic. A more achievable first step might be sitting downstairs for ten minutes, stepping outside the front door or identifying one activity they might consider attending in the future.
Ask:
“How confident do you feel that you could do this?”
“What might get in the way?”
“Could we make the first step smaller?”
“What would help on a difficult day?”
“Is this your goal, or does it feel like something other people want you to do?”
If the person has very little confidence in completing the action, the plan probably needs to be adjusted.
Limit the Number of Actions
A short plan that is followed is more useful than a long plan that is forgotten.
There is no fixed number of actions suitable for every person, but two or three priorities will often be enough for the period between reviews. Someone who is significantly overwhelmed may need only one small action.
Additional ideas can be recorded as longer-term goals rather than immediate expectations. This communicates that they have not been forgotten while protecting the person from an unmanageable list.
Priorities should usually include anything required for immediate safety, followed by the actions most likely to support the person’s agreed goals.
Clarify Who Is Responsible
Each action should have a named owner. Avoid plans stating that something “will be arranged” without identifying who will arrange it.
Responsibility may sit with:
The person receiving support.
The case worker.
A parent or carer, where appropriate and agreed.
Another member of the multidisciplinary team.
A school, college or employer.
A GP or external service.
Only allocate actions to people who have agreed to undertake them or whose role has been appropriately confirmed. Do not promise that another professional will provide a particular intervention or response unless this has been agreed.
Where the case worker is responsible, the action should be within their role and competence. For example, a case worker may send information, support a referral, arrange a follow-up appointment or communicate an update to the clinical team. They should not independently alter medication, diagnose a condition or make a specialist treatment decision.
Agree Timescales
A plan without a timescale can easily be postponed. Agree when each action should happen and when progress will be reviewed.
Timescales might include:
“Before the next appointment.”
“By Friday.”
“Within the next seven days.”
“Three times during the coming week.”
“The case worker will speak to the supervising clinician today.”
“The team will provide an update once the referral has been considered.”
Timescales should be clinically appropriate. Urgent concerns must not be placed into a routine plan for discussion several weeks later.
If the response of another service cannot be predicted, be honest about this. State when the referral or contact will be made and how the person will be informed, without guaranteeing an outcome that is outside your control.
Identify Barriers and Contingency Plans
Before finalising an action, consider what may prevent it from happening. This is not pessimistic; it is good planning.
Common barriers include:
Low motivation or energy.
Anxiety and avoidance.
Forgetfulness or executive functioning difficulties.
Lack of transport.
Financial pressures.
Family conflict.
Unclear instructions.
Fear of failure or judgement.
The action depending on someone else.
Mental or physical health deterioration.
Help the person decide what they could do if the original plan becomes difficult.
For example:
“The aim is to attend the full lesson on Monday. If that feels unmanageable, the alternative plan is to attend for the first 20 minutes and speak to the pastoral worker afterwards.”
A contingency should support flexible progress rather than provide a reason to abandon the goal altogether.
Promote Independence Without Withdrawing Support
A clear action plan should identify what the person can do for themselves and what support is genuinely needed. The case worker should avoid taking over tasks that the person could complete with appropriate encouragement.
For example, rather than automatically making a telephone call on the person’s behalf, the case worker might:
Help them prepare what to say.
Write down the telephone number.
Practise the conversation.
Sit with them while they make the call.
Agree that they will attempt the call before the next review.
However, promoting independence does not mean withholding reasonable support. The level of help should reflect the person’s age, needs, current mental state, communication preferences and ability to complete the task safely.
The aim is supported participation, not forced independence.
Confirm the Person’s Agreement
Agreement should not be assumed because the person remained silent or did not object. Ask directly whether the plan feels acceptable.
Useful questions include:
“How does that plan sound to you?”
“Is there anything you do not feel comfortable agreeing to?”
“Which part feels most achievable?”
“Is there anything you would like to change?”
“What do you understand your next step to be?”
When working with children or young people, there may be differences between their priorities and those of their parents or carers. These differences should be acknowledged and documented. The plan should not falsely imply that everyone agreed when they did not.
Where appropriate, separate actions can be identified for the young person, family and professional team.
Use Teach-Back to Check Understanding
People may say that they understand a plan even when it remains unclear. Anxiety, distress, attention difficulties, unfamiliar terminology or the amount of information discussed can affect how much they remember.
