Associate Professor University of Iowa Iowa City, Iowa, United States
Overview: Results from a quasi-experiment comparing students who completed a suicide intervention skills course with a comparison group who completed another skill-building course found stronger skill development and confidence in the intervention group. Recommendations for integrating suicide intervention skills development into social work curricula are described in detail.Proposal text: Background Suicide in the U.S. is a growing problem. In 2019, suicide was the 10th leading cause of death among all age groups and the 2nd leading cause among people ages 10-34 (Hedegaard & Warner, 2021). Yet most social work students receive little suicide intervention skill development during their programs (Kourgiantakis et al., 2019).
We embedded the Applied Suicide Intervention Skills Training (ASIST; LivingWorks, 2021), a 16-hour CDC-recommended skill development model, into a for-credit social work course. ASIST is consistent with social work principles such as collaborative problem-solving, reducing mental health stigma, and creating greater resource equity by integrating suicide prevention resources into all communities.
Researchers evaluating ASIST found that teachers, nurses, and other professional groups felt more prepared, competent, or confident at post-training (Yonemoto et al., 2019). ASIST has not been evaluated with social work students. Moreover, there is limited evidence on whether ASIST improves participants’ suicide-specific intervention skills (Authors, 2021). Our study assessed whether social work students’ skills and confidence using those skills increased from pre- to post-course.
Methods We used a non-equivalent pretest-posttest comparison-group design, comparing students in the ASIST course (Intervention group) to students who completed another skill-building course (Comparison) that did not include content on working with people contemplating suicide. The social work program held both courses at the same location during the same timeframe (two weeks apart). The courses had the same format and length and included the same population.
The Suicide Counseling Skills Inventory (SCSI) and the Suicide Counseling Confidence Scale (SCCS) were used to measure effects. SCSI, a 30-item self-administered survey, has 10 hypothetical client-helper scenarios that measure students’ ability to identify appropriate responses to statements made by a person thinking of suicide. SCCS, a six-item self-administered survey, measures students’ confidence using six core skills taught in ASIST. The measures have very good content validity, construct validity, and reliability. Repeated measure GLM (2 x 2 mixed-design MANOVA) was used to test the interaction between the effect of time (pre- to post-course change on confidence) and the course (ASIST course v. comparison).
Results The sample included 64 students (ASIST: 36; comparison: 28). The two groups were equivalent on race/ethnicity, gender identity, educational level, employment, human services experience, and age, and did not differ on baseline measures of suicide counseling skills or confidence.
The ASIST group experienced substantial skill and confidence improvement, while the comparison group showed little change. ASIST students had significantly better skills at post-test than comparison students (M=15.34, SD=4.29; M=22.41, SD=7.68, respectively; p=.0001). ASIST students had significantly greater confidence at post-course than comparison students (M=90.44, SD=8.60; M=76.30, SD=13.95, respectively; p=.0001).
Conclusions A brief course increased students’ skills and confidence to respond appropriately to suicidal clients. Given the likelihood that social workers will encounter clients contemplating suicide, all students should receive foundational skills in this area before entering professional practice. We present suggestions for integrating this important content into social work education and highlight implementation issues.
