Development and Pilot Study of a Suicide Prevention Intervention Delivered by Peer Support Specialists
Development and Pilot Study of a Suicide Prevention Intervention Delivered by Peer Support Specialists
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DOI：
10.1037/ser0000257
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发表时间：
2019-08-01
影响因子：
2.3
通讯作者：
Valenstein, Marcia
中科院分区：
文献类型：
--
作者：
Pfeiffer, Paul N.;King, Cheryl;Valenstein, Marcia
近年来，美国的自杀率一直在上升，精神病住院后的这段时间是自杀死亡的风险特别高的时期之一。同伴支持专家可以发挥重要作用，在解决建议，自杀预防活动的重点是保护因素，通过提高希望和连通性。本研究开发了一个同行专家干预题为同伴有价值的生活（PREVAIL），以减少自杀风险，将动机访谈和心理治疗的组成部分，针对自杀风险到恢复为基础的同伴支持。进行了随机对照试验研究，以评估干预的可接受性、可行性和保真度。共有70名自杀风险高的成年精神病住院患者参加了这项研究。参与者随机接受常规护理（n = 36）或为期12周的PREVAIL同伴支持干预（n = 34）。PREVAIL组在12周的过程中平均完成了6.1次（SD = 5.0）同伴会话。对20次同伴支持会话进行了保真度评级，85%的同伴专家会话表现出足够的保真度来管理关于希望，幸福或安全的对话工具，72.5%的一般支持技能（例如，验证）以足够的保真度进行。参与者的定性反应（n = 23）是非常积极的同行专家的能力，关系，倾听，并建议，并提供支持，特别是在讨论自杀。研究结果表明，同侪支持专家自杀预防干预是可行的，可以接受的自杀高危患者。
Suicide rates in the United States have been increasing in recent years, and the period after an inpatient psychiatric hospitalization is one of especially high risk for death by suicide. Peer support specialists may play an important role in addressing recommendations that suicide prevention activities focus on protective factors by improving hope and connectedness. The present study developed a peer specialist intervention titled Peers for Valued Living (PREVAIL) to reduce suicide risk, incorporating components of motivational interviewing and psychotherapies targeting suicide risk into recovery-based peer support. A randomized controlled pilot study was conducted to assess the acceptability, feasibility, and fidelity of the intervention. A total of 70 adult psychiatric inpatients at high risk for suicide were enrolled into the study. Participants were randomized to usual care (n = 36) or to the 12-week PREVAIL peer support intervention (n = 34). Those in the PREVAIL arm completed an average of 6.1 (SD = 5.0) peer sessions over the course of 12 weeks. Fidelity was rated for 20 peer support sessions, and 85% of the peer specialist sessions demonstrated adequate fidelity to administering a conversation tool regarding hope, belongingness, or safety, and 72.5% of general support skills (e.g., validation) were performed with adequate fidelity. Participants' qualitative responses (n = 23) were highly positive regarding peer specialists' ability to relate, listen, and advise and to provide support specifically during discussions about suicide. Findings demonstrate that a peer support specialist suicide prevention intervention is feasible and acceptable for patients at high risk for suicide.