The Cass Identity Model, formally the Homosexual Identity Formation Model is a 6-stage process for “coming out.” It describes the stages that an individual may go through as they come to terms with their sexuality, both internally and externally. The six stages are as follows:
- Identity Confusion
- Identity Comparison
- Identity Tolerance
- Identity Acceptance
- Identity Pride
- Identity Synthesis
These are explored in more detail below:
During this first stage, individuals receive information about LGBT identities, which most people consider personally irrelevant to themselves. At some point, some people will experience thoughts, feelings, or physiological response (arousal) that leads them to ask themselves if they may be LGBT.
This stage may involve significant confusion and concern, as there is a conflict between one’s view as heterosexual and the thoughts they are experiencing. Cass notes the question “If my behaviour may be called homosexual, does that mean I am a homosexual?” This leads to the broader “Who am I?” conversation.
The result of this first stage is one of 3 reactions:
- If the individual recognizes they are LGBT and likes this, no attempt is made to change their behaviour
- If the individual recognizes they are LGBT and dislikes this, they may deny their identity and become homphobic (“moral crusader”) – this can lead to a self-hating identity
- If the individual believes their behaviour is incorrect and also dislikes it, they may respond by redefining it as non-homosexual behaviour. Cass gives the example of a prisoner, or other groups where men who have sex with men may occur without needing to label it
During Identity Comparison the individual begins to ask themselves if they’re homosexual. This is the first tentative acceptance of a potential LGBT identity. In Identity Comparison comes the need to tolerate social alienation and belief that they are different (and potentially, alone.)
Two major potential reactions to Identity Comparison result:
- The individual recognizes they are different and is not bothered by this – the result is that they devalue the judgemental opinions of others
- The individual recognizes they are different and does not like this. They redefine the meaning of their sexuality (e.g. I am only homosexual with this person) or otherwise denies the meaning of their sexuality
In the identity tolerance stage, the individual has moved towards understanding they are homosexual. They no longer maintain their state of turmoil or identity confusion but may feel more alienated because those who see them as heterosexual struggle to see them otherwise.
At this stage meeting other LGBT individuals helps reduce the feelings of alienation and isolation is helpful in moving through this stage to identity acceptance. The opposite of this, is an alienation from the community and continued self-hatred.
At the end of this stage the individual can firmly say “I am a homosexual.”
In the Identity Acceptance stage, the individual has further normalizing and validating contacts with others in the LGBT community and the LGBT subculture begins to be a larger part of their life.
It’s noted here that there may be a clash between the LGBT individual who wishes to live their life “openly” gay, versus the heterosexual individuals in their life who may tolerate their sexuality but not wish it to be displayed openly. This may result in insulation of the individual from intolerant friends and other methods to limit their exposure to them.
In Identity Pride, the pendulum has swung far to the right, and the individual may dichotomize the world into two categories, a significant LGBT category and an insignificant heterosexual category. Pride also results in the devaluation of heterosexual institutions and values like marriage and sexual roles.
Heteronormativity appears at this stage as well, with Cass noting the slogan “How dare you presume I’m heterosexual” representing the LGBT individual’s desire to make their homosexuality aware to those around them, at the expense of recognizing heterosexual identities in their life.
Identity Synthesis is the six and final stage. In this stage, the individual’s sexuality becomes just another part of them, and it no longer dominates or defines them. Just as a heterosexual individual doesn’t see the world through just the lens of their heterosexuality (as opposed to ethnic, cultural, gender, or other lenses), nor does the synthesized LGBT individual. The coming out process is complete.
Research on the Cass Identity Model
Kenneady & Oswalt (2014) conducted a comprehensive review of the literature and found a number of other models that closely matched the Cass model, in addition to research supporting its application in the form of questionnaires and other assessment tools. They highlight four major critiques of the model:
- It is linear and may not represent the process in reality
- There is only a focus on gay and lesbians, not on bisexual or trans individuals
- Sexual identity development is assumed to be gender-free, with no difference between men and women
- There is nothing addressing racial or ethnic impacts on sexual identity development
Degges-White, et. al. (2000) noted that the model was developed primarily in interviews with gay men, and its utility with lesbian women may be limited. Degges-White herself followed up in 2005 with the Adolescent Lesbian Identity Formation Model to address some of these weaknesses.
