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Cited by 40Suicide and Self-Harm StudiesHuman Resource Development and Performance EvaluationCounseling Practices and Supervision

Measuring trainer fidelity in the transfer of suicide prevention training

Open access
Cross, Wendi F., Pisani, Anthony R., Schmeelk-Cone, Karen, Xia, Yinglin, Tu, Xin, McMahon, Marcie, Munfakh, Jimmie Lou, Gould, Madelyn S.·2014·Crisis
DOI 10.1027/0227-5910/a000253PMC PMC4273242
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Abstract

Background: Finding effective and efficient models to train large numbers of suicide prevention interventionists, including ’hotline’ crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied. Aims: To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments. Method: We recorded and reliably rated trainer fidelity, defined as adherence to program content and competence of program delivery, for 34 newly trained ASIST trainers delivering the program to crisis center staff on two separate occasions. A total of 324 observations were coded. Trainer demographics were also collected. Results: On average, trainers delivered two-thirds of the program. Previous training was associated with lower levels of trainer adherence to the program. In all, 18% of trainers’ observations were rated as solidly competent. Trainers did not improve fidelity from their first to second training. Significantly higher fidelity was found for lectures and lower fidelity was found for interactive training activities including asking about suicide and creating a safe plan. Conclusions: We found wide variability in trainer fidelity to the ASIST program following TTT and few trainers had high levels of both adherence and competence. More research is needed to examine the cost-effectiveness of TTT models.

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  • Across all modules, therapists delivered 86% of essential components and demonstrated capable skills (M = 3.2 out of 4), indicating sufficient adherence and predominantly capable competence.

    “Across all modules, on average, therapists delivered 86% (12%) of essential components and demonstrated capable skills (M = 3.2 [0.4] out of 4), indicating sufficient adherence and predominantly capable competence (Cross et al., 2014).”

    From Brief modular anxiety intervention for primary care: Hybrid I pilot randomized controlled trial of feasibility, acceptability, effectiveness, and implementation potential (2024) · cites this paper as Cross et al., 2014

    The Abstract’s Results report that trainers delivered two-thirds of the program on average, not 86% of essential components. The Discussion says only 18% of trainer observations were rated solidly competent, contrary to the claim of predominantly capable competence. The paper studies trainers, not therapists; our copy does not report the claimed mean of 3.2 out of 4. (LLM, conf=0.90)

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Research works printed but not linked: 2

  1. Byrne BM 2010 Structural Equation Modeling With Mplus New York: Routledge Taylor & Francis Group
  2. Pisani AR Cross WF Watts A Conner K 2012 Evaluation of the Commitment to Living (CTL) curriculum: A 3-hour training for mental health professionals to address suicide risk Crisis: The Journal of Crisis Intervention and Suicide Prevention 33 1 30 38 PMC3529124 21940243

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Authors
Cross, W. F., Pisani, A. R., Schmeelk-Cone, K., Xia, Y., Tu, X., McMahon, M., Munfakh, J. L., & Gould, M. S.
Affiliations
  • University of Rochester Medicine (US)
  • Department of Psychiatry, University of Rochester Medical Center (URMC), Rochester, NY, USA
  • New York State Psychiatric Institute (US)
  • Columbia University Irving Medical Center (US)
ORCID
Venue
Crisis
Publisher
Hogrefe Publishing Group
Published
2014-05-01
Volume
35
Issue
3
Pages
202-212
ISSN
  • 0227-5910 (ISSN-L)
  • 2151-2396
DOI
10.1027/0227-5910/a000253
PMC
PMC4273242
OpenAlex
W2099389850
Cited by
40
References
48
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 1 · 2022: 7 · 2021: 2 · 2020: 3 · 2019: 6 · 2018: 1 · 2017: 3 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 2
FWCI
3.93
Type
journal article
Language
en
Open access
Locations
  • Crisis (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r01mh082537-02, 5t32mh020061-25, KL2TR000095)
  • National Institute of Mental Health (T32 MH20061, R01 MH082537, R01MH082537-01A1, K23MH73615, T32-MH020061, K23MH073615, R25MH080916)
  • National Center for Research Resources (KL2RR024136)
  • National Center for Advancing Translational Sciences
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Applied Psychology › Human Resource Development and Performance Evaluation
  • Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
Keywords
trainer training, suicide prevention training, ASIS&T, program adherence, trainer competencies, cost-effectiveness
MeSH terms
Suicide Prevention, Crisis Intervention, Female, Humans, Male, Teaching

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