ASIST’s Impact on Crisis Center Counselors

Training for telephone crisis counselors should include a strong focus on helping callers explore their reasons for living, helping callers use informal sources of support, and assessing suicide risk, according to the authors of a study comparing National Suicide Prevention Lifeline crisis center counselors who were trained using Applied Suicide Intervention Skills Training (ASIST) with counselors who only received each crisis center’s standard training.

The research revealed that that callers “were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful” by the end of calls handled by crisis counselors who had been trained using ASIST compared to callers who spoke with counselors who had not received ASIST training. These outcomes were associated with the ability of ASIST-trained counselors to keep callers on the telephone longer, explore callers’ reasons for living and ambivalence about dying, and discuss the caller’s use of informal supports.

At the same time, the ASIST-trained counselors did not engage in more comprehensive suicide risk assessments (by, for example, asking about past suicide attempts or current suicide plans) than other counselors. Nor were they more likely to engage in positive behaviors such as “allowing the caller to talk about his or her feelings/situation,” “establishing rapport with the caller,” or “showing empathy/validating caller.” The authors stress the importance of assessing suicide risk during calls, and note that whether or not they had been trained in ASIST, counselors too often did not include such assessments.

This summary based on: Gould, M.S., Cross, W., Pisani, A.R., Munfakh, J., and Kleinman, M. (2013). Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline. Suicide and Life-Threatening Behavior 43 (6): 676-691.