Gervacio (2012) compared the Cass Identity Model with the Fassinger (1998) model and found that although both required updates to respond to changing social attitudes they were effective in describing the experiences of gay and lesbian individuals.
Zubernis, et. al. (2011) also used the Cass Identity Model along with Chickering’s Model of College Student Development to demonstrate how lesbian and gay college students can be assisted in the coming out process.
Cass, V.C. (1979) Homosexual Identity Formation: A theoretical formation. Journal of Homosexuality. 4(3). 219-236
Degges-White, S., Rice, B., & Myers, J. E. (2000). Revisiting Cass’ Theory of Sexual Identity Formation: A Study of Lesbian Development. Journal Of Mental Health Counseling, 22(4), 318.
Degges-White, S. E., & Myers J. E. (2005). The Adolescent Lesbian Identity Formation Model: Implications for Counseling. Journal Of Humanistic Counseling, Education & Development, 44(2), 185-197.
Fassinger, R. E. & Miller, B. A. (1996). Validation of an inclusive model of sexual minority identity formation on a sample of gay men. Journal of Homosexuality, 32(2), 53-78.
Gervacio, J. (2012). A Comparative Review of Cass’s and Fassinger’s Sexual Orientation Identity Development Models. Vermont Connection, 3350-59.
Kenneady, D. A., & Oswalt, S. B. (2014). Is Cass’s Model of Homosexual Identity Formation Relevant to Today’s Society?. American Journal Of Sexuality Education, 9(2), 229-246. doi:10.1080/15546128.2014.900465
Zubernis, L., Snyder, M., & Mccoy, V. A. (2011). Counseling Lesbian and Gay College Students through the Lens of Cass’s and Chickering’s Developmental Models. Journal Of LGBT Issues In Counseling, 5(2), 122-150 29p. doi:10.1080/15538605.2011.578506
With an increase in school shootings, such as the 1999 Columbine shootings and the 2012 Sandy Hook shooting, it has become more important for educators, police and mental health professionals. This article reviews the literature on threat assessment in schools, primarily focusing on elementary and secondary schools.
Safe Schools Initiative
The Safe Schools Initiative “examined incidents of targeted school violence from the time of the incident backward, to identify the attackers’ pre-incident behaviors and communications and to explore whether such information might aid in preventing future attacks.” (Vossekuil, et. al., 2004)
The Safe Schools Initiative developed out of the same threat assessment process used and refined by the Secret Service in their examination of threats against public officials, called the Exceptional Case Study Project (ECSP) that examined violence focused on a particular individual and leading to credible threats. (Fein, et. al., 2002)
The ten key findings of the Safe Schools Initiative are listed below (Vossekuil, et. al., 2004):
- Incidents of targeted violence at school rarely were sudden, impulsive acts
- Prior to most incidents, other people knew about the attacker’s idea and/or plan to attack
- Most attackers did not threaten their targets directly prior to advancing the attack
- There is no accurate or useful “profile” of students who engaged in targeted school violence
- Most attackers engaged in some behavior prior to the incident that caused others concern or indicated a need for help
- Most attackers had difficulty coping with significant losses or personal failures. Moreover, many had considered or attempted suicide
- Many attackers felt bullied, persecuted, or injured by others prior to the attack
- Most attackers had access to and had used weapons prior to the attack
- In many cases, other students were involved in some capacity
- Despite prompt law enforcement responses, most shooting incidents were stopped by means other than law enforcement intervention
Principles of Threat Assessment
There are six principles of the threat assessment process. (Fein, et. al., 2002; Vossekuil, Fein, & Berglund, 2015)
- Targeted violence is the end result of an understandable, and oftentimes discernible, process of thinking and behavior
- Targeted violence stems from an interaction among the individual, the situation, the setting, and the target
- An investigative, skeptical, inquisitive mindset is critical to successful threat assessment
- Effective threat assessment is based on facts rather than on characteristics or “traits.”
- An integrated systems approach should guide threat assessment inquiries and investigations
- The central question in a threat assessment inquiry or investigation is whether a student poses a threat, not whether a student has made a threat
Threat Assessment Screening Protocol
The “Student Threat Assessment and Management System – Level 1 Screening Protocol” (Salem-Keizer School District, 2010) provides a comprehensive process that begins with obtaining parental consent, exploring the threat and collecting information from the student and other resources (e.g. classmates), and finally – where available – having a mental health assessment conducted. All the information is documented and provided to the School Board and/or law enforcement so that follow-up action can be taken.
