Suicide Intervention Response Inventory (SIRI)

The Suicide Intervention Response Inventory is designed to assess the ability of paraprofessionals (as well as professionals) to recognize and respond to suicidal statements. (Neimeyer  R.A. & Maclnnes, 1981)

It is comprised of 25 segments, each of which represents an excerpt from a counselling session, and two potential responses. The test-user must rank the responses to each excerpt from +3 (highly appropriate) to -3 (highly inappropriate.)

The SIRI was created by Robert Neimeyer, and validated by Neimeyer & Hartley in 1986. It is currently used in the LivingWorks suicideCare course, which teaches advanced suicide case management.

Factorial Structure (Neimeyer & Hartley, 1986):

  • Elaboration of the Complaint
  • Exploration of Suicidality Involvement
  • Reflection of Negative Feelings

Scoring:

SIRI 1 – The original SIRI involved using a scoring chart that indicated which of the responses was the more appropriate of the two. As long as the test-user indicated the correct answer as being more accurate, they scored a point. If they listed them as being the same, count this as an incorrect answer. A higher score indicates better suicide intervention skills.

SIRI 2 – An updated version of the SIRI changes (Neimeyer & Bonnelle, 1997) the scoring from the original. Instead, the answers are compared to a set of “best possible” answers given by a panel of suicidologists, and the difference subtracted from the panel’s answer to each question. With this scoring, a lower score is better because it represents less deviation from the expert opinion.

Tool and Related Links

Bibliography:

Neimeyer, R.A., Maclnnes, W.D. (1981), Assessing paraprofessional competence with the suicide intervention response inventory. Journal of Counseling Psychology, 28(2), pp. 176-179. doi: 10.1037/h0077970

Neimeyer, R. A., & Bonnelle, K. (1997). The suicide intervention response inventory: A revision and validation. Death Studies, 21(1), pp. 59-81. doi: 10.1080/074811897202137

Neimeyer R.A., Hartley R.E. (1986) Factorial structure of the suicide intervention response inventory. Journal of Suicide and Life Threatening Behavior. 16(4), pp.434-447; doi: 10.1111/j.1943-278X.1986.tb00729.x



Cite this article as: MacDonald, D.K., (2015), "Suicide Intervention Response Inventory (SIRI)," retrieved on November 17, 2017 from http://dustinkmacdonald.com/suicide-intervention-response-inventory-siri/.

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What is Social Listening?

Social listening is an area of customer (or client)-relationship management that, as the name implies, involves listening to social networks. This is important both for for-profit companies who want to know if their customers are having poor experiences on social media and non-profits who want to make sure that they are serving their customers the best they can.

There are a few elements involved in creating a Social Listening Plan.

  • Discover which social media your clients are using
  • Identify the positives and negatives they’re expressing about your organization
  • Design a process for reaching out to them
  • Implement the process and collect feedback
  • Repeat the process on a regular basis

We’ll go into each of these elements below.

Discover which Social Media Your Clients are Using

It’s important to know where your clients are, and this will depend on your demographics. Many non-profits service clients who are economically disadvantages and so they don’t use or own computers at all, but as more and more individuals from lower socioeconomic backgrounds move online, it will become more important for non-profits to know where their clients are.

Learning some basic Google searching skills will help you find your clients.

  • Typing your organization’s name in brackets will search for exact matches of your agency name
  • Using the hyphen or minus sign “-“ will remove elements from the search
  • Using the asterisk “*” will find wildcards, so if your organization is known as “Center” but is commonly misspelled “Centre”, you can search for “Cent**” and both matches will be found.

If you circulate any kind of survey or evaluation, you can ask your clients what kind of social media they use. This can be part of a broader social media strategy, to help your organization engage with clients online. The more involved your organization is with those clients the more likely it is that they will reach out directly to you. The best social listening is the social listening you don’t have to do – because your clients do it for you.

Identify Areas of Praise and Concern

No organization has perfectly satisfied clients. It shouldn’t be too difficult from reading the communication your clients are posting what their major concerns are. It’s important at this stage to resist the urge to respond defensively; barring something inconceivable (a person claims that a crime was committed against them by one of your staff in a program your agency doesn’t offer, for instance) these complaints should be treated as valid.

If your organization has a large online footprint it can be helpful to summarize this information so that you can begin making a plan to rectify the identified issues. This can be an ad hoc process, or integrated into your organization’s strategic planning process.

Begin Reaching Out

Depending on the exact natures identified by your clients, the concerns may be obvious. For instance, if a lot of the negative feedback surrounds how difficult it is to access services, that’s very straight-forward. If complaints describe poor service by staff or other more subjective complaints, then you might have more work cut out for you.

