Psychological Self-Help

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people with depression. They found the Psychosocial/Cognitive-
Behavioral approaches work quite well and, based on those results,
they suggest a working model for therapy. The focus of these studies
is on the effectiveness of short-term therapy with depressed
Special mention needs to be made of Coombs (1990) who with the
help of professional organizations (counselors, school psychologists,
nurses, social workers, and principals) developed a training ”SOS
Manual” for (a) directly teaching students the warning signs of suicide
(in themselves and others) and then encouraging two prompt
responses to a person with those signs: (b) showing they care and
want to help and (c) telling a responsible adult. The recommended
emergency-like procedure is called ACT, standing for ACKNOWLEDGE
the signs, show you CARE, and TELL an authority. Every young
person should know ACT, just like CPR. This is not a therapy approach
but an educational program that helps students recognizes serious
depression in others (and in them) and then gets help. 
Aseltine & DeMartino (2004) did a large randomized control study
of the ACT method for stopping suicide and found that this program
reduced suicide attempts by 40%! That is an impressive finding,
suggesting that suicide attempts and suicides could be substantially
reduced by 1 or 2 hours in the classroom costing about 40 cents per
student. Since 2000, this program has been implemented in over 1300
schools, so it should soon be possible to determine if ACT training
reduces the number of suicides or just the number of attempts and if
the number of attempts are actually reduced or just the number
reported on a self-report three months after the training. 
On the other hand, the numerous evaluations of two hour “general
education programs” about suicide have yielded mixed results. See
UCLA Sch Psy ( The programs usually
consist of suicide statistics, warning signs, and mental health
resources, much as I am doing in this book. Often students say they
already know this stuff (of course!) but they learn some facts. Yet,
they don’t seem to change their attitudes about suicide nor learn more
techniques for coping with depression nor become more inclined to
seek psychological help. In fact, students who have attempted suicide
do not find the program helpful, are even more reluctant after the
program to talk about their suicidal thoughts, have less confidence in
mental health professionals, and still see suicide as a possible solution
for them. Some educational programs sensationalize suicide and
others normalize it; both not good. There are questions: Do school
programs make students too responsible for stopping suicide in fellow
students? Do students, who have already attempted suicide, become
more likely to try again after a program? Some researchers and
administrators think so. Obviously, the impact of a program depends
on how the information and experience are processed within each
student’s mind. That can’t be predicted perfectly. However, we need
more knowledge so the program content can be tailored to each kind
of student. 
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