An important part of this document is the presence of a safety plan that allows the assessor to document the steps they have taken to mitigate the risk of danger.
This screening protocol covers the Key Questions identified by the ECSP and SSI studies as important to assessing threats, which include:
- Motives and goals for the violence
- Who the individual has talked to about their plans or thoughts
- Whether they’ve researched other cases of violence
- Have knowledge of or access to weapons
- What previous violence they may have engaged in (stalking, harassing, preparing or rehearsing attacks)
- Their mental state (including hopelessness or desperation)
- How capable are they of committing an act of violence (logistically, organized)
- Is there corroboration from other sources about the violence? Do the people around the individual have concerns?
- Are there attitudes supporting violence? (E.g. seeing it as acceptable; this is also a part of the Spousal Assault Risk Assessment tool that explores individual violence)
- Are there modifiable risk factors that could increase or decrease the individual’s level of risk?
Training in Violence and Threat Risk Assessment
The Canadian Centre for Threat Assessment and Trauma Response has developed the Violence Threat Risk Assessment (VTRA) which comes in two levels. Level 1 VTRA is designed for front-line staff including educators, administrators, police officers, mental health workers and others who may need to perform risk assessment in the educational setting.
Level 2 VTRA is designed for actual risk assessment and interviewing potentially violent individuals. It is designed as a follow up to the Level 1 VTRA. A variety of other organizations provide generic threat assessment training focusing on elementary and secondary schools.
Books on Threat Assessment
Threat Assessment in Post Secondary
So far we have looked at threat assessment in an elementary and secondary school environment but there is work being done on the post-secondary side (colleges and universities) as well, given well-known attacks such as the 2007 Virginia Tech Massacre.
Perloe & Pollard (2016) explains the role of counsellors at a college with a Threat Assessment and Management (TAM) team, also called (e.g. in Bolante & Dykeman, 2015) a Threat Assessment Team (TAT). Counsellors are advised to provide consultation to non-clinical members of the team and be one part of a multifacted approach, but, where possible, avoid being the treatment provider of any student of concern directly to avoid breaching confidentiality.
Perloe & Pollard also point out that forensic violence risk assessment in this context is different from the normal suicide risk assessment or violence-to-others assessment that clinicians are normally familiar with and so outside professionals may be required to competently assess risk.
Bennett & Bates (2015) note the importance of establishing a culture where reporting is encouraged. Given that the vast majority of threats never lead to an incident of violence, students and staff should know that reporting will not result in punitive measures but rather a collaborative approach to help the individual cope with their feelings.
The U.S. Department of Justice, through their Community Oriented Policing Services produced “Campus Threat Assessment Case Studies” (2008) as a training aid.
Threat assessment is an emerging field that requires a coordinated, professional response at both the elementary/secondary and the post-secondary levels.
For counsellors, specialized training in forensic violence risk assessment is important to ensure that they respond competently and effectively. For educators and police officers, building partnerships with the community and encouraging reporting so that safety plans can be put into place will help mitigate the risk of violence.
Bennett, L., & Bates, M. (2015). Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges. JEP: Ejournal Of Education Policy, 1-16.
Bolante, R., & Dykeman, C. (2015). Threat assessment in community colleges. Journal Of Threat Assessment And Management, 2(1), 23-32. doi:10.1037/tam0000033
Department of Justice. (2008) Campus Threat Assessment Case Studies. Retrieved on July 30, 2016 from http://ric-zai-inc.com/Publications/cops-w0693-pub.pdf
Fein, R., Vossekuil, B., Pollack, W., Borum, R., Modzeleski, W., & Reddy, M. (2002). Threat assessment in schools: A guide to managing threatening situations and to creating safe school climates. Washington, DC: U.S. Secret Service and U.S. Department of Education.
Vossekuil, B., Fein, R.A., Reddy, M., Borum, R. & Modzeleski, W. (2004) The Final Report and Findings of the Safe School Initiative: Implications for the Prevention of School Attacks in the United States. United States Secret Service & United States Department of Education.
