Biomedical subjects
Publications and source records attributed to J Kalafat.
Building on a recent paper by Lester (1997) on shame and suicide, a case is presented of a woman who made a serious attempt to kill herself, motivated in large part by shame. The therapeutic strategies employed are described, and the case brought to a successful resolution.
As part of the Kentucky Education Reform Act, school-based Family Resource/Youth Service Centers were commissioned to address those poverty-related issues that attenuate children and youths' coming to school prepared to learn. The centers had flexible mandates and were to adapt their service profiles to local urban, suburban and rural communities. A variety of grounded, inductive qualitative strategies were employed in an implementation evaluation that yielded profiles or domains of program elements, and descriptions of implementation strategies and impact on participants. These program descriptors were considered accurate by program personnel, formed the basis for training new program coordinators, and have served as reliable predictors of educational outcomes for program participants, thus affirming the utility of the qualitative evaluation approaches.
This study employed simulations of encounters with suicidal peers to assess the impact of classroom suicide response lessons. Students were asked to anonymously write how they would respond, and how concerned they would be in regard to two vignettes of troubled peers. On the posttest, students who had participated in the classes provided significantly more "tell an adult" responses than those in the control group, whereas no differences existed between the groups on the pretest. On both the pretest and posttest, all students expressed greater concern on the unambiguous vignette (student said that he has been thinking about killing himself) than on the ambiguous vignette (student wrote an essay about final decisions); and, overall, females expressed greater concern than males. These results provide evidence for the efficacy of the classes and the utility of the simulations for assessing their impact.
This paper reviews the needs and conceptual bases of school-based youth suicide prevention programs, summarizes their current status, and recommends objectives, processes, and evaluation strategies for focused educational programs in this area. In addition, a broad systemic approach is called for that reorganizes the school context to increase students' contributions, to and involvement with the educational process. Such approaches appear to have been effective with a variety of youth deviant behaviors such as dropout and delinquency, and seem to be particularly appropriate to suicidal behavior that is characterized by alienation and withdrawal from social supports. A combination of these broad and narrow foci may be necessary to address suicidal behavior in the educational context.
This study employed a self-report questionnaire in a Solomon four-groups design to assess the efficacy of suicide intervention classes in achieving their instructional objectives. Because adolescents are often the first to know of a peer's suicidal thoughts or plans, the goal of the classes was to increase the likelihood that students who come into contact with potentially suicidal peers can more readily identify them and will be consistently inclined to take responsible action on their behalf. Students who participated in the classes as compared to controls showed significant gains in relevant knowledge about suicidal peers and significantly more positive attitudes toward help seeking and intervening with troubled peers. Results of this study will be used to strengthen components of the lessons aimed at enhancing the likelihood of performance of responsible interventions.
The present study investigated a sample of 325 suburban high school students' knowledge of suicidal peers, whether they had ever talked to a suicidal peer, and, if so, what they actually did in that situation. Sixty-eight percent of the females and 42.5% of the males reported knowing a teen who had committed or attempted suicide. Ninety-seven students reported having talked to a peer who was definitely considering suicide; of these, 63% talked to their peer about his or her concerns, 24.7% told an adult, and 12% did nothing in response to the encounter. Ninth graders were significantly more likely to do nothing as compared to eleventh graders. A mixed pattern of results was found as to the relationship of the response of youth to suicidal peers and their general experience with suicidal peers. The results confirm the importance of adolescents themselves for the prevention of youth suicide, and the need to convince adolescents to report at-risk peers to an adult.
This article describes a systemic quality service program implemented in a community hospital as an initial component of a total quality approach. The program interventions are based on consumer research and principles that have been effective in producing organizational change and enhancing worker performance. The description of the program is organized around six change and performance-enhancement principles: (1) establishing the importance of the performance, (2) specifying the expected performance, (3) ensuring the ability to carry out the performance, (4) accurately measuring the performance, (5) providing consequences, and (6) addressing systemic blocks to effective performance. Evaluative data are presented, indicating enhanced performance in the critical areas of documented resolutions to problems and reduced response time to problems.
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The effectiveness of indigenous paraprofessional helpers is thought to be partially due to the similarity in style and values between then and their clients. However, there is a concern that as they gain experience in an agency, their identification may shift from the clients to the agency. Also, there is a question as to how effective paraprofessionals (selected due to their shared values with a target population) are with value-dissimilar clients. Truax and Carkhuff's scales of facilitative conditions as well as a technique functioning scale were used to assess the helping behavior of paraprofessional telephone counselors at three levels of experience in response to value-similar and value-dissimilar simulated calls. The results indicate that performance generally improved with training and experience and that instead of a uniform deterioration with dissimilar value calls, a complex relationship existed between performance, values, and experience level.
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