Analysis of a Standardized Suicide Intervention Training for Counselor Trainees

Army Goes Into Battle Against Soldier Suicides

A commentary on suicide prevention training: The process of implementing an ASIST pilot in postsecondary nursing education

Finding effective and efficient models to train large numbers of suicide prevention interventionists, including 'hotline' crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied. To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments. We recorded and reliably rated trainer fidelity, defined as adherence to program content and competence of program delivery, for 34 newly trained ASIST trainers delivering the program to crisis center staff on two separate occasions. A total of 324 observations were coded. Trainer demographics were also collected. On average, trainers delivered two-thirds of the program. Previous training was associated with lower levels of trainer adherence to the program. In all, 18% of trainers' observations were rated as solidly competent. Trainers did not improve fidelity from their first to second training. Significantly higher fidelity was found for lectures and lower fidelity was found for interactive training activities including asking about suicide and creating a safe plan. We found wide variability in trainer fidelity to the ASIST program following TTT and few trainers had high levels of both adherence and competence. More research is needed to examine the cost-effectiveness of TTT models.

Suicide Prevention in an International Context.

Wee Fish in a World Pool: Using Applied Suicide Intervention Skills Training

The aim of this study was to develop knowledge about the significance of the Applied Suicide Intervention Skills Training workshop (equal to “Vivat — Førstehjelp ved selvmordsfare”) to Public Health Nurses ‘practice with suicidal adolescents.Data was gathered through three focus groups, which were interviewed twice. The empirical material was processed using qualitatively content analysis.The main findings and interpretations were that the Public Health Nurses reports that the workshop has increased their professional mastery, their proficiency in actions and their dialogue competency. This has expanded their professional repertoire and probably improved the quality of their care.

In addition to the normal developmental tasks, racial and ethnic minority youth may experience other unique challenges that are related to their social, cultural, and structural positions in the US. Specifically, African American adolescents are at increased risk for dropping out of schools and engaging in health risk behaviors due to contextual stressors such as poverty, neighborhood disorder, community violence, and racial discrimination. Group counseling is a developmentally appropriate approach for working with adolescents; however, the counselor training concerning culture-specific considerations for working with African American adolescents in group settings was rarely explored. Therefore, this article aims to serve as a fundamental conceptual framework for working with African American adolescents in groups across different settings by addressing the appropriateness of group counseling for African American adolescents; reflecting on the current counselor preparation and training in group work with African American adolescents; discussing the development, culture, stressors, and strengths of African American adolescents; and providing implications and practical suggestions.

Objective Implementation of evidence-based suicide prevention is critical to prevent death by suicide. Contrary to previously held beliefs, interventions including contracting for safety, no-harm contracts, and no-suicide contracts are not best practices and are considered contraindicated. Little is known about the current use of best practices and contraindicated interventions for suicide prevention in community settings. Methods Data were collected from 771 individuals enrolled in a suicide prevention training. Both mental health clinicians (n = 613) and mental health allies (e.g., teachers, first responders) (n = 158) reported which best practices (i.e., safety plan, crisis response plan) and contraindicated interventions (i.e., contracting for safety, no-harm contract, no-suicide contract) they use with individuals who presents with risk for suicide. Results The majority of both mental health clinicians (89.7%) and mental health allies (67.1%) endorsed using at least one evidence-based practice. However, of those who endorsed using evidence-based interventions, ∼40% of both mental health clinicians and allies endorsed using contraindicated interventions as well. Conclusion Contraindicated interventions are being used at high rates and suicide prevention trainings for evidence-based interventions should include a focus on de-implementation of contraindicated interventions. This study examined only a snapshot of what clinicians and allies endorsed using. Additional in depth information about each intervention and when it is used would provide helpful information and should be considered in future studies. Future research is needed to ensure only evidence-based interventions are being used to help prevent death by suicide. Highlights: The majority of both mental health clinicians and mental health allies use evidence-based practices for suicide prevention. This indicates good implementation rates of evidence-based interventions for suicide prevention. Approximately 40% of both mental health clinicians and mental health allies who endorsed using evidence-based practices for suicide preventions also endorsed using contraindicated interventions. A focus on de-implementation of contraindicated suicide interventions is warranted and should be part of the focus on suicide prevention efforts.