Vossekuil, B., Fein, R. A., & Berglund, J. M. (2015). Threat assessment: Assessing the risk of targeted violence. Journal Of Threat Assessment And Management, 2(3-4), 243-254. doi:10.1037/tam0000055
Introduction to Text and Chat
With text and chat services increasingly moving online, emotional support work – the core element of the work of crisis lines is needing to be adapted to work in new formats that require a change in your perspective and technique. On the telephone, there are a number of ways of providing a warm, genuine experience. For instance, your voice tone and pitch communicates a lot, as well as the speed in which you talk, whether you speak over the caller or let them lead, and so on. There is a lot of non-verbal communication that happens on the phone.
In contrast, online all you have is text. So many of the dimensions that are used to promote warmth, communicate empathy and demonstrate caring are simply absent. This makes it more difficult to build rapport with these visitors and be effective.
The elements of active listening, or the active listening process are the same, although of course it seems unusual to call it “listening” since you aren’t using your ears. There is still an effort made to be alert for and respond to communication, however. Some people prefer “emotional support” instead.
Chat and Text Length
Chat and text conversations tend to be longer than telephone conversations; an average telephone call may be 20 minutes while a crisis chat or text conversation will be 45-60 minutes. This is due to the time required for you to send a text, for the visitor to receive it, read it, decide what they’re going to write, and then write back. You may not send a lot of messages in this 60 minutes, but that doesn’t mean that you aren’t accomplishing a lot – which is reflected in the outcomes, often up to 30% reduction in subjective distress over an hour.
In the opening of a text-based conversation, it’s important to be warm and genuine. Your opening message should give your name, because the visitor doesn’t have anything else to go on. You may want or need to identify your organization as well. Finally, you’ll want to ask the visitor what brought them to text in.
An example of an opening message I could use on the ONTX Project is “Welcome to the ONTX Project. My name is Dustin, what’s going on in your life?”
Sometimes a visitor will text in with a lethality statement, something like, “I want to die.” This doesn’t necessarily change your opening, but it doesn’t hurt to acknowledge the suicidal feeling. “Welcome to the ONTX Project. My name is Dustin, it sounds like you’re really struggling. Did you want to tell me what’s been going on?”
Some visitors though, may need a bit of encouragement. If you ask a visitor how they’re feeling, they may reply “idk” (I don’t know) or “bad”, and not elaborate. Other visitors may be much more articulate and be able to explain what’s going on in their life.
If someone says “idk” or “bad”, usually my next move is to ask them what’s on their mind tonight. This is a gentle way of rewording the question that helps them feel more comfortable. Usually at this point they’ll begin talking, but if not my final option is “What were you hoping to get out of texting in tonight?”
I’ve never had a visitor respond with “idk” or other messages after this much encouragement but I would likely empathize with how difficult it’s been for them to text in before ending the conversation and inviting them to try us again when they’re more able to speak.
Because of a 140 character limit, some of these messages may need to be sent as a pair of messages on text.
Exploring the Issue
Exploring the issue that the visitor is texting in about can be challenging. Unlike the helpline, where you may need to take a while to establish rapport, visitors on text tend to jump right to their primary concern rather quickly. They don’t have the luxury of many messages back and forth.
If you’ve used the above Opening the Conversation ideas, you should be well into exploring the issue. This section should proceed just the same way as an offline conversation does, using all elements of the active listening process (open ended questions, paraphrasing and summarizing.)
You may notice that you need to ask more clarifying questions than usual, because with text and a lack of tone it’s easier for things to be misunderstood or misconstrued.
In an online environment, you have no voice tone to demonstrate empathy. For this reason it’s important to write out your empathy statements clearly in order to show that you have an idea what the visitor is going through. Clarifying and paraphrasing can help in rapport building as well, by demonstrating that you are paying attention. It’s important to recognize that clarifying, paraphrasing and other open and close-ended questions are not a replacement for pure empathy.
Empathy: You sound really alone.
Clarifying: You just lost your dog?
Paraphrasing: You’ve been having trouble since you lost your pet.
Note the difference, empathy highlights an emotion (alone) while clarifying and paraphrasing primarily on content without regard to an emotional undertone.
Suicide Risk Assessment and Intervention
Suicide risk assessment and intervention is a challenging topic over chat and text. The primary challenges in this environment include the difficulty collecting the amount of information required to perform a competent assessment in 140 characters and the lack of voice tone and body language.