Teach-back involves asking the person to explain the plan in their own words. It is a check on the clarity of the practitioner’s communication, not a test of the person.
For example:
“We have covered quite a lot today. Just so I can check that I have explained it clearly, could you talk me through what will happen next?”
If the person cannot describe the plan, clarify it and check again. Avoid sounding as though they are being examined.
Written information can also be helpful, particularly when there are several actions or when the person experiences memory, concentration or organisational difficulties.
Include Safety-Netting
Safety-netting explains what the person should do if their circumstances change before the next review. It is especially important when there are concerns about deterioration, self-harm, suicidal thoughts, aggression, exploitation, safeguarding or vulnerability.
Safety-netting should be specific to the situation. It may include:
Warning signs to monitor.
Existing coping strategies or protective actions.
People the individual can contact for support.
How to contact the clinical team during working hours.
What to do if risk increases.
When urgent or emergency help is required.
Case workers must follow the organisation’s crisis and safeguarding procedures. Immediate or serious concerns should be escalated during the appointment rather than left solely within a future action plan.
A case worker should never provide false reassurance that routine support will be available outside the service’s operating hours. The person should be given accurate information about urgent services and told to call 999 or attend Accident and Emergency when there is an immediate danger to life.
Safety-netting is not a substitute for clinical escalation. If the practitioner is concerned that the person may not remain safe, they must contact an appropriate senior clinician and follow the relevant risk-management procedure.
Arrange Follow-Up
The ending should clarify whether another appointment is needed, approximately when it will occur and what its purpose will be.
The person should understand:
Whether a further review is planned.
Who will arrange it.
The expected timeframe.
What will be reviewed.
What they should do if they have not received an appointment.
Whether any information or preparation is required beforehand.
Where discharge or transition is being considered, the plan should clearly identify ongoing sources of support and any outstanding actions. Ending involvement should not be presented unexpectedly at the end of an appointment.
Document the Plan Clearly
The written record should allow another member of the team to understand what was agreed without having attended the review.
Documentation should include:
A concise summary of the person’s current presentation and progress.
Relevant changes since the previous review.
Important risk or safeguarding information.
The person’s priorities and views.
Each agreed action.
The person responsible for each action.
The relevant timescale.
Any disagreement or uncertainty.
Advice and safety-netting provided.
Matters escalated to a senior clinician.
Follow-up arrangements.
Use factual, respectful and neuroaffirmative language. Avoid judgemental phrases such as “failed to engage”, “attention-seeking” or “non-compliant” without describing the actual situation and its context.
For example, rather than writing:
“She was non-compliant with the plan.”
Write:
“She reports that she did not attend the planned group because anxiety increased while she was travelling there. She would like to consider a supported introductory visit before trying again.”
The second account provides clinically useful information and identifies a possible adjustment.
Distinguish an Action Plan From a Clinical Decision
Case workers contribute valuable observations and can help people develop practical plans. However, some decisions must be made by appropriately qualified clinicians.
A case worker should escalate matters involving:
New or increasing suicidal intent.
Significant self-harm or risk to others.
Safeguarding concerns.
Suspected abuse, exploitation or neglect.
Marked deterioration in mental state.
Possible psychosis, mania or severe depression.
Significant medication side effects.
Requests to start, stop or change medication.
Diagnostic conclusions.
Decisions about treatment that sit outside the case worker’s competence.
Uncertainty about the urgency or safety of the situation.
The action plan may record that the concern has been escalated, but it should not substitute the case worker’s own decision for the required clinical assessment.
For example:
“The case worker will discuss the reported increase in suicidal thoughts with the supervising clinician immediately after the appointment and will follow the clinician’s advice regarding the next steps.”
If the concern appears immediate, the case worker should not wait until after the appointment to seek help.
Ending the Conversation
After confirming the plan, finish the review in a calm and deliberate way.
A useful closing sequence is:
Summarise the main themes.
Confirm the agreed priorities.
State each action, owner and timescale.
Check understanding and agreement.
Confirm safety-netting.
Confirm follow-up arrangements.
Invite any final clarification.
For example:
“To summarise, your sleep has improved, but anxiety is still making Monday mornings difficult. Your action is to prepare your clothes and bag on Sunday evening and aim to attend the first lesson on Monday. Your father will help with transport, and I will send the college support contact today. If you cannot manage the full lesson, the alternative is to meet the pastoral worker when you arrive. We will review how this went in two weeks. If your distress increases or you feel unable to keep yourself safe, you should tell your father and seek urgent support using the crisis information we have discussed. Could you tell me what you understand the plan to be?”
