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2000 Oregon Youth Suicide Prevention SKILL-BUILDING SUPPORT GROUPS
The Oregon Plan for Youth Suicide Prevention
Related WWW links.STRATEGY 13: PROVIDE SKILL-BUILDING SUPPORT GROUPS FOR YOUTH
Resources for Strategy #13
OBJECTIVE
Provide skill-building support groups for identified at-risk youth in school and community settings that work to reduce the impact of multiple-risk factors, enhance protective factors, and involve families in supporting youth involvement and success. AUDIENCE
The primary audience is young people who have multiple risk factors linked to suicidal behavior. The strategy should concentrate on school and community locations where at-risk young people are found. These include, but are not limited to, high schools, teen health clinics, college counseling/health centers, youth activity centers, community health centers, juvenile detention facilities, youth shelters, and Job Corps centers.
Skill building that includes learning to set goals, make decisions, reduce anger, solve problems, and abstain from alcohol and other drugs is a promising approach to reduce suicidal behavior.

RATIONALE AND EFFICACY
Skill-based support groups offer an opportunity to intervene with troubled youth and young adults short of the clinical intervention necessary for those at high risk of suicidal behavior. One feature that often characterizes at-risk youth is the challenge of facing multiple problems at the same time. Risk factors such as emotional distress, family strain, school strain, drug involvement, poor school performance, and low levels of personal and social support may overwhelm a young person?s coping abilities. Conducting skill-based support groups for identified at-risk youth can be an effective prevention strategy.58

Studies show that youth with suicidal thoughts and behaviors are more likely to use emotion-based coping strategies and less likely to use problem-solving strategies than non-suicidal youth. 59,60 Deficiencies in such functions as goal setting, decision-making, anger management, problem-solving, and drug use control compound a youth?s sense of hopelessness. Social and family support combined with skill development in these areas shows promise in reducing youth suicidal behaviors.61,62,63 Cognitive and behavioral experiences that increase feelings of competency and mastery will increase protective factors that offset risk factors of hopelessness and poor self esteem.

Talking with at-risk youth about their suicidal thoughts, combined with the support of caring adults in the youth?s social network,appears to significantly reduce critical risk factors linked to suicidal behavior.62

Several programs have shown to be effective for depressed youth and youth at risk for suicidal behavior, including the Coping with Depression Course, Group Problem-Solving/Support Interventions, and Reconnecting Youth.64,65,61 Each of these programs has developed curricular materials for program planning and implementation.

IMPLEMENTATION CONSIDERATIONS
Young people in need of mental health services beyond the scope of skill-building support groups should be referred to mental health providers. Adults working with youth identified to be at high suicide risk should contact parents immediately and refer the family to a behavioral health care provider.

Lack of parental or family support is associated with youth suicidal behaviors.66 The family component of skill-building groups focuses on parent involvement and linking youth and their families to sources of support. Collaboration between each youth,the program manager,and a parent/guardian (or adult friend or family member for a young adult) is important for involving at least one caring adult in a young person?s life.58

It is important to select an evidence-based model that offers a multi-component prevention approach. It is also important to assess existing groups according to the model followed and to what extent they are skill based, they provide a family support component concurrent with the youth?s group involvement, and they are effective in reducing depression and suicidal ideation/behavior.

Youth with multiple risk factors have a dramatically higher probability of having attempted suicide than youth with few risk factors.54 Assessing youth who may benefit from participation in skill-based support groups depends on identifying those with risk factors linked to suicide or youth populations with an elevated suicide risk (Appendix A). Care should be taken to avoid including youth who do not need the group intervention and to assure that high suicide-risk youth receive more intensive clinical services.

The presence of risk factors or a combination of risk factors can be indicative of risk behaviors other than suicide.

SAMPLE IMPLEMENTATION ACTIVITIES

  • Identify support/skill-building groups for youth and young adults that already exist in school and community settings,and identify gaps in services.
  • Identify locations where high-risk youth are likely to be found as possible places to conduct groups.
  • Train professionals to conduct skill-building groups for high-risk youth.
  • Conduct group programs in coordination with screening programs and referral systems.
  • Develop a plan for ongoing facilitator training,consultation and supervision services, and program evaluation.


REFERENCES
58 Washington State Department of Health.Washington State Injury Prevention Program.Youth Suicide Prevention Plan for Washington State. 1995. Olympia, Washington.
59 Puskar K, Hoover C, Miewald C. Suicidal and non suicidal coping methods of adolescents. Perspectives in Psychiatric Care. 1992;2 8(2):15-20.
60 Sadowski C, Kelley M. Social problem solving in suicidal adolescents. J Consult Clin Psychol. 1993. 61(1)121-7.
61 Eggert L, Thompson E, Herting J, Nicholas,L. Reducing suicide potential among high-risk youth: Tests of a school-based prevention program. Suicide and Life-Threatening Behavior. 1995; 25:276-296.
62 Brent D, Perper J, Moritz G, et al. Stressful life events and adolescent suicide: A case control study. Suicide &Life-Threatening Behavior. 1993; 23(3):179-189.
63 Shaffer D,Philips I,Garland A,Bacon K.Prevention issues in youth suicide.In D Shaffer,I Philips & N Enzer.eds. Prevention of Mental Disorders, Alcohol and Other Drug Use in Children and Adolescents. pp.373-412. OSAP Prevention Monograph-2, US Dept of Health and Human Services. Washington, DC. US Government Printing Office.
64 Lewinsohn P, Clarke G, Hops H, Andrews J. Cognitive-behavioral treatment for depressed adolescents. Behavior Therapy. 1990; 21(4):385-401.
65 Clum G, Priester M, Weaver T, et al. Group decision-making and group support treatments for chronic suicide ideation. Paper presented at the meeting of the American Association of Suicidology Conference. 1993 San Francisco, California.
66 Pfeffer C. Family characteristics and support systems as risk factors for youth suicidal behavior. In L Davidson & M Linnoila, eds. Risk Factors for Youth Suicide (pp.55-71). New York, NY: Hemisphere.
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