Core Competency Model for Corrections (CCM-C)

Development and Implementation of a Self-Directed Violence (SDV) Prevention Training Program for the North Carolina Department of Adult Corrections

The overall goal of this project is to design, implement, and revise the Core Competency Model for Corrections (CCM-C), an evidence-based Self-Directed Violence (SDV) prevention training program for correctional mental health providers in the North Carolina Department of Adult Corrections (DAC). The proposed specific aims are:

Aim 1: To create the CCM-C training program. Aim 2: To assess preliminary training effectiveness. Aim 3: To gather training program quality improvement feedback from corrections stakeholders.

Study Overview

• Status: Enrolling by invitation
• Conditions: Knowledge, Attitudes, Practice
• Intervention / Treatment: Other: Core Competency Model for Corrections (CCM-C) Self-Directed Violence Prevention Training

Detailed Description

Investigators will conduct a pilot feasibility and preliminary effectiveness evaluation of the Core Competency Model for Corrections (CCM-C; Cramer et al., 2022). This training approach involves psycho-educational content, self-assessment tools, interactive exercises to address 10 clinical care and practitioner-focused skill sets for suicide and self-injury risk assessment and management. The protocol employs a waitlist control sequential cross-over design and mixed-method evaluation approach targeting 50-100 NC correctional behavioral health clinicians (BHCs). Through an ongoing academic-community partnership, investigators will employ a Corrections Advisory Panel (CAP) to provide expert review of training. The CAP will comprise six NC-DAC BHCs and 4-6 external BHCs with experience in correctional behavioral health. Two training groups will each provide three assessments via an online self-report evaluation battery gathering information regarding participant demographics; SDV prevention knowledge, attitudes, and perceived skills; incarceration-related attitudes; and perceived importance of and intention to use SDV prevention practices.

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Raleigh, North Carolina, United States, 27699
      • North Carolina Department of Adult Corrections

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Behavioral Health Clinician (BHC)
• 18 years of age or older
• Living in the U.S.
• Currently employed by the NC DAC

Exclusion Criteria:

• Decisional or cognitive impairments that preclude being able to consent to study participation
• Being a member of the study correctional advisory panel (CAP)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Core Competency Model for Corrections (CCM-C) Self-Directed Violence Prevention Training group 1; Receives CCM-C training two weeks after baseline assessment.	Other: Core Competency Model for Corrections (CCM-C) Self-Directed Violence Prevention Training; The Core Competency Model (CCM; Cramer et al., 2013, 2019) is an evidence-based educational training program for BHCs in suicide prevention core suicide prevention skills. The ten core competencies are: (1) Manage personal attitudes and reactions to suicide; (2) Maintain a collaborative stance toward the client; (3) Elicit evidence-based risk and protective factors; (4) Focus on current suicide plan and intent of suicidal ideation; (5) Determine risk level; (6) Enact a collaborative evidence-based treatment plan; (7) Notify and involve other persons; (8) Document risk, plan, and reasoning for clinical decisions; (9) Know the law concerning suicide, and; (10) Engage in debriefing and self-care. The CCM will be adapted for this pilot trial. In light of the SDV problem in carceral settings, the CCM for Corrections (CCM-C; Cramer, Kaniuka, & Peiper, 2022) was adapted to address both suicide and self-injury assessment, treatment, and prevention.
Experimental: Core Competency Model for Corrections (CCM-C) Self-Directed Violence Prevention Training group 2; Receives CCM-C training two weeks after follow-up 1 assessment.	Other: Core Competency Model for Corrections (CCM-C) Self-Directed Violence Prevention Training; The Core Competency Model (CCM; Cramer et al., 2013, 2019) is an evidence-based educational training program for BHCs in suicide prevention core suicide prevention skills. The ten core competencies are: (1) Manage personal attitudes and reactions to suicide; (2) Maintain a collaborative stance toward the client; (3) Elicit evidence-based risk and protective factors; (4) Focus on current suicide plan and intent of suicidal ideation; (5) Determine risk level; (6) Enact a collaborative evidence-based treatment plan; (7) Notify and involve other persons; (8) Document risk, plan, and reasoning for clinical decisions; (9) Know the law concerning suicide, and; (10) Engage in debriefing and self-care. The CCM will be adapted for this pilot trial. In light of the SDV problem in carceral settings, the CCM for Corrections (CCM-C; Cramer, Kaniuka, & Peiper, 2022) was adapted to address both suicide and self-injury assessment, treatment, and prevention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility	Feasibility of CCM-C training as measured by the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater feasibility.	Immediately post-training
Acceptability	Acceptability of CCM-C training as measured by the self-report subscale on the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater acceptability.	Immediately post-training
Appropriateness	Appropriateness of CCM-C training as measured by the self-report subscale of the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater appropriateness.	Immediately post-training
Usability	Usability of CCM-C training as measured by the self-report subscale of the Feasibility of Intervention Measure (FIM; Weiner et al., 2017); the scale ranges from 5-20 where higher scores indicate greater usability.	Immediately post-training