This ending is collaborative, specific and easy to review.
Clinical Example
Amelia has been receiving support for low mood, social withdrawal and reduced daily structure. During her review, she describes spending most days in bed and feeling overwhelmed by suggestions that she should immediately return to college. She has, however, started eating breakfast downstairs twice a week.
An unhelpful ending might be:
“Amelia should improve her routine, exercise more, return to college and socialise.”
This plan is broad, demanding and does not identify responsibility, timescales or support.
A clearer ending would be:
“Amelia would like to continue building a morning routine before focusing on returning to college. She will aim to eat breakfast downstairs on Monday, Wednesday and Friday. She will use a telephone reminder at 9.30 am, and her mother will knock once at 9.15 am but will not repeatedly prompt her. The case worker will contact the college pastoral lead, with Amelia’s agreement, to ask about a gradual return meeting. Progress will be reviewed in one week. Any significant deterioration in Amelia’s mood or thoughts of harming herself will be shared with the clinical team promptly.”
This plan begins with Amelia’s current capacity, builds on an existing success and clearly allocates responsibility.
4. Clinical Perspective
Clinical Pearls
A good plan can usually be understood by someone who was not present at the review. If another practitioner cannot tell what is happening next, the plan is probably not clear enough.
The person’s own words can be especially useful when recording their priority. For example, “I want mornings to feel less chaotic” may be more meaningful than a professionally worded but abstract goal.
End with fewer actions than you initially think are necessary. A focused plan is more likely to support genuine progress.
Always include what is already working. Existing strengths, routines and supportive relationships often provide the most practical starting points for change.
Silence does not necessarily mean agreement. Check the person’s view directly.
Practical Tips for Everyday Practice
Keep a visible note of possible actions during the review. This makes the final summary easier and reduces the risk of forgetting an important commitment.
Reserve sufficient time for the ending. If every review repeatedly runs out of time before a plan can be agreed, the structure of the appointment needs to change.
Use plain language. The person should not need clinical knowledge to understand their own action plan.
Where possible, provide the plan in an accessible written format. Consider the person’s age, literacy, preferred language, communication needs and neurodevelopmental profile.
At the next review, begin by returning to the previous plan. Ask what helped, what became difficult and what was learned. Do not treat an incomplete action as a moral failure.
Common Pitfalls and Misconceptions
One common mistake is creating an action plan entirely at the end without involving the person. A plan is collaborative only when the person has had a meaningful role in shaping it.
Another mistake is confusing professional activity with progress. “Referral sent” may be an important service action, but it does not describe the person’s wider goal or what support is needed while they wait.
Avoid including actions that depend on unavailable resources. If a service has not accepted a referral, do not describe its involvement as confirmed.
Do not use safety-netting as a formulaic final sentence. It should be relevant to the person’s actual risks and circumstances.
Practitioners should also avoid promising confidentiality without limits. If information indicates a significant risk or safeguarding concern, it may need to be shared in accordance with professional and organisational procedures.
Advice for Newly Qualified Practitioners
It is acceptable to tell the person that you need to discuss an issue with a senior clinician. This demonstrates safe practice rather than uncertainty or failure.
Do not feel pressured to solve every problem within one review. Your role may be to identify the immediate priority, agree the next manageable step and ensure that more complex issues reach the appropriate professional.
When you are unsure whether a concern needs escalation, seek supervision. It is safer to discuss a concern than to make assumptions about its significance.
Remember that documentation is part of the clinical intervention. A carefully written plan promotes continuity, accountability and safety.
When to Escalate
Seek immediate senior support if:
There is evidence of immediate danger to the person or someone else.
The person reports suicidal intent, planning or an inability to remain safe.
There is a significant safeguarding concern.
Mental state has deteriorated markedly.
The person appears severely agitated, psychotic, manic, intoxicated or unable to participate safely.
You are uncertain whether the person can leave the appointment safely.
Escalate promptly through routine clinical channels when:
The person reports new medication side effects.
A treatment or medication decision is required.
The current plan is repeatedly ineffective.
Risk is increasing even if it does not appear immediate.
Diagnostic assessment may be required.