Before you begin reaching out, you need to design a process for this. Will you appoint one employee for the task, or have each program coordinator or individual employee handle complaints in their area? The advantage of using someone who works in that area is that they have more experience and are more aware of the nuances of providing service in that area, but they are also vulnerable to getting defensive.

Small organizations may be stretched thin and want to add a little bit of this work to each employee, while larger organizations may have an Outreach Coordinator or similar who adds social media outreach to their existing duties.

Depending on the platform, the exact way you reach out will differ. Twitter and Facebook both have opportunities to be seen as your organization (Facebook’s “Pages” and company-branded Twitter accounts), while other social networks may make it more difficult.

Think carefully about how you will respond. Make changes in advance if possible, to begin rectifying the situations identified. If you can tell people that changes are underway, they are much more likely to respond positively.

Invite those with more difficult problems to get in touch with the organization directly. Make it known that you want to make sure that their negative experience isn’t repeated.

Implement the Process and Collect Feedback

Once you let your clients on social media know that you are beginning this process of improvement, you’ll want to collect feedback from them. Invite them to complete an anonymous survey to find out about their experiences. Integrate this into your existing evaluation procedures if you have them, and consider using tools like SurveyMonkey to automate the process of data collection.

Be aware that positive change may not be reflected in feedback immediately. Dissatisfied clients may not have the energy to respond, and they’ll need to be coaxed. Knowing that you’re not going to judge or fight them, and merely accept what they have to say as valid from their point of view, will go a long way to helping feel comfortable in responding.

Wash, Rinse, Repeat

It’s important that your social listening not be a “one off” process. Social media is changing every day, and more and more contributions will pour in from your clients. If you take your ear off the ground, you’ll miss these important communication and reputation management opportunities.

Consider using tools like HootSuite to manage your overall social media presence as well, to ensure that clients can make it as easy as possible to tell you exactly how great a job you’re doing, and ways that you can continue improving.

It takes work to perform adequate social listening, but with efforts you can improve your organization’s reputation in the community and improve your services.



Cite this article as: MacDonald, D.K., (2015), "What is Social Listening?," retrieved on November 17, 2017 from http://dustinkmacdonald.com/what-is-social-listening/.

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Least-Squares Regression

Regression is a technique used to predict future values based on known values. For instance, linear regression allows us to predict what an unknown Y value will be, given a series of known X and Y’s, and a given X value.

Given the following, it’s easy to see the pattern. But assuming no obvious pattern exists, regression can help us determine what the Y value will be given our known X values.

X Y
2 3
4 6
6 9
8 12
10 15
12
14

 

The X value is known as the independent variable, the “predictor variable”, while the Y value is the value you’re being predicted.

The linear regression (or “least squares regression”) equation is Y’ = a + bX

  • Y’ (Y-prime) is the predicted Y value for the X value
  • a is the estimated value of Y when X is 0
  • b is the slope (the average change in Y’ for each change in X)
  • X is any value of the independent variable

There are additional formulas for both a and b.

a b

Let’s take a look at the following data-set, that compares the number of calls made for a product against the number of sales:

Calls (X) Sales (Y)
20 30
40 60
20 40
30 60
10 30
10 40
20 40
20 50
20 30
30 70
220 450

 

First we need to calculate the sum of X-squared, Y-squared and X*Y:

Calls (X) Sales (Y) X2 Y2 XY
20 30 400 900 600
40 60 1600 3600 2400
20 40 400 1600 800
30 60 900 3600 1800
10 30 100 900 300
10 40 100 1600 400
20 40 400 1600 800
20 50 400 2500 1000
20 30 400 900 600
30 70 900 4900 2100
Total 220 450 5600 22100 10800

 

Returning to our formula, let’s start with b first:

b

The top of the equation looks like this: b = 10(10800) – 220 * 450 / n(∑X2)-(∑X)2. We’ve simply filled in the values from our chart.

b = 10(10800) – 220 * 450
b = 108,000 – 99,000
b = 9,000 / n(∑X2)-( ∑X)2

Now we have to do the bottom half of the equation:

n(∑X2)-(∑X)2

=10(5600)-(220) 2
=56,000 – 48,400
=7,600

Returning to our equation:

b = 9,000 / 7,600
b = 1.1842

Now let’s move on to a:

a2

a = 450 / 10 – 1.1842 * (220 / 10)
a = 45 – (1.1842 * 22)
a = 45 – 26.0524
a = 18.9476

So, going back to our original regression equation, Y’ = a + bX and plugging our numbers, we get:

Y’ = 18.9476 + (1.1842)X

To use this equation, we now put our desired value in for X. With an estimated 20 calls:

Y’ = 18.9476 + (1.1842)*20
Y’ = 18.9476 + 23.684
Y’ = 42.63

So, a salesperson who makes 20 calls will expect to make 42 sales.



