Crisis intervention (Mental health services), Suicide -- Prevention, Volunteer workers in mental health


The need for behavioral evaluations of volunteers performing hotline crisis work led to the development of the Lethality Assessment (LA) Analogue. This measure is designed to evaluate the competence of hotline volunteers in performing the specific crisis intervention skill of Lethality Assessment. This skill is the ability of the volunteers to assess suicide risk in a caller. The specific procedures used in the development of the LA Analogue and preliminary validation data on its use are reported. The development stages of the LA Analogue were following: (a) operationally defining the skill to be assessed, (b) the formulation of a case summary and caller script based on the skill to be assessed, (c) the formulation of a performance rating scale, (d) the standardization of instructions given to the hotline volunteers being assessed and simulators performing the script, and € training and evaluation of simulators. The construct validity of the LA Analogue was evaluated by assessing a group of hotline volunteers beginning a training program at a crisis intervention center. As expected, LA Analogue scores for hotline volunteers increased significantly following specific training in Lethality Assessment with control group scores showing no significant change over the same interval of time, t(25) = 4.50, p < .0005, one-tailed. In addition, a comparison between the significance levels of the LA Analogue and two other instruments measuring a similar attribute, the Suicide Intervention Response Inventory (SIRI) and the Test for Evaluation of Training in Suicide Prevention (SP Test), showed the LA Analogue to be significantly superior to the other two instruments in measuring training effect, LA Analogue p < .0005, SIRI p< .005, and SP Test p < .05, one-tailed. High reliability was demonstrated for the rating system used, .95 to 1.00. The expected correlation between the LA Analogue, SIRI, and SP Test was not found. It is speculated that this lack of correlation may be due to the instruments assessing different levels (performance vs. cognitive) of the same construct (McGee, 1974) and the correlation coefficient's sensitivity to a small range of scores (Pfeiffer & Olson, 1981). For further validation and resolution of this lack of correlation, additional work employing a larger sample size is needed. The formulation of the LA Analogue has several implications for the advancement of assessment in suicide prevention and hotline crisis intervention training. The availability of a consistent behavioral assessment procedure will enable centers to compare the performance of their volunteers. With other methods of assessment in which the presenting stimulus is not controlled, comparisons would be inappropriate for the reason that volunteers are being assessed in response to different caller variables. An additional advancement is the LA Analogue's focus in measuring a skill specific to crisis intervention. In the area of training, the LA Analogue also provides the volunteer with an experiential learning experience in which he or she is directly confronted with the anxieties, fears, and rewards associated with being a hotline crisis worker. The LA Analogue and applications of its design will contribute to the advancement of assessment of hotline crisis intervention skills.


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Graduation Date





Guest, Sandra S.


Master of Science (M.S.)


College of Arts and Sciences

Degree Program

Clinical Psychology




99 p.




Public Domain

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Masters Thesis (Open Access)



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Sandra S. Guest (Q58335245)

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