Approximately 45,000 people die by suicide annually in the United States with over 60% seeking help in the year leading up to their death. Of students receiving suicide-specific training in their degree programs, nearly two-thirds feel inadequately prepared for practice with suicidal clients. This study explores the outcomes of an educational pilot study (N = 29) integrating didactic instruction, readings, role-plays, and simulation for teaching suicide intervention skills. The Collaborative Assessment and Management of Suicidality (CAMS) framework is used as a guideline to develop knowledge, skills, and confidence in working with clients who are suicidal. Repeated measures ANOVA results indicate statistically significant improvements in students’ knowledge and Counseling Self-Estimate Inventory (CSEI) scores overtime (p <.05). Moreover, CSEI and the subscale of dealing with difficult client behaviors showed statistically significant improvements from pre-simulation to post-simulation (p <.05). While an abundance of research exists regarding the use of simulation within medical education, a limited amount of research examines the relevance of simulation within graduate education for helping professionals (e.g., counselors and social workers). These results suggest an added benefit of high-fidelity simulations in the training of helping professionals to develop clinical suicide intervention skills.

Child and youth care practitioners are likely to encounter issues of suicidality. Practitioners play an important role in the well-being of youth; thus, mental health literacy, and suicide prevention education in particular, should be an integral part of child and youth care pedagogy and curricular practices in higher education programs. With the aim of explicating a social process of learning and applying mental health literacy, this grounded theory study examined how a curriculum specifically designed for child and youth care practitioners is subsequently applied in suicide or mental health interventions. Thirteen students enrolled in youth work courses at a large university in Eastern Canada participated in the 18-month study in 2015 and 2016. Informed by critical and social literacy theories, conceptualizations of mental health literacy, and experiential pedagogy within higher education, analysis of the data identified a process of becoming and being in youth work comprising two subcategories: struggling to become a youth worker, and being a youth worker. Conditions, such as particular pedagogical strategies and specific content, served to shape and influence the process and, consequently, participants’ movement therein. The inclusion of a suicide intervention learning activity was a condition that influenced participants’ learning processes, yet also reflected a struggle with the dialectical position of presence and procedure. Recommendations and insights are discussed with the aim of enhancing pedagogical approaches to suicide intervention within child and youth care higher education programs.

ZusammenfassungHintergrundLesbische, schwule („gay“), bisexuelle, trans und queere Jugendliche („LGBTQ+“) sind stärker gefährdet als ihre heterosexuellen und cis Altersgenoss:innen, mindestens einmal in ihrem Leben einen Suizidversuch zu begehen. Evidenzbasierte suizidpräventive Zugänge und Modelle für LGBTQ+-Jugendliche fehlen jedoch.MethodikAnhand deutschsprachiger und internationaler (Forschungs‑)Literatur werden die Hintergründe suizidalen Verhaltens bei LGBTQ+-Jugendlichen aufgezeigt, Lücken identifiziert und basierend darauf ein Modell intersektionaler und multisektoraler Suizidprävention entworfen.ErgebnisseDie wenigen Vorschläge und Konzepte zur Stärkung psychischer Gesundheit und Suizidprävention bei LGBTQ+-Jugendlichen stammen aus der Sozialen Arbeit, der Klinischen Psychologie und der Psychiatrie/Medizin. Eine konsequent multisektorale Sichtweise und die Berücksichtigung der Verschränkung weiterer Diversitätsdimensionen wie etwa „race“, sozioökonomischer Status etc. mit sexueller Orientierung und/oder Geschlechtsidentität stehen in der Suizidprävention jedoch aus. Ausgehend vom Modell von Russell und Fish (2016) wurden ein neues konzeptionelles Modell der Suizidprävention für LGBTQ+-Jugendliche entworfen und universelle, selektive und indizierte Zugänge exemplarisch dargelegt.SchlussfolgerungDas vorgeschlagene Modell bietet einen neuen konzeptionellen Rahmen, suizidpräventive Maßnahmen auf verschiedenen Ebenen zu verorten, zu planen und durchzuführen, dies intersektional und über verschiedene Professionen und Sektoren hinweg.

The purpose of this investigation was to examine the personal and professional factors that predict trainees’ self-perceived readiness to work with child and adolescent clients utilizing a newly developed measure, the Assessment of Youth Counseling Competency Indicators (AYCCI). Participants included 205 master’s-level counselors-in-training (CITs) from various counselor education programs across the United States. Through an electronic survey, participants were asked to complete a demographic form and the AYCCI. Using exploratory factor analysis, the researcher examined the internal structure of the AYCCI. Results of the principal components analysis with promax rotation yielded a 65-item measure with four factors that could explain 52.61% of the variance. Then, the researcher conducted a series of hierarchical linear regressions to explore the specific trainee- and training-factors that could predict CITs’ subscale and total scores on the AYCCI while controlling for potential confounding variables. Overall, the control variables revealed a statistically significant relationship with the dependent variables across all RQs. The two strongest controls were CITs’ number of completed credit hours and CITs’ previous/current youth work experience. On average, CITs’ focus area demonstrated a statistically significant relationship with the dependent variables across all RQs, with Youth Specialty as the dominant predictor. Similarly, the number of youth counseling courses CITs completed demonstrated a strong predictive relationship with self-reported AYCCI scores. Lastly, the program variables, delivery type and accreditation status, did not yield a statistically significant result and were not noteworthy predictors of participants’ scores. Implications for counselor education and areas for future research are also discussed.

