CALM: Counseling on Access to Lethal Means


(For resources, this is the publication date. For programs, this is the date posted.)


Injury Prevention Center at Children's Hospital at Dartmouth

CALM training is available directly or as a train-the-trainer program. Depending on the type of training and the distance involved, costs range from $750 to $1,500 plus travel costs for a workshop to $3,000 to $5,000 plus travel for a train-the-trainer program.

Developed by Elaine Frank and Mark Ciocca, CALM: Counseling on Access to Lethal Means is a 1.5 to 2 hour workshop designed to help providers implement counseling strategies to help clients at risk for suicide and their families reduce access to lethal means, particularly (but not exclusively) firearms. It includes a number of components: background on suicide data and lethal means; an introduction to firearms; video presentation that models the counseling strategy; a presentation and discussion on conducting a counseling session; optional role plays; and a course evaluation.

A typical 90-minute training agenda includes:

  1. The problem: Youth suicide and access to lethal means.
  2. Negotiation of means restriction (video presentation).
  3. Conducting a family firearms assessment.
  4. Wrap-up and evaluation.

The CALM program has developed over time with the benefit of initial funding from the Suicide Prevention Partnership/Gutin Family Foundation and in collaboration with Means Matter, a project of the Harvard Injury Control Research Center. It has benefited from evaluations received from many different audiences in a variety of states.

A free online version of this course has also been developed.

Program Objectives

At the end of the training, CALM training participants will have:

  1. Increased knowledge about the association between access to lethal means and suicide, and the role of means restriction in preventing suicide.
  2. Increased skills and confidence to work with clients and their families to assess and reduce their access to lethal means.

Implementation Essentials

  • CALM training should be conducted by a qualified CALM trainer.

2012 NSSP Objectives Addressed: 

Objective 6.1: Encourage providers who interact with individuals at risk for suicide to routinely assess for access to lethal means.