The person’s needs appear to exceed the case worker’s role or the service’s remit.
Always record the concern, who was contacted, the advice received and the action taken.
5. Summary
Every mental health review should end with a shared understanding of the current situation and a clear plan for what will happen next.
An effective ending includes a concise summary, a small number of realistic actions, named responsibility, appropriate timescales, safety-netting and arrangements for follow-up. The practitioner should check both agreement and understanding rather than assuming that the person has accepted or remembered the plan.
Action plans should be collaborative, strengths-based and proportionate to the person’s current capacity. They should promote independence while providing reasonable support.
Case workers must work within their competence. Risks, safeguarding matters, medication concerns, diagnostic questions and complex clinical decisions must be escalated to an appropriately qualified senior clinician.
A review has been ended well when the person can explain what they will do next, what the professionals will do, when progress will be reviewed and where they can seek help if their situation deteriorates.
6. Further Reading
National Institute for Health and Care Excellence: Shared decision making (NG197)
NHS England: Personalised care and support planning—brief summary guide
Care Quality Commission resources concerning person-centred care, consent, safeguarding and good governance.
Miller, W. R. and Rollnick, S. Motivational Interviewing: Helping People Change and Grow. Guilford Press.
Tew, J. Social Approaches to Mental Distress. Palgrave Macmillan.
7. Knowledge Check
Question 1
What is the main purpose of an action plan at the end of a review?
A. To record every subject discussed during the appointment
B. To give the person a list of instructions chosen by the practitioner
C. To clarify agreed next steps, responsibility, timescales and follow-up
D. To demonstrate that all of the person’s difficulties have been resolved
Correct answer: C
Explanation: An action plan translates the review into clear and collaboratively agreed next steps. It should identify what will happen, who is responsible and when progress will be reviewed.
A is incorrect because the clinical record may summarise the wider discussion, but an action plan should focus on priorities and next steps rather than repeat everything said.
B is incorrect because action plans should be developed collaboratively. Instructions imposed by the practitioner may not reflect the person’s priorities or capacity.
D is incorrect because a review does not need to resolve every difficulty. It should identify realistic steps towards improvement and any support still required.
Question 2
Which is the clearest action?
A. “Daniel will try to improve his routine.”
B. “Daniel will be more motivated before the next review.”
C. “Daniel will get up by 10.00 am on Monday, Wednesday and Friday for the next two weeks.”
D. “Daniel’s family will make sure he functions normally.”
Correct answer: C
Explanation: C describes a specific, observable action and includes both frequency and timescale. It can be reviewed fairly at the next appointment.
A is incorrect because “improve his routine” does not explain what Daniel will do.
B is incorrect because motivation is an internal state rather than a clearly defined action.
D is incorrect because it is vague, unrealistic and places inappropriate responsibility on Daniel’s family. The phrase “functions normally” is also judgemental and poorly defined.
Question 3
A person agrees to an action but says they are only 2 out of 10 confident that they can complete it. What should the practitioner do?
A. Keep the plan unchanged because the person has already agreed
B. Explain that failure to complete it will be recorded
C. Explore the barriers and consider making the first step smaller
D. Complete the task for the person without further discussion
Correct answer: C
Explanation: Low confidence suggests that the action may be too difficult, insufficiently supported or poorly matched to the person’s priorities. The practitioner should explore barriers and agree a more achievable step.
A is incorrect because verbal agreement does not mean that a plan is realistic.
B is incorrect because a punitive response may increase shame and discourage honest discussion.
D is incorrect because automatically taking over can reinforce dependency and removes the opportunity to provide graded support. Direct help may sometimes be appropriate, but it should be agreed and proportionate.
Question 4
Which statement is the best example of checking understanding?
A. “You understand everything, don’t you?”
B. “I have explained the plan, so we can finish now.”
C. “Do you have any questions?”
D. “Could you talk me through what you understand will happen next?”
Correct answer: D
Explanation: D uses teach-back. It allows the practitioner to check whether the plan was explained clearly and gives the person an opportunity to identify misunderstandings.
A is incorrect because it is a leading question and may make it difficult for the person to admit that they are unsure.
B is incorrect because providing information does not guarantee that it has been understood.
C is better than not checking at all, but people may not know what they have misunderstood or may feel uncomfortable asking questions. Teach-back provides a more reliable check.