Background and Purpose. Clinical education represents a significant segment of the physical therapist education program curriculum and allows students to apply and integrate theory and didactic knowledge to the real world of practice. The purpose of this study was to explore the perceptions of center coordinators of clinical education (CCCEs) with regard to the optimal length of full-time clinical education experience for PT students who have completed their first and final full-time clinical education experiences. Case Description. A pilot study was conducted using an open-format questionnaire. The questionnaire was sent to CCCEs at clinical sites across the United States that currently have agreements with American International College (N = 273). Results. A response rate of 57% was obtained. For students in their first full-time clinical education experience, an average of 7.3 ± 2.26 weeks was suggested, with a range of 3-16 weeks. For a student's final full-time clinical education experience, the average was 9.1 ± 2.09 weeks with a range of 5.5-16 weeks. Discussion. The results of this survey support the current trends for those professional programs that require PT students to complete an 8-week clinical experience as part of their first experience. The results also demonstrated a bimodal split in the distribution between a 5-8-week full-time clinical experience and a 9-12-week clinical experience for a student's final clinical experience as expressed by the CCCEs. This study may assist the director of clinical education (DCE) and/or the academic coordinator of clinical education (ACCE) to develop a consensus on the optimal time for the development of skills in the clinical environment. Key Words: Physical therapy, Clinical internship experience, Clinical education. INTRODUCTION Moving professional (entry-level) physical therapist (PT) students into a clinical education experience is an important aspect of a physical therapist education program curriculum and requires careful and deliberate planning on the part of both the educational institution and the clinician. Clinical placements that consider each student's unique needs are optimal. The physical therapist clinical education experience is a relationship fostered between the academic institution and the clinical facility and should ensure an environment that is engaging and provides a critical learning environment.1 Paschal indicated that clinical education in real practice settings, with real patients and with real physical therapists as clinical teachers.2(p257) Clinical education represents a significant segment of the PT curriculum and allows students to apply and integrate theory and didactic knowledge to the real world of practice while under the supervision of clinical instructors. According to Mostrom and Shepard,' physical therapist professional preparation occurs in 2 environments, the classroom and the clinical setting, each of which contribute to the students' learning experience. Integration of the didactic portion of the PT curriculum occurs through the implementation of carefully thought out clinical experiences providing an opportunity for problem solving which occurs as students participate in clinical settings.3 The Division of Physical Therapy at American International College (AIC) in Springfield, Massachusetts, requires all PT students to successfully complete three 8-week full-time clinical education experiences for a total of 24 weeks in order to fulfill the requirement for a master's degree in physical therapy.4 According to the American Physical Therapy Association 2002 Fact Sheet for Physical Therapist Education Programs,5 the average length for a student's final fulltime clinical education experience is 14.5 weeks at the master's level, with a total length of the full-time clinical education experience averaging 27.9 weeks.5 While visiting clinical sites, conversations with the center coordinators of clinical education (CCCEs) often lead to questions inquiring if AIC PT students could continue beyond the required 8 full-time clinical experience weeks. …

Acute suicide prevention: A systematic review of the evidence and implications for clinical practice

Telephone emergency services (TES) play an important role in suicide prevention across different health care systems around the world. However, little is known about the telephone counselors who often volunteer to provide free and confidential help for people in emotional crises. The current study aims to examine the interpersonal values of volunteer counselor trainees and further investigates their personality traits, life satisfaction and expectations regarding their future counseling style. For the current study, 261 counselor trainees were recruited within the German nationwide organization TelefonSeelsorge at the beginning of their paraprofessional training. Interpersonal values were described according to the interpersonal circumplex (IPC) model with the structural summary method. Compared to a matched nonclinical reference group, trainee counselors reported significantly higher interpersonal values for the scales Harmony (LM) and Helpful Influence (NO). A cluster analysis revealed 3 distinct groups of trainees, which can be described as predominantly submissive-altruistic, helpful-influential, and friendly-harmonious. The 3 groups further differed in the Big Five personality traits Extraversion, Neuroticism and Agreeableness, as well as in self-reported mentalization, attachment anxiety, and avoidance, but not in life satisfaction. Furthermore, the groups differed with regard to their expected future counseling style. The results contribute to an understanding of interpersonal goals and motives of volunteer counselor trainees in TES. (PsycINFO Database Record