Training

The CCM (Cramer et al., 2013, 2023) provides training for mental health providers in basic-to-intermediate skills. Based on a social-cognitive training approach, the CCM addresses 10 clinical care and clinician self-management skills:

1. Managing your attitudes and reactions toward suicide-related topics
2. Maintaining a collaborative, empathetic stance toward the client
3. Assessing evidence-based, culturally-informed risk and protective factors
4. Eliciting details of current plan and intent of suicidal ideation
5. Developing a therapeutic and tailored risk formulation
6. Enacting a collaborative evidence-based treatment plan
7. Involving supportive other persons
8. Documenting formulation, plan, and reasoning for clinical decisions
9. Knowing the law concerning suicide
10. Engaging in debriefing and self-care

Training includes psycho-educational, interactive scenarios, and resources for mental health providers. It is also accompanied by the Suicide Competency Assessment Form-Revised (Cramer et al., 2023), a self- and/or observer-rated tool for use in clinical supervision, self-reflective practices, and training evaluation. Training in these essential skills sets the provider up to move to advanced risk management and therapeutic interventions.

The CCM-M tailors core competency model training to the unique needs and considerations of military active duty and veteran populations.  Based on a social-cognitive training approach, the CCM addresses 10 clinical care and clinician self-management skills:

1. Managing your attitudes and reactions toward suicide
2. Maintaining a collaborative, empathic stance toward the client
3. Eliciting evidence based risk and protective factors
4. Focusing on current plan and intent of suicidal ideation
5. Determining level of risk
6. Developing and enacting a collaborative evidence-based treatment plan
7. Notifying and involving other persons
8. Documenting risk, plan, and reasoning for clinical decisions
9. Knowing the law concerning suicide
10. Engaging in debriefing and self-care

CCM-M training draws on the Veterans Affairs/Department of Defense (VA/DoD, 2019) suicide clinical practice guidelines to provide entry level suicide prevention skills for mental health providers. Using CCM training approaches (e.g., case scenarios), military-specific suicide prevention attitudes, policies, and treatments are also covered.

The CCM-C (Cramer, Kaniuka, & Peiper, 2022) program is an adapted version of the original Core Competency Model (CCM), tailored for considerations of carceral populations and settings. Adopting the Centers for Disease Control Self-Directed Violence (SDV) framework, the CCM-C program provides training in correctional suicide and self-injury prevention skills for mental health providers. The program covers the following essential skills:

1. Managing your attitude and reactions toward self-directed violence
2. Maintaining a collaborative, empathetic stance toward the client
3. Knowing and eliciting evidence-based risk and protective factors
4. Focusing on current plan and intent of self-directed violence
5. Determining level of risk
6. Developing and enacting a collaborative evidence-based treatment plan
7. Notifying and involving other persons
8. Documenting risk, plan, and reasoning for clinical decisions
9. Knowing the law concerning self-directed violence
10. Engaging in debriefing and self-care

CCM-C training provides psycho-educational content, clinical scenarios, and self-assessment resources. A core part of the training covers development and use of the Self-Injury Risk Assessment Protocol for Corrections (SIRAP-C; Cramer et al., 2022), a structured approach to assessing risk/protective factors, risk level, and intervention options. 

This training program is appropriate for any professional (e.g., journalism, research, advocates, clinicians) involved in suicide prevention efforts. It is framed by both the Social-Ecological Model of Suicide Prevention (Cramer & Kapusta, 2017) and Interprofessional Education (World Health Organization, 2016) perspectives. The Interprofessional Approaches to Suicide Prevention training provides an overview of core public health suicide prevention and interprofessional learning competencies. Skills addressed in this training are:

Foundational Suicide Prevention:

1. Using contemporary suicide prevention-related terminology
2. Managing personal attitudes, reactions, and social norms concerning suicide
3. Knowing evidence-based risk and protective factors, and theories of suicide
4. Recognizing legal and ethical considerations concerning suicide

Clinical/Individual (Tertiary Prevention):

• Developing and maintaining a collaborative, empathic stand toward persons experiencing suicidality
• Conducting and documenting a clinical risk assessment
• Understanding mental health service approaches to suicide prevention

Social/Interpersonal & At-risk Group (Secondary Prevention):

• Enacting a collaborative evidence-based plan
• Comprehending social support approaches to suicide prevention

Community-Based (Primary Prevention & Postvention):

1. Knowing public health approaches to suicide prevention
2. Articulating community organizing and advocacy-based approaches to suicide prevention
3. Adapting suicide prevention to special population needs (e.g., military, LGBTQ, adolescents)
4. Framing suicide prevention within a strategic plan

Interprofessional Education:

1. Ethical approach and respect for mutual contribution to provision of care
2. Roles and responsibilities
3. Interprofessional communication
4. Teams and team work
5. Ability to transfer interprofessional learning to the work setting
6. Community engagement and centeredness

Training includes a variety of interactive exercises, psycho-educational content, and suicide prevention tools. Emphasis is placed on translation of skills to real-world settings; subject matter can be tailored to suit trainees’ needs.

Operating on the belief that campus suicide prevention and mental health promotion is everyone’s business, the College Campus Suicide Prevention training program applies the Social-Ecological Model of Suicide Prevention (Cramer & Kapusta, 2017) to a university setting. The training addresses the following subjects:  

1. Guidelines and a case illustration (Cramer et al., 2022) of designing a comprehensive, social-ecologically based campus suicide prevention program
2. Sample programs and interventions across levels of the social-ecological model
3. Considerations for high-risk student groups
4. Review of campus policies and strategic planning

The training concludes with a discussion of lessons learned and beginning efforts to develop a plan for any local campus community.  

Stigmatizing beliefs about suicide can be focused on oneself or other persons. Such stigma exacerbates suicide risk and limits help-seeking, especially among military active duty service members. This training addresses military suicide stigma from a public health perspective in order to identify strategies to assess and reduce the problem. The Military Suicide Stigma training program covers:

1. Definitions of self-stigma, public stigma, and military suicide stigma
2. Stigma measurement tool uses and limitations
3. Patterns and impacts of stigma in the military
4. Options for stigma reduction interventions

Hate-motivated behavior (HMB), comprising both hate crimes and non-criminal bias-motivated acts, remains a concerning problem. Historically, HMB prevention was addressed through criminal justice and legal solutions. This training uses the Social-Ecological Model of HMB (Cramer et al., 2020) to reframe the problem as a public health polemic. The training is appropriate for a variety of legal, criminal justice, public health, research, and other professionals. Topics addressed include:

1. Preferences and biases as the foundation of hate
2. HMB prevalence and incidence
3. The Social-Ecological Model of HMB
4. Measurement approaches to attitudes about and commission of HMB
5. Empirically-supported drivers or causes of HMB
6. Sample policy- and public health-focused solutions