Typically the first question asked on chat and text after confirming suicide thoughts are present is to determine if they’re at imminent risk. This is usually accomplished by asking something like “Have you done anything to kill yourself?” or “Have you taken any steps to end your life tonight?”
Chatters and texters will sometimes text in immediately after an overdose, and will readily reveal their level of danger but not until you ask. Sooner rather than later!
Next, I’ll ask the visitor what’s led them to feeling suicidal. This, when combined with an empathy statements, helps to begin exploring the visitor’s reasons for living or dying. For example, “You must be feeling so overwhelmed. Tell me what’s led you to feeling suicidal?”
After this, I move onto the elements of the DCIB Suicide Risk Assessment tool.
Winding Up Conversations
Because visitors are using their cell phones, they can put their phone in their pocket, and then pull it out without thinking about the time that passes in a few minutes. It’s not uncommon that at the end of your 45-60 minutes, when it comes to winding up, the visitor doesn’t even realize that amount of time has passed. They find themselves feeling better, however, which is great news!
Winding up has to be deliberate, otherwise the visitor is unlikely to wind up in a decent time. Past experience has shown that crisis chats can last 3 hours or longer lacking a proper wind up. In order to initiate a windup, you simply have to give the visitor an opportunity to express anything else on their mind and then let them know that you have to go. For example,
“We’ve been talking for about an hour so we’ll need to wrap our conversation up soon. I’m wondering if there’s anything else on your mind that you haven’t shared yet.”
Or, more succinctly,
“We’re just coming up on 45 minutes of chatting so we’ll need to wind up soon. Was there anything else you wanted to share before we do?”
This cues the visitor that the conversation needs to end and lets them focus on any outstanding issues. For instance, you may be convinced of their safety and they may not be – and by pointing that out by replying “I don’t know what to do to avoid attempting suicide tonight” then you can spend your remaining 15 minutes implementing a comprehensive safety plan for that visitor. In this way, the windup can be a tool for you and the visitor.
The Z-test is a simple tool for hypothesis testing that can be used to identify whether a mean result, when compared to a larger set is statistically significant when the larger set is a normal distribution.
Many datasets (for instance population height, test scores, etc.) have normal distributions. If you’re unsure whether your dataset has a normal distribution you can approximate and assume that it does if you have at least 30 items to draw on (e.g. 30 students heights, 30 test scores.)
You will need to know the population mean and the standard deviation in order to perform the one-sample z-test. If you don’t know the standard deviation you should use a t-test instead.
The following six steps are for a Z-test:
- Identify our population, comparison distribution, hypothesis and assumptions. Choose an appropriate test.
- State the null and research hypotheses.
- Determine the characteristics of the comparison distribution.
- Determine the cutoffs that indicate the points beyond which we reject the null hypothesis
- Calculate the test statistic.
- Decide whether to reject or accept (fail to reject) the null hypothesis.
One-Sample Z-Test Formula
The following is the formula for the z-test:
Where x̄ (x-bar) is the sample mean, ∆ (delta) is the value you are comparing it with (the population mean), σ (sigma) is the population standard deviation and n is the number of values in the larger set.
The example we will work with for our one-sample z-test is a set of students who received 4 hours of study strategies tutoring before beginning a statistics course and another set of students who did not. You can compare the grades of these students to find out if the tutoring has impacted their grades.
There are 150 students in the class. The mean score in the class (x-bar) is 72, with a SD of 6. The mean score of the 20 students who received tutoring (delta) is 75 with a SD of 5. These values seem too close for us to estimate purely by hand so we will use our formula. Plugging this into the formula, we get:
z = 75 – 73 / (5 / sqrt(150))
z = 75 – 73 / (5 / 12.25)
z = 75 – 73 / 0.41
z = 2 / 0.82
z = 2.44
Looking up 2.44 in our Z-Table gives us 49.27.
We subtract 49.27 from 50 (the mean) gives us 0.0073 (the % in tail value in the z-chart.) Because we are performing a two-tailed test (we want to know whether our value is significantly above or significantly below the mean), we multiply 0.0073 by to get a p value of 0.0146.
