The course curriculum is taught by an RY leader, either a member of the school staff or partnering agency who has abilities as a “natural helper,” has healthy self-esteem, is The Good Behavior Game The Good Behavior Game (GBG), a program for students in elementary schools, is now included in SAMHSA’s National Registry of Evidence-Based Programs and Practices (Paxis, 2018). It has growing evidence to support its use in suicide prevention (Newcomer et al., 2016), and has been used successfully in 10,000 classrooms across the country. GBG is based on classroom interactions by building teamwork and fostering behavior management to help children develop. It uses intrinsic self- regulation by rewarding teams that meet the behavior standards set by their teachers. A fundamental goal is to create a positive classroom environment free from aggression and disruptive behavior where students are supported by their peers and can learn effectively. Students are intentionally separated into groups, with an equal distribution of those with a disruptive and aggressive behavior history. The teachers publish the rules of the game with respect to student behavior, and the group with four or fewer infractions of permissible student behavior is rewarded. The game teaches students to “flip on” their internal focus switch, required for any learning. It teaches students how to work toward valued goals and how to cooperate with each other to reach those goals. Students learn how to self-regulate during both learning and fun and how to delay gratification for a bigger goal (Paxis, 2018). The game also protects students against lifetime mental, emotional, behavioral, and related physical illnesses for their futures. Attachment-based family therapy Given the dearth of empirically-supported evidence for treatments of suicidal youth, attachment-based family therapy (ABFT) was one of the first interventions to show some evidence of a reduction of suicidal ideation and depressed mood in adolescents at high risk for suicide (Diamond, Kobak, Ewing, Levy, Herres, Russon, & Gallop, 2019; Feder & Diamond, 2016). Of course, the unique aspect of this psychotherapy model is its family approach to treatment. While it was not the first model of family therapy examined for use with suicidal youth, ABFT’s focus on resolution of attachment ruptures in order to form a more secure and safe base for adolescents seems to address a core protective feature, namely feeling supported and loved by significant individuals in one’s life. In one study, 66 adolescents were assigned randomly to either ABFT or enhanced usual care (EUC), a model of usual care in the community with regular contact by research staff and the availability of immediate crisis management. Although adolescents in both ABFT and EUC treatment conditions showed a reduction in suicidal ideation and depressed mood, adolescents in the ABFT condition more quickly reduced suicidal thoughts and had better outcomes three months following the end of treatment than adolescents in the EUC condition (Diamond et al., 2019). ABFT aims to repair ruptures in the attachment relationship and establish or resuscitate the secure base that is so important for adolescent development. This is accomplished through the use of five sequential treatment tasks. The first three tasks can often be accomplished in three to five sessions. Task four may take between three to six sessions, depending on the breadth and depth of issues being discussed. Finally, task five may take two to four sessions, thus making ABFT an intervention often lasting eight to 15 sessions. The five treatment tasks are the following: American Indian life skills development As was previously noted in the discussion about demographic factors in suicidal behavior, the American Indian/Alaska Natives population represents the ethnic group with the highest suicide rate in the US, and rates appear to be moving upward since
motivated to work with high-risk youth, and is willing to comply with implementation requirements.
According to the Paxis Institute (2018), the Good Behavior Game has been shown to improve such key risk factors as drug, tobacco, and alcohol use in adolescence and early adulthood. It works by targeting early aggressive and disruptive behavior, which is a shared risk among students, and thereby prevents later maladaptive behavioral outcomes. A reduction in these risk factors has a potential for affecting suicide rates. It is well-known that poor academic performance can be linked to an increased propensity for suicidal behaviors, impulse-control problems, drug use disorders, and antisocial personality disorder. A randomized control trial evaluated the GBG program. The trial included first-grade students in 42 different classrooms in 19 separate elementary schools over a two-year period. Classrooms and teachers were randomly assigned to the GBG intervention or the control group (in this case the standard school program). A total of 1,918 study participants completed follow-up interviews over 15 years. The primary outcomes measured suicidal ideation and suicidal attempts. Individuals who participated in the GBG intervention were half as likely to experience suicidal ideation compared to the control group and were, therefore, less likely to attempt suicide as compared to the control group. The Good Behavior Game has been shown by empirical research to decrease such key risk factors as drug, tobacco, and alcohol use in adolescence and early adulthood. A reduction in risk factors could potentially positively affect suicide rates by preventing suicide-related risk factors and improving academic performance. 1. Establishing a relational frame : “Re-attachment” occurs by first helping family members to access their longing for greater closeness and to adopt the idea of rebuilding trust as a worthy initial goal of therapy. 2. Building an alliance with the adolescent : In individual sessions, adolescents are helped to identify and articulate their perceived experience of the attachment failures and commit to a discussion of these experiences with their parents. 3. Building an alliance with the parent : Parents, also in individual sessions, are encouraged to consider how their own intergenerational legacies affect their parenting style, which typically leads to their developing greater empathy for their adolescent’s experiences. 4. Re-attaching : When adolescents and parents are ready, the clinician brings them back together to discuss the adolescent’s concerns. As adolescents get these thoughts, feelings, and memories “off their chests” and receive acknowledgment and empathy from their parents, they become more willing to consider their own contributions to family conflict. Although not all issues are necessarily addressed or resolved, this mutually respectful and often emotionally-laden dialogue serves as a “corrective attachment experience” that can set in motion a renewed sense of trust and commitment. 5. Promoting competency : As tension and conflict is diffused at home, therapists encourage adolescents to pursue prosocial activities outside the home that will promote competency and autonomy. Parents serve as the secure base from which adolescents seek comfort, advice, support, and encouragement in exploring these new opportunities. (Feder & Diamond, 2016) 2003 (Leavitt et al., 2018). Therefore, this group is a particularly important target for early intervention. American Indian Life Skills Development is a culturally-adapted prevention program designed to reduce suicide risk factors and improve protective
Page 99
Book Code: PYCA1423
EliteLearning.com/Psychology
Powered by FlippingBook