Proximate Outcomes of Gatekeeper Training for Suicide Prevention in the Workplace

Department of Psychiatry, University of Rochester Medical Center, Rochester, Ny 14642, USA.
Suicide and Life-Threatening Behavior (Impact Factor: 1.4). 01/2008; 37(6):659-70. DOI: 10.1521/suli.2007.37.6.659
Source: PubMed


In this pilot study we report on proximate outcomes of a 1-hour community gatekeeper training in-service for 76 nonclinical employees in a university hospital workplace setting. Pre-post analyses resulted in positive changes in participants' knowledge about suicide and attitudes (self-efficacy) about intervening with suicidal individuals. A subset of participants engaged in role play practice of gatekeeper skills following training and rated the experience positively. Fifty-five observations were rated using an observational measure developed for this study and approximately half of these demonstrated satisfactory skills post training. Participants in this workplace gatekeeper training reported sharing new knowledge and skills with family, friends, and coworkers.

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    • "An additional four articles were obtained from the reference list of other articles. At the last stage, two articles were excluded due to ambiguous details about whether the programmes were provided to employees within workplaces or to service users/students (Cross et al., 2007; Cao et al., 2013). After exclusions, there were 13 interventions that remained relevant for this review. "
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    ABSTRACT: There are a number of published studies on workplace suicide prevention activities, and an even larger number of activities that are not reported on in academic literature. The aim of this review was to provide a systematic assessment of workplace suicide prevention activities, including short-term training activities, as well as suicide prevention strategies designed for occupational groups at risk of suicide. The search was based on Meta-analysis of Observational Studies in Epidemiology (MOOSE) Guidelines. The databases used for the searches were the Cochrane Trials Library and PubMed. A range of suicide prevention websites were also searched to ascertain the information on unpublished workplace suicide prevention activities. Key characteristics of retrieved studies were extracted and explained, including whether activities were short-term training programmes or developed specifically for occupations at risk of suicide. There were 13 interventions relevant for the review after exclusions. There were a few examples of prevention activities developed for at-risk occupations (e.g. police, army, air force and the construction industry) as well as a number of general awareness programmes that could be applied across different settings. Very few workplace suicide prevention initiatives had been evaluated. Results from those that had been evaluated suggest that prevention initiatives had beneficial effects. Suicide prevention has the potential to be integrated into existing workplace mental health activities. There is a need for further studies to develop, implement and evaluate workplace suicide prevention programmes.
    Health Promotion International 09/2014; 30(1). DOI:10.1093/heapro/dau085 · 1.94 Impact Factor
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    • "For example, indirect methods such as clinician self-report have relatively poor concordance with objective observer ratings of actual in-session practice (e.g., [32]), but direct methods, including review of actual in session practice, are more expensive and time-consuming [33,34] and ‘differ considerably from most psychotherapy supervision’ [16]. Alternatively, skill building/behavioral rehearsal (BR) may provide a particularly cost-effective proxy for obtaining objective ratings of actual practice in community settings [35], in that the supervisor can observe demonstration of core treatment elements via role-play [36,37]. When combined with other strategies, BR may be a valid, feasible, and effective fidelity monitoring strategy that also allows for ongoing skill building and coaching to fidelity [36,38]. "
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    ABSTRACT: Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes 'gold standard' supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes.Methods/design: The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes.Trial registration: NCT01800266.
    Implementation Science 08/2013; 8(1):89. DOI:10.1186/1748-5908-8-89 · 4.12 Impact Factor
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    • "984 ) which is typically accomplished using modeling and practice opportunities . One method that can be used is the behavioral rehearsal methodology ( Beidas et al . 2013 ) which can be defined as a simulated interaction between a therapist and a trained actor where the therapist takes on the role that they are expected to take on in the future ( Cross et al . 2007 ) . Behavioral rehearsal has beenfound to be an effective way to increase provider fidelity ( Cross et al . 2011 ) . This methodology can be used within the context of consultation to increase the likelihood of mastery skill - building . In a recent study , behavioral rehearsal was used during virtually delivered consultation sessions ("
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    ABSTRACT: There is great interest in the dissemination and implementation of evidence-based treatments and practices for children across schools and community mental health settings. A growing body of literature suggests that the use of one-time workshops as a training tool is ineffective in influencing therapist behavior and patient outcomes and that ongoing expert consultation and coaching is critical to actual uptake and quality implementation. Yet, we have very limited understanding of how expert consultation fits into the larger implementation support system, or the most effective consultation strategies. This commentary reviews the literature on consultation in child mental health, and proposes a set of core consultation functions, processes, and outcomes that should be further studied in the implementation of evidence-based practices for children.
    Administration and Policy in Mental Health and Mental Health Services Research 05/2013; 40(6). DOI:10.1007/s10488-013-0502-8 · 3.44 Impact Factor
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