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Digital Commons @ George Fox University Doctor of Psychology (PsyD) Theses and Dissertations 6-3-2020 Suicide Risk Assessment: An Evaluation of Graduate Students with the Columbia-Suicide Severity Rating Scale Savannah Hamilton [email protected] Follow this and additional works at: https://digitalcommons.georgefox.edu/psyd Part of the Psychology Commons Recommended Citation Hamilton, Savannah, "Suicide Risk Assessment: An Evaluation of Graduate Students with the Columbia- Suicide Severity Rating Scale" (2020). Doctor of Psychology (PsyD). 332. https://digitalcommons.georgefox.edu/psyd/332 This Dissertation is brought to you for free and open access by the Theses and Dissertations at Digital Commons @ George Fox University. It has been accepted for inclusion in Doctor of Psychology (PsyD) by an authorized administrator of Digital Commons @ George Fox University. For more information, please contact [email protected]. Suicide Risk Assessment: An Evaluation of Graduate Students with the Columbia-Suicide Severity Rating Scale by Savannah Hamilton Presented to the Faculty of the Graduate School of Clinical Psychology George Fox University in partial fulfillment of the requirements for the degree of Doctor of Psychology in Clinical Psychology Newberg, Oregon June 3, 2020 CSSRS RISK ASSESSMENT ii Suicide Risk Assessment: An Evaluation of Graduate Students with the Columbia-Suicide Severity Rating Scale (C-SSRS) Savannah L Hamilton, M.A, Has been approved By the Graduate School of Clinical Psychology George Fox University As a Dissertation forthe PsyD Degree Signatures: � Pd-(}._ i\qo Mary Peterson, PhD, Chair M��1\J) Kathleen A. dl.thercoal, PhD Glena Andrews, PhD ��� Luann Foster, PsyD CSSRS RISK ASSESSMENT iii Suicide Risk Assessment: An Evaluation of Graduate Students with the Columbia-Suicide Severity Rating Sacle Savannah Hamilton Graduate School of Clinical Psychology George Fox University Newberg, Oregon Abstract The critical need for more sensitive suicide screening is highlighted by the fact that 75% of individuals who complete suicide has seen a health care provider within the previous 3 months (Graves et al., 2018). Additionally, health care providers play a crucial role in identifying patients who are at risk, but they often are not adequately trained. The current research project investigated the effectiveness of a risk assessment training to increase doctoral students’ general and applied knowledge in suicide risk assessment. The training was completed by a cohort of 23 first year doctoral students in the Graduate Psychology of Clinical Psychology at George Fox University. The participants were divided into three equal groups; Group A, Group B and Group C. Group A received the primary intervention training as well as four enhanced training interventions or “booster” session trainings. Group B only received the primary intervention training, and Group C did not receive any additional training. The three levels of participants completed a pre-test prior to and post-test to assess participants’ knowledge immediately following the training session to assess the relative effectiveness of the primary training, primary CSSRS RISK ASSESSMENT iv plus booster sessions, versus course content. None of the three groups showed an increase in their general knowledge over time, rather, the group means showed a decrease in general knowledge over the course of the intervention. However, change scores indicated that Group A, who received the most extensive training, increased in their skills in the application of knowledge over time in comparison to the two other groups. Results suggest that informational training and continuous applied training together may enhance clinical trainees’ competency in suicide risk assessment. Keywords: suicide assessment, training, knowledge, confidence, skills CSSRS RISK ASSESSMENT v Table of Contents Approval Page ............................................................................................................................ ii Abstract .....................................................................................................................................iii List of Tables ............................................................................................................................ vii List of Figures .......................................................................................................................... viii Chapter 1: Introduction ............................................................................................................... 1 Suicide Epidemic............................................................................................................. 1 Risk Factors: Static and Dynamic .................................................................................... 2 Provider’s Response to Epidemic .................................................................................... 3 Critical Intersection ......................................................................................................... 4 Training in Evidenced-Based Assessment ........................................................................ 5 Current Resources ........................................................................................................... 6 Purpose of This Study ..................................................................................................... 6 Chapter 2: Methods ..................................................................................................................... 8 Participants ...................................................................................................................... 8 Materials ......................................................................................................................... 8 Procedures ....................................................................................................................... 9 Data Analysis ................................................................................................................ 11 Chapter 3: Results ..................................................................................................................... 12 Descriptive Statistics ..................................................................................................... 12 Effect Size Analyses ...................................................................................................... 15 Chapter 4: Discussion ............................................................................................................... 18 Limitations .................................................................................................................... 19 Implications................................................................................................................... 20 CSSRS RISK ASSESSMENT vi Suggestions for Future Research .................................................................................... 21 References ................................................................................................................................ 23 Appendix A Informed Consent ................................................................................................ 28 Appendix B C-SSRS Assessment ............................................................................................ 29 Appendix C Columbia-Suicide Severity Rating Scale.............................................................. 32 Appendix D Curriculum Vitae................................................................................................. 33 CSSRS RISK ASSESSMENT vii List of Tables Table 1: General Knowledge Mean Scores ................................................................................ 12 Table 2: Applied Knowledge Mean Scores ................................................................................ 14 Table 3: Observed Power of the ANOVA components .............................................................. 15 Table 4: Interactions of Group and Time for General Knowledge .............................................. 17 Table 5: Interactions of Group and Time for Applied Knowledge ............................................. 17 CSSRS RISK ASSESSMENT viii List of Figures Figure 1: General Knowledge Mean .......................................................................................... 13 Figure 2: Applied Knowledge Mean.......................................................................................... 14 Figure 3: Formula for dppc ....................................................................................................... 16 CSSRS RISK ASSESSMENT 1 Chapter 1 Introduction The high suicide death rate in the United States has prompted the Director for the Centers for Disease Control and Prevention (CDC), to issue a “wake-up call” to increase resources to address the ongoing crisis (Centers for Disease Control and Prevention [CDC], 2017. As rates of suicide continue to rise, it has become increasingly important for mental health professionals to gain expertise in identifying the factors placing people at risk for self-harm and suicidality. The following sections detail suicide epidemiology, summarize risk factors, and explore options for training programs to better equip psychologists-in-training to address this issue. Suicide Epidemic Suicide is the 10th leading cause of death in the United States and accounts for more than 800,000

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