Published on: June 23, 2025
A NABITA Tip of the Week by W. Scott Lewis, J.D., TNG, and John Grady, Ph.D., Kean University
Clinicians play a crucial role in Behavioral Intervention Teams (BITs) and may be tasked with conducting certain types of risk assessments. However, this responsibility may not always align with their role. Their expertise is invaluable, but it’s important to consider whether risk assessments should fall within their scope of responsibilities.
The types of clinicians commonly serving on BITs include counseling center directors, campus mental health professionals, and community-based mental health professionals.
When and How Clinicians Can Assess Risk
Are clinicians the best suited to evaluate risk of harm to others? The short answer is no. In under-resourced settings, it might seem like clinicians are the only ones available to conduct these assessments. Ironically, these very situations highlight why clinicians should not be the ones performing them. Their time and specialized skills are far better spent providing counseling and care.
For instance, if a team has only one or two clinicians, they may have to focus on urgent, high-priority cases, such as immediate suicidality or other critical mental health crises in addition to their regular case load. For certain assessments, non-clinical tools and instruments can and should be employed to ease the workload. These tools enable clinicians to focus their energy on their core responsibilities, ensuring the most appropriate use of their expertise. NABITA offers targeted training on four practical, easy-to-use non-clinical assessment tools that assess harm to self and harm to others, specifically designed for K-12 and higher education professionals.
Strategies for Communicating Roles and Boundaries
In cases where a clinician must step into an assessment role due to limited staffing, it’s vital to communicate clear boundaries. From the outset, clinicians should define their role and set appropriate expectations with the individual being assessed, ensuring transparency and maintaining trust. For example, they might say:
“I’m a licensed clinician, but today I’m here in a different capacity. This is not a therapy session, and it’s important to note that this conversation will not remain privileged, but will be confidential. The information you provide will be shared with an assessment team of people whose role is to evaluate these situations. My job today is to gather information to help better understand what’s happening in your life right now. In the future, if you’d like me to be your therapist, we can explore that option later. But right now, my focus is solely on assisting with this assessment process.”
By being transparent and direct, clinicians can maintain professionalism and establish a clear understanding of their purpose in the interaction. This approach reinforces their primary role as clinicians, enabling them to focus their expertise where it is most impactful. Key topics to address include clarity of role, confidentiality, informed consent, professional privilege, and any potential conflicts of interest.
Informed Consent
The mandated assessment process begins with a notification letter, which informs the individual about the assessment. This letter should outline who the individual will meet and why, and it explains that the evaluation may include general topics (i.e., suicidality). NABITA offers a sample notification letter in the BITKit for Higher Education, included in Super Memberships.
The second page of this mandated assessment letter should contain an informed consent form that the individual must sign and return. It alleviates undue pressure on clinicians, as the responsibility for enforcing the signing of informed consent lies with Student Conduct or the BIT, not the clinicians themselves.
If Student Conduct requires counseling for the individual through a sanctioning process, the informed consent form should already be included in the documentation provided. Clinicians should not be tasked with managing this responsibility. Adding the burden of managing informed consent unnecessarily complicates their role. This responsibility should remain with Student Conduct to ensure the process is handled clearly and efficiently.
Non-Clinical Tools and Instruments
Train and certify your non-clinical BIT members on the following NABITA tools to ensure your clinical staff remains focused on the most critical cases and high-priority needs:
- NABITA’s Risk Rubric: Assess risks by identifying early behaviors and emerging threats, enabling fair interventions and reducing liability.
- Violence Risk Assessment of the Written Word (VRAWW): Assess the risk of violence in written content using a research-based and objective approach.
- Structured Interview for Violence Risk Assessment (SIVRA): Uses evidence-based methods to assess individuals who may pose a risk to others, enabling informed decision-making.
- Non-Clinical Assessment of Suicide Tool (NAS): Evaluates individuals at risk of self-harm with targeted questions to assess suicide risk and provide actionable intervention recommendations.
Feeling Uncertain? NABITA Can Help
If you’re unsure where to begin, NABITA provides the resources you need to build your skills in non-clinical assessments. With practical risk assessment tools and comprehensive training, we’ll help you develop your confidence and expertise.
For tailored support, engage with NABITA’s consultants to conduct comprehensive threat assessments for your institution.