The overall goal of this project is to design, implement, and revise the Core Competency Model for Corrections (CCM-C), an evidence-based Self-Directed Violence (SDV) prevention training program for correctional mental health providers in the North Carolina Department of Adult Corrections (DAC). The proposed specific aims are: Aim 1: To create the CCM-C training program. Aim 2: To assess preliminary training effectiveness. Aim 3: To gather training program quality improvement feedback from corrections stakeholders.
Investigators will conduct a pilot feasibility and preliminary effectiveness evaluation of the Core Competency Model for Corrections (CCM-C; Cramer et al., 2022). This training approach involves psycho-educational content, self-assessment tools, interactive exercises to address 10 clinical care and practitioner-focused skill sets for suicide and self-injury risk assessment and management. The protocol employs a waitlist control sequential cross-over design and mixed-method evaluation approach targeting 50-100 NC correctional behavioral health clinicians (BHCs). Through an ongoing academic-community partnership, investigators will employ a Corrections Advisory Panel (CAP) to provide expert review of training. The CAP will comprise six NC-DAC BHCs and 4-6 external BHCs with experience in correctional behavioral health. Two training groups will each provide three assessments via an online self-report evaluation battery gathering information regarding participant demographics; SDV prevention knowledge, attitudes, and perceived skills; incarceration-related attitudes; and perceived importance of and intention to use SDV prevention practices.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
100
The Core Competency Model (CCM; Cramer et al., 2013, 2019) is an evidence-based educational training program for BHCs in suicide prevention core suicide prevention skills. The ten core competencies are: (1) Manage personal attitudes and reactions to suicide; (2) Maintain a collaborative stance toward the client; (3) Elicit evidence-based risk and protective factors; (4) Focus on current suicide plan and intent of suicidal ideation; (5) Determine risk level; (6) Enact a collaborative evidence-based treatment plan; (7) Notify and involve other persons; (8) Document risk, plan, and reasoning for clinical decisions; (9) Know the law concerning suicide, and; (10) Engage in debriefing and self-care. The CCM will be adapted for this pilot trial. In light of the SDV problem in carceral settings, the CCM for Corrections (CCM-C; Cramer, Kaniuka, \& Peiper, 2022) was adapted to address both suicide and self-injury assessment, treatment, and prevention.
North Carolina Department of Adult Corrections
Raleigh, North Carolina, United States
Feasibility of the CCM-C training intervention
Feasibility of CCM-C training as measured by the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater feasibility.
Time frame: Immediately post-training
Acceptability
Acceptability of CCM-C training as measured by the self-report subscale on the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater acceptability.
Time frame: Immediately post-training
Appropriateness
Appropriateness of CCM-C training as measured by the self-report subscale of the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater appropriateness.
Time frame: Immediately post-training
Usability
Usability of CCM-C training as measured by the self-report subscale of the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater usability.
Time frame: Immediately post-training
Perceived self-directed violence prevention skills
The Suicide Competency Assessment Form (SCAF; Cramer et al., 2013, 2020) will be used to measure participants' perceived SDV prevention skill mastery. The SCAF is a self-report questionnaire that contains 10 items capturing core competencies of the CCM-C training; these items are measured on a four-point scale of perceived competency (1 = incapable; 4 = advanced) where higher scores denote better competency. For the present study, these 10 items was adapted to capture SDV-focused skills.
Time frame: Immediately post-training
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Willingness to intervene with a suicidal person
The Attitudes about Intervening with a Suicidal Person (AIBS; Aldrich et al., 2014) self-report questionnaire will be used to measure SDV prevention-focused attitudes and the willingness to intervene in an event where a person is experiencing SDV. The AIBS is a subscale of the larger, recently revised Willingness to Intervene against a Suicidal Person Enhanced questionnaire (Aldrich \& Cerel, 2023). Higher scores (range 14-90) convey more positive attitudes and greater willingness to intervening with someone in distress.
Time frame: Immediately post-training
Beliefs about incarcerated persons engaging in self-directed violence
The Attitudes toward Prisoners who Self-Harm (APSH; Garbutt \& Casey, 2015; Ireland \& Quinn, 2007) scale is a self-report questionnaire that will be used to measure SDV prevention-focused attitudes and stigma. The APSH consists of 25 items with a total score; higher scores (range 25-125\_ denote more stigmatizing beliefs.
Time frame: Immediately post-training
Self-directed violence prevention knowledge
For this pilot evaluation, investigators created a 10 multiple-choice CCM-C Knowledge Quiz. Correct answers are summed for a total score (range 0-10) where higher scores indicate greater understanding of the CCM-C.
Time frame: Immediately post-training
Perceived importance of training
Investigators will use the intention to use training content scale (Cramer et al., 2019), a brief self-report questionnaire, to capture BHC's perceived importance in using (pre-training) and intent to use (post-training) CCM-C training content. Across seven items, higher scores (item mean 1-5) denote greater perceived importance of the training.
Time frame: Immediately post-training