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived self-directed violence prevention skills	The Suicide Competency Assessment Form (SCAF; Cramer et al., 2013, 2020) will be used to measure participants' perceived SDV prevention skill mastery. The SCAF is a self-report questionnaire that contains 10 items capturing core competencies of the CCM-C training; these items are measured on a four-point scale of perceived competency (1 = incapable; 4 = advanced) where higher scores denote better competency. For the present study, these 10 items was adapted to capture SDV-focused skills.	Immediately post-training
Willingness to intervene with a suicidal person	The Attitudes about Intervening with a Suicidal Person (AIBS; Aldrich et al., 2014) self-report questionnaire will be used to measure SDV prevention-focused attitudes and the willingness to intervene in an event where a person is experiencing SDV. The AIBS is a subscale of the larger, recently revised Willingness to Intervene against a Suicidal Person Enhanced questionnaire (Aldrich & Cerel, 2023). Higher scores (range 14-90) convey more positive attitudes and greater willingness to intervening with someone in distress.	Immediately post-training
Beliefs about incarcerated persons engaging in self-directed violence	The Attitudes toward Prisoners who Self-Harm (APSH; Garbutt & Casey, 2015; Ireland & Quinn, 2007) scale is a self-report questionnaire that will be used to measure SDV prevention-focused attitudes and stigma. The APSH consists of 25 items with a total score; higher scores (range 25-125_ denote more stigmatizing beliefs.	Immediately post-training
Self-directed violence prevention knowledge	For this pilot evaluation, investigators created a 10 multiple-choice CCM-C Knowledge Quiz. Correct answers are summed for a total score (range 0-10) where higher scores indicate greater understanding of the CCM-C.	Immediately post-training
Perceived importance of training	Investigators will use the intention to use training content scale (Cramer et al., 2019), a brief self-report questionnaire, to capture BHC's perceived importance in using (pre-training) and intent to use (post-training) CCM-C training content. Across seven items, higher scores (item mean 1-5) denote greater perceived importance of the training.	Immediately post-training

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Compassion fatigue: Job burnout	The Compassion Fatigue-Short Scale (CF-SS; Adams, Boscarino, & Figley, 2006), a self-report questionnaire, will be used to assess feelings of compassion fatigue, conceptualized as secondary traumatic stress (5 items) and job burnout (8 items). This measure contains 13 items. This subscale score denotes higher job burnout (range 8-80).	Immediately post-training
Compassion fatigue: Traumatic stress	The Compassion Fatigue-Short Scale (CF-SS; Adams, Boscarino, & Figley, 2006), a self-report questionnaire, will be used to assess feelings of compassion fatigue, conceptualized as secondary traumatic stress (5 items) and job burnout (8 items). This measure contains 13 items. This subscale score denotes higher traumatic stress (range 5-50).	Immediately post-training

Collaborators and Investigators

• Sponsor: University of North Carolina, Charlotte
• Collaborators: North Carolina Department of Health and Human Services; North Carolina Department of Adult Corrections

Publications and helpful links

General Publications

• Cramer RJ, Kaniuka AR, Peiper LJ. The core competency model for corrections: An education program for managing self-directed violence in correctional institutions. Psychol Serv. 2022 Nov;19(4):658-670. doi: 10.1037/ser0000624. Epub 2022 Feb 7.

Study record dates

Study Major Dates

• Study Start (Actual): April 5, 2024
• Primary Completion (Estimated): December 31, 2024
• Study Completion (Estimated): January 30, 2025

Study Registration Dates

• First Submitted: March 6, 2024
• First Submitted That Met QC Criteria: April 5, 2024
• First Posted (Actual): April 11, 2024

Study Record Updates

• Last Update Posted (Actual): April 16, 2024
• Last Update Submitted That Met QC Criteria: April 13, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: Suicide prevention; Risk assessment; Attitudes; Competency; Self-injury; Mental health provider
• Other Study ID Numbers: IRB-24-0209

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No