Cite this article as: MacDonald, D.K., (2015), "Least-Squares Regression," retrieved on November 17, 2017 from http://dustinkmacdonald.com/least-squares-regression/.

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Online Counselling and Suicide Intervention Specialist (OCSIS) Review

The Online Counselling and Suicide Intervention Specialist (OCSIS) course is an online, self-study 40-hour course designed to teach basic suicide intervention skills and focusing on online and chat environments, offered by the QPR Institute.

Given the changes in help-seeking behaviour, with more people, especially youth moving online (Horrigan & Rainie, 2006) it’s important that helplines also begin to expand services in this area so that they can better support their clients.

Few online services have been reviewed, but the RAINN online chat has experienced positive reviews. (Finn & Hughes, 2008)

I completed the OCSIS certificate in August 2014, and feel it is an excellent value for the money (the course is approximately $200). It is split into the following modules:

  • Orientation and Introduction to Suicide Prevention
  • Ethics Education for Online Helpers
  • Basic Helping Skills
  • QPR Gatekeeper Training for Suicide Prevention
  • Foundations in Understanding Suicidal Behavior
  • QPR Suicide Triage Training
  • Suicide: The Forever Decision – A text-based Intervention
  • Crisis Mitigation: Part 1
  • Crisis Mitigation: Part 2
  • Course Wrap-Up

Each part of the course includes PowerPoints, audio to listen to and a series of roleplays demonstrating best practices along with explanations for the incorrect answers.

The course is obviously designed for individuals who have had no other experience in helping (with the QPR Gatekeeper Training and the Basic Skills modules included along with the more online-focused skills).

As an experienced helper, I feel like this was a weakness of the course. Lots of the course time was spent reviewing information not relevant specifically to online helping, but general helping skills.

Like many helping skills courses, I felt the roleplays were the most useful element, and any crisis chat training program would do well to spend a minority of the time covering the logistics of online crisis chat and the remainder of the time practicing with roleplays.

Specific elements identified in the course that I have found hold true in the crisis/emotional support chats that I’ve participated in include:

  • The length of chats can be much longer, easily an hour where a similar call can be 20 minutes
  • Chats can be more asynchronous (depending on the platform) and so can stretch on for several days or weeks; this can lead to burnout if helpers are not careful
  • Because of technology limitations, active rescue is more difficult or impossible. This can cause helpers to experience a sense of powerlessness if they experience a suicide attempt in progress.

The course is also a prerequisite for IMAlive, the online crisis chat run by the Kristin Brooks Hope Center, the organization that (formerly) ran the 1-800-SUICIDE line.

Bibliography

Horrigan J., & Rainie, L. (2006). The Internet’s major role in life’s major moments.
PEW Internet and American Life Project (2006)

Finn, J., & Hughes, P. (2008). Evaluation of the RAINN National Sexual Assault Online Hotline. Journal Of Technology In Human Services, 26(2/4), 203-222. doi:10.1080/15228830802094783



Cite this article as: MacDonald, D.K., (2015), "Online Counselling and Suicide Intervention Specialist (OCSIS) Review," retrieved on November 17, 2017 from http://dustinkmacdonald.com/online-counselling-and-suicide-intervention-specialist-ocsis-review/.

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Conducting Psychosocial Assessments

As a Social Service Worker student I spent 8 months as a Bereavement and Palliative Care Case Manager with Durham Hospice, an organization that provides counselling, peer support and friendly visiting individually and in group sessions for individuals suffering from life-limiting illnesses (in particular those with less than a year to live) and those who are bereaved.

One task required of that, and an important skill for social workers, social service workers and others in the helping profession is how to perform psychosocial assessments. These assessments give a biographical sketch of an individual and may include areas such as:

  • Presenting Problem
  • Basic Information
  • Family History
  • Medical History (including often separate sections for Substance Use and Abuse)
  • Support Systems
  • Education and Employment
  • Spirituality
  • Assessment Summary and Next Steps

There are a variety of free structured and semi-structured assessment tools, so no need to re-invent the wheel. Many tools change or modify this sequence, and it should be interpreted as a rough, example outline at best. Most agencies, if a tool doesn’t exist, eventually end up developing their own that covers what they need. For instance, Durham Hospice’s tool incorporated the Bereavement Risk Assessment Tool.

