Most individuals at risk for committing suicide experience self-defeating and self-destructive thought processes that can be conceptualized as an internal dialogue or “voice.” The FASI is based on voice therapy theory, which is a comprehensive approach to psychopathology and corresponding model of mental health. It is a short efficient subscale derived from the larger instrument, the Firestone Assessment of Self-Destructive Thoughts (FAST). Whereas the FAST assesses a broad range of self-destructive thoughts, the FASI more specifically determines an individual’s suicidal risk.

Dr. Firestone discusses insights which lead to development of FAST assessment tool
One in five practicing clinical psychologists will lose a client to suicide, and the odds increase to one in two for psychiatrists. The signs and symptoms exhibited by a suicidal individual are diverse, and clinicians receive little training in how to deal effectively with these clients. Also, therapists often have difficulty empathizing with seriously suicidal clients.

The FASI yields significant information that helps a clinician establish whether or not the client is in imminent danger of self-harm and then decide upon the most suitable immediate action.

The FASI is a 27-item self-report questionnaire. Clients endorse the items on a 5-point Likert-type scale from never to most of the time. The scale incorporates a unique approach: instead of being asked to report symptoms, the client is asked to endorse how frequently he or she is experiencing various self-directed negative thoughts. This allows individuals to reflect on and report the contents of their negative thought process or “voice.” Items presented in this form bring to light elements of a self-destructive process that have been partially or completly unconscious.


  • Provides a prompt, easy-to-administer and thorough clinical assessment strategy for evaluating suicidal risk.
  • Allows quick assessment of client’s imminent danger of self-harm.
  • Aids the clinician in determining the most appropriate course of action for a client exhibiting a significant degree of self-destructive thoughts.