Preparing social work students for high‑stakes care

For even the most seasoned social worker, evaluating the risk of suicide is a high-pressure, high-stakes task.

Fresh out of Ohio State’s College of Social Work, Lois Stepney ’95 MSW, ’23 PhD worked as a case manager for young people with severe emotional disturbances and mental health challenges. Over time, she learned to ask suicide screening questions in a way that encouraged people to open up. She learned to gauge which patients were most likely to move from self-harming behaviors or suicidal ideation to suicide attempts. She also discovered the key to effective care: embracing discomfort.

“Even after 30 years of clinical practice, there are times when these questions feel uncomfortable,” Stepney says. “But becoming comfortable with being uncomfortable helps us to learn and grow—and can help save lives.”

Now an assistant clinical professor in the College of Social Work, Stepney is passionate about training the next generation of social workers to become “present and engaged with human beings who are hurting.”

One of the first challenges she faces is bridging the gap between theory and reality for first-year master’s students, many of whom have minimal experience working with clients. Inspired by an AI-powered poverty simulation she tested out as a new instructor, she worked with the college’s instructional design team to identify an AI platform that could bring material to life for students. They selected CogniTrainer, an AI simulator that helps students become more adept and confident in evaluating suicide risk.

The platform offers a variety of text-based modules. When students enter one, they communicate in writing with a “client” while the platform analyzes their interaction. One module features “Darren,” a high school basketball star whose academic and athletic performance is slipping. He becomes increasingly withdrawn and disengaged, eventually arriving at the emergency department in an acute mental health crisis.

Stepney frequently encounters situations like this in her role as a part-time medical social worker at Nationwide Children’s Hospital. For her, using the standard Ask Suicide-Screening Questions (ASQ) checklist has become second nature. For many of her students, logging onto CogniTrainer and interacting with “Darren” is their first time asking these questions. They typically spend from five to 30 minutes in the simulation, gathering information that paints a more complete picture of the challenges facing their client.

Student feedback has been overwhelmingly positive, Stepney says. “AI simulation offers an engaging, low-stakes way for people to build a lifesaving skill set.”

That’s true for students who already have experience in the field, too. Christian Castro, a first-year master’s student in a course Stepney teaches called Generalist Practice with Individuals, Families and Groups, has spent the past 15 years working in nonprofit advocacy and research spaces and has even assessed the risk of suicide as a research project manager in an academic setting.

“[CogniTrainer] was a helpful refresher in how to structure a session, pace conversation and ask the right questions,” he reflects. “I appreciated the way it provided in-depth feedback on where I could improve, such as identifying points in the conversation where I could have dug deeper.”

When Stepney was in Castro’s grad-student shoes in the mid-1990s, she relied on the library card catalog for her research. Now, most people in the profession use AI tools to summarize session notes, develop sample case studies and help create class assignments. “The world has changed, and we’re not going back,” she says. “I’m embracing AI because it’s here.”

An AI platform like CogniTrainer will never be able to fully replicate or meet the uniquely human challenges involved in social work, Stepney says. But it can play a powerful role in preparing students for the real thing, and in doing so, become a meaningful partner in the effort to prevent suicide.