In order to reject the null hypothesis, our p value must be under 0.05. Because our p value is below 0.05, we reject the null hypothesis. This means that the students who received 4 hours of tutoring did have better grades than those who didn’t.
The following is the last in a series of articles (posted once a week) where I began to fill in basic crisis intervention skills in order to make this website a more comprehensive and useful resource to beginning crisis workers as well as experienced ones.
Basic strategies for crisis intervention have been identified by Myer and James (2005) in the book “Crisis Intervention Strategies, 6th Edition.” These nine strategies are used to help stabilize the client and can be used at any time in the crisis intervention process. These strategies are listed below:
Crisis Intervention Strategy 1: Creating Awareness
The crisis worker can promote an awareness of the feelings underlying a client’s behaviour. For instance, someone who is suicidal may have not considered their reasons for living or dying. The worker can help them get awareness of these thoughts and feelings which helps give them new perspective.
Crisis Intervention Strategy 2: Allowing Catharsis
Catharsis is the expression of emotion, for therapeutic purposes. Clients may experience a range of emotions and behaviours, including crying, yelling, swearing, and so on as they vent about what they’re going through. As a client describes what’s going on in their life they may find themselves brought right back to the same emotional intensity when they originally experienced the situation, or even worse.
Someone who talks about a situation that made them powerless or angry will find their blood pressure rising, sweating, and all the other physiological responses from the first time. Keep in mind that if a client is getting too elevated it may be more helpful to practice deep breathing and grounding exercises to bring the client back to the present.
Crisis Intervention Strategy 3: Providing Support
This strategy involves naturalizing the client’s response to what they’ve been going through. Often times clients will think that they are crazy or that they are overreacting. Note I didn’t use the word “normal”, because their suspended coping skills are not effective or even typical in someone who is not experiencing a crisis. They are however common, and we need to point out that they are natural given people who are so overwhelmed.
As an example of providing support, many people see suicidal behaviour or an inability to cope as a sign of weakness, which can impair their ability to respond effectively. Pointing out that reaching out for help, the behaviour that brought them into contact with the crisis worker in the first place, is itself a good response, and working with them to build a plan will help them feel less overwhelmed.
Crisis Intervention Strategy 4: Increasing Expansion
Increasing expansion involves helping clients get out of their tunnel vision. This is very common with suicidal individuals who are totally unable to see anything but hopelessness in their situation. By providing alternative perspectives, the client will begin to see that their situation can be different.
Reframing in general is a very common strategy throughout crisis intervention and in therapy, especially cognitive behavioural therapy (CBT), where distorted thoughts are the cause of depression and suicidal thoughts.
Crisis Intervention Strategy 5: Emphasizing Focus
When clients have the opposite of tunnel vision and their cognitions are all over the place with no basis in reality, emphasizing focus becomes more important. This helps the client to focus on the specific causes of the crisis and break solutions down into manageable steps that help clients work through these things.
Crisis Intervention Strategy 6: Providing Guidance
Guidance involves providing information and referral services to clients, to help them fix specific issues in their life. This is more commonly achieved by case management in the long-term, but in the short-term may be performed by telephone or in-person crisis workers.
Crisis Intervention Strategy 7: Promoting Mobilization
Mobilization involves helping crisis workers access external supports. Because individuals in crisis have difficulty accessing their internal coping skills external and peripheral supports become more important. These include the people around them that they can trust and be supported by, and professional supports like counsellors and therapists.
Crisis Intervention Strategy 8: Implementing Order
Implementing order helps clients break their problem down into manageable pieces and decide which ones are the most important. By dealing with the most important issues first, they’ll be able to get a sense of control and begin to take advantage of internal coping strategies.
Crisis Intervention Strategy 9: Providing Protection
Finally, providing protection (which is Step 2 of the Six Step Model of Crisis Intervention) involves protecting the client from their own self-injurious behaviour and potentially harmful behaviour towards others. Suicide and homicide risk assessment is an important part of this strategy, which is demonstrated throughout the crisis intervention process.
If you’re a Durham College student enrolled in SSW2506 Crisis Intervention then you’ll want A Guide to Crisis Intervention, 4th + Helping Professions Learning Center 2-Semester Printed Access Card instead.
Myer, R.A. & James, R.K. (2005) Crisis intervention workbook and CD-ROM. Belmont, CA: Thomson Brooks/Cole.