Goals of a Psychosocial Assessment

The goals of a psychosocial assessment is to establish where the client is at the moment of contact (or changes – positive or negative if this is a subsequent assessment) and to determine what services would be most effective to remove the barriers a client is currently experiencing.

Depending on your agency you may be limited in the services that you have at your disposal but it is important to perform a comprehensive evaluation so that you and the client can make decisions with all available information.

Establishing Rapport

The first step to conducting a psychosocial assessment is to establish rapport. This involves any steps you can take to ensure a warm and welcoming environment.

If a person is coming to your office, it’s important to have a confidential area for you to talk, with comfortable chairs and limited distractions. If visiting someone’s home, showing respect for their home is important. Depending on your clients, it may not be safe for you to remove your shoes, but showing that you care about their environment is important.

In either situation, you should speak slowly and with a gentle (but not condescending) voice tone; if your environment permits it, offer them coffee or tea. Your goal is to help the client feel comfortable so that they’re willing to open up to you in what may be a very stressful and scary situation.

Collecting Information

Once you’ve begun the actual interview process, it is important to remember that while you have a need to collect information, you are speaking to a human being. Starting with more lightweight questions allows you to begin learning information about the person’s employment and school status, their physical health, and their family history.

Sections of the Assessment

Presenting Problem

In this section, you describe the problem that initially led the person to seeking out your services. Depending on much information you have this section may not be particularly detailed. For instance, “Mario phoned in seeking housing assistance as he is about to be evicted from his rooming house.”

Basic Information

In this section, you describe the gender, age, marital status, race and ethnicity and living arrangements. For instance, “John is a 32 year-old white male who lives alone in an apartment in [neighbourhood]-area and is not married.” Depending on the cooperation of the client, this information shouldn’t be too difficult.

Family History

In the family history section, you want to describe the client’s family and their relationships with those individuals. Who the person has in their life, and how much of a support they are. If you have their ages, this information can also be included.

For example, “Allison has a good relationship with her mother (51) and father (53). She is an only child. She has one aunt and uncle who she has no relationship with, and little knowledge of her extended family. She expresses no interest in relationships with her extended family but does want to learn about her family tree.”

Medical History

In the medical history section, you can list details about any medical health issues the person is experienced. If they take medication, listing it (and dosages if available) is helpful.

For example, “Lois is diagnosed with Major Depressive Disorder (MDD) and sees a psychiatrist twice monthly. She is currently on Lexapro (escitalopram) 20mg once a day. She also suffers from asthma and has been a smoker since her early teens. Her medication makes her feel bloated and this makes it hard for her to stay compliant with her medication.”

Support Systems

In the support system (or similar) section, you can list any supports that a person has. This can include her friends, family, any other community organizations and so on. Does the client have any hobbies? These are also important to record.

For example, “Lisa has two friends she considers good supports. Additionally, she volunteers for a local charity store to keep busy and has weekly telephone contact with a friendly visiting organization. She enjoys knitting.”

Education and Employment

Sometimes this section is found in one of the others, and sometimes it is separate. You’ll want to describe the job title, industry, organization (if available) of a person’s employment. Additionally, make sure you describe the permanence (or lack thereof.)

With regards to education, note the type of qualification, school and major/program, and what a person hopes to do with it. An example is below:

“Sarah works part-time as a cashier at a grocery store. This work pays minimum wage and is permanent; her work is not threatened in the near future. She is a full-time student in a two-year Veterinary Technician program and hopes to seek employment in that field after her graduation next year.”

Spirituality

A person’s religion may be a very strong factor in their life, but for others it may not come up. At Hospice, because of the potential for dying soon, spirituality was likely a more important element in our clients than in many organizations. You’ll want to record a person’s religion (if present), their degree of involvement in the organization and any other thoughts.

For instance, “James is a devout Catholic who attends Mass every week. He has a strong relationship with the Church and with his local clergy. He finds the Church a strong source of emotional support.”

Assessment Summary and Next Steps

In this section, you’ll want to record your overall impressions of the client and what services you think are most helpful for the client. This section will likely be the least standardized because it is most dependent on the services your agency actually provides.

Conducting psychosocial assessments is an important skill for every person in the social services to learn, and I recommend every social worker or social service worker spend time performing them under supervision so they can develop this core competency.



Cite this article as: MacDonald, D.K., (2015), "Conducting Psychosocial Assessments," retrieved on November 17, 2017 from http://dustinkmacdonald.com/conducting-psychosocial-assessments/.

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