Question 5
During the final five minutes of a routine review, a person reports that they have developed a plan to end their life that evening. What should the case worker do?
A. Record it as an action for discussion at the next review
B. Give general crisis information and end the appointment on time
C. Seek immediate senior clinical support and follow the service’s risk procedures
D. Ask the person to promise not to act on the plan
Correct answer: C
Explanation: A current suicidal plan with an identified timeframe requires immediate escalation and assessment. The case worker should not manage this concern alone or allow the person to leave without following the appropriate procedure.
A is incorrect because the concern cannot safely wait until a later review.
B is incorrect because crisis information alone is not an adequate response to an immediate and specific risk.
D is incorrect because a promise does not replace a proper risk assessment, escalation or safety intervention.
Question 6
Which plan best promotes independence?
A. The case worker makes every telephone call because it is quicker
B. The person is told to manage alone so that dependency does not develop
C. The person prepares and makes the call, with the case worker helping them plan what to say
D. The person’s relative completes every task without involving them
Correct answer: C
Explanation: C provides graded support while allowing the person to participate actively. It develops confidence and practical skills without withdrawing help.
A is incorrect because routinely taking over tasks can reduce opportunities for the person to develop independence.
B is incorrect because promoting independence does not mean removing necessary support.
D is incorrect because excluding the person from decisions and actions may undermine autonomy. Family support can be helpful, but it should be proportionate and appropriately agreed.
Question 7
Which information is essential when documenting an agreed action?
A. Only the practitioner’s opinion of the person’s motivation
B. The action, responsible person and relevant timescale
C. Every sentence spoken during the review
D. A guarantee that the action will be successful
Correct answer: B
Explanation: Clear documentation should state what will be done, who will do it and when it should happen or be reviewed.
A is incorrect because a subjective judgement about motivation does not provide a clear plan and may be misleading.
C is incorrect because clinical records should be accurate and sufficiently detailed, but they do not usually require a complete transcript.
D is incorrect because outcomes cannot be guaranteed. The record should describe the agreed plan and any contingencies honestly.
Question 8
A young person and their parent disagree about the main priority for the action plan. What is the most appropriate response?
A. Record that everyone agreed with the parent
B. Ignore the disagreement and choose the practitioner’s preferred goal
C. Explore both perspectives, identify any shared priorities and document remaining disagreement
D. End the review without making any plan
Correct answer: C
Explanation: Different perspectives should be acknowledged rather than concealed. The practitioner should seek common ground, clarify responsibilities and document any disagreement that remains.
A is incorrect because the record would be inaccurate and would exclude the young person’s view.
B is incorrect because the plan should not be based solely on professional preference when collaborative planning is possible.
D is incorrect because disagreement does not necessarily prevent all planning. Safety actions, areas of shared concern or further discussion can still be agreed.
Question 9
Which is the best example of safety-netting?
A. “Contact someone if things get bad.”
B. “Everything should be fine before the next review.”
C. “If your thoughts of self-harm increase or you feel unable to remain safe, tell your support person and seek urgent help using the crisis contacts we discussed; call 999 if there is an immediate danger.”
D. “Wait for the case worker to contact you, regardless of what happens.”
Correct answer: C
Explanation: C identifies warning signs, actions, sources of support and the threshold for emergency help. Safety advice must also be consistent with local procedures and the person’s individual plan.
A is incorrect because it is too vague. The person may not know what “bad” means or whom to contact.
B is incorrect because it offers false reassurance and provides no contingency if the situation deteriorates.
D is incorrect because routine case-worker contact may not be immediate or available outside operating hours.
Question 10
At the next appointment, the person reports that they did not complete an agreed action. What should the practitioner do first?
A. Conclude that the person is not engaging with support
B. Explore what became difficult and what can be learned from the attempt
C. Repeat the identical plan without discussion
D. Remove the person from the service immediately
Correct answer: B
Explanation: An incomplete action provides useful information about barriers, readiness, support needs and whether the plan was realistic. The practitioner should explore the situation without judgement and revise the plan where necessary.
A is incorrect because one incomplete action does not establish that the person is unwilling to engage. There may be practical, emotional or clinical barriers.
C is incorrect because repeating an ineffective plan without understanding the difficulty is unlikely to produce a different outcome.
D is incorrect because immediate discharge would generally be disproportionate and could increase risk. Any decision about continued involvement must follow clinical, organisational and contractual procedures.
