Background <p>Self-directed violence encompasses both suicide and self-injury. United States correctional settings face high self-directed violence rates. Training correctional behavioral health clinicians (BHCs) in evidence-based self-directed violence prevention practices represents one solution. The Core Competency Model for Corrections (CCM-C) is a self-directed violence prevention training program addressing clinician self-management (e.g., managing personal reactions to self-directed violence) and clinical care (e.g., eliciting evidence-based risk and protective factors) skills. The present study held aims to: (1) assess CCM-C feasibility, appropriateness, acceptability, and usability; (2) evaluate short-term impacts on BHC self-directed violence knowledge, attitudes, and skill usage; and (3) explore short-term impacts on BHC compassion fatigue.</p> Methods <p>The present study was a statewide hybrid feasibility-effectiveness trial evaluating the CCM-C taking place between January and December 2024. Pre-training feedback was gathered from a corrections advisory panel (<i>N</i> = 7). For the trial implementation, we conducted a waitlist control sequential cross-over design. BHCs (<i>N</i> = 60) were randomly assigned to two training groups: Baseline training versus waitlist control. BHCs provided quantitative and qualitative survey input on CCM-C feasibility outcomes (aim 1), and completed self-report inventories of self-directed violence-related outcomes (aims 2 and 3). Descriptive statistics and thematic analysis assessed feasibility outcomes. Repeated-measures analysis of variance (ANOVA) tests examined CCM-C outcomes.</p> Results <p>CCM-C was highly acceptable, appropriate, feasible, and usable. Recommended improvements included removing non-corrections content, enhancing opportunities for BHC participation and interaction, and creating participant handout packages. CCM-C increased BHC self-directed violence prevention knowledge, perceived skill mastery, intent/actual use of training content, and lowered compassion fatigue levels. Attitudes toward intervening with a suicidal person only improved for the waitlist control group. Attitudes towards incarcerated individuals who self-harm remained unchanged.</p> Discussion <p>Early results show CCM-C to be a feasible, effective self-directed violence prevention training program for correctional BHCs. Results support broader CCM training literature and a social-cognitive training model. Statewide partners will generate the <i>CCM-C Toolkit</i>, a package comprising training materials, implementation guidance, and train-the-trainer materials. The Toolkit will provide accessible resources for further CCM-C implementation, adaptation, and evaluation.</p> Trial registration <p>This study was registered at clinicaltrials.gov (NCT06359574).</p>

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Core competency model self-directed violence prevention training program for corrections: a hybrid feasibility-effectiveness trial

  • Skyler D. Prowten,
  • Sam C. Cacace,
  • Jessamyn Moxie,
  • Ava Peters,
  • Adria Corral,
  • Marvella Bowman,
  • Lewis J. Peiper,
  • Robert J. Cramer

摘要

Background

Self-directed violence encompasses both suicide and self-injury. United States correctional settings face high self-directed violence rates. Training correctional behavioral health clinicians (BHCs) in evidence-based self-directed violence prevention practices represents one solution. The Core Competency Model for Corrections (CCM-C) is a self-directed violence prevention training program addressing clinician self-management (e.g., managing personal reactions to self-directed violence) and clinical care (e.g., eliciting evidence-based risk and protective factors) skills. The present study held aims to: (1) assess CCM-C feasibility, appropriateness, acceptability, and usability; (2) evaluate short-term impacts on BHC self-directed violence knowledge, attitudes, and skill usage; and (3) explore short-term impacts on BHC compassion fatigue.

Methods

The present study was a statewide hybrid feasibility-effectiveness trial evaluating the CCM-C taking place between January and December 2024. Pre-training feedback was gathered from a corrections advisory panel (N = 7). For the trial implementation, we conducted a waitlist control sequential cross-over design. BHCs (N = 60) were randomly assigned to two training groups: Baseline training versus waitlist control. BHCs provided quantitative and qualitative survey input on CCM-C feasibility outcomes (aim 1), and completed self-report inventories of self-directed violence-related outcomes (aims 2 and 3). Descriptive statistics and thematic analysis assessed feasibility outcomes. Repeated-measures analysis of variance (ANOVA) tests examined CCM-C outcomes.

Results

CCM-C was highly acceptable, appropriate, feasible, and usable. Recommended improvements included removing non-corrections content, enhancing opportunities for BHC participation and interaction, and creating participant handout packages. CCM-C increased BHC self-directed violence prevention knowledge, perceived skill mastery, intent/actual use of training content, and lowered compassion fatigue levels. Attitudes toward intervening with a suicidal person only improved for the waitlist control group. Attitudes towards incarcerated individuals who self-harm remained unchanged.

Discussion

Early results show CCM-C to be a feasible, effective self-directed violence prevention training program for correctional BHCs. Results support broader CCM training literature and a social-cognitive training model. Statewide partners will generate the CCM-C Toolkit, a package comprising training materials, implementation guidance, and train-the-trainer materials. The Toolkit will provide accessible resources for further CCM-C implementation, adaptation, and evaluation.

Trial registration

This study was registered at clinicaltrials.gov (NCT06359574).