By Katie Kelleher
The H.O.P.E lab designs and implements research to prevent, intervene and treat suicide risk, and evaluate how those impacted by disaster make sense of suffering through their faith. Most recently, our team has been running a partially nested randomized control trial (PN-RCT) of an 8-week “caring contacts” intervention for 777 older adults at the margins of the margins. H.O.P.E. lab graduate students Lauren Cason, Andrea Dailey and I were fortunate to present on this research at the Association for Assessment and Research in Counseling (AARC) conference from this grant several times.
The first presentation was an overview of the methodology of the clinical trial and what it was like to work on various aspects of the research grant. I learned that social isolation and loneliness play a key role in lethal suicidality later in life and that COVID-19 raised this risk for older adults. The overarching research question that Dr. Shannonhouse raised was, “can a small dose of sincere connection improve mental health outcomes for older adults?” The PN-RCT had three conditions: two treatment conditions and a delayed waitlist control condition (received treatment after the trial was completed).
In the first treatment condition, trained helpers received two hours of training in narrative reminiscence, enabling them to build relationships with older adults over time, fostering a sense of belongingness and empathy. Those in the second treatment condition received this relationship training, plus and additional 14 hours of training in suicide intervention, LivingWorks ASIST, which is standardized, manualized and evidence-based. This enabled the 60 helpers that were trained to provide the treatment to the older adults to perform a life-assisting intervention when one might be needed. ASIST training enabled those providing the treatment to listen for ambiguity as most persons who have suicidal ideations or attempt suicide just want the pain to end, they don’t want to die, therefore working effectively with ambivalence about dying is critical in an intervention.
In between the caring contacts (20-30 minute weekly relational connections via the phone between trained helpers and older adults), research members administered surveys to assess the older adult’s well-being and this data was used to evaluate the effectiveness of the treatment. The control condition did not receive any treatment during this time but completed the same surveys. In addition to the surveys, all caring contacts were audio recorded and transcribed, and our team has been quantitatively coding a subset of approximately 110 older adults as part of the first coding study.
The second presentation focused on explaining the coding protocol (augmented from Gould’s 2013 famous NSPL study) and the intricate details regarding the coding process, consensus, database and analyses we are using. Our current quantitative coding is focused on the older adult’s social supports, health concerns, emotions, improvement or worsening over the course of a caring contact treatment dosage, and many more.
There are 70 total quantitative domains to code on the older adult side. Once these have been completed, we will then move to coding the trained helper side with a different coding protocol. We have been mentored by Dr. Madelyn Gould, a psychiatrist and suicide researcher at Columbia, who has been evaluating the National Suicide Prevention Lifeline (now 988) in understanding that as coders it is too complex to code from both the perspective of the older adult and trained helper simultaneously. Therefore, we split the coding protocol and reorganized and restructured it significantly to reduce cognitive complexity. This past week our team coded an additional 15 audio files, and we are running a nuanced interrater agreement (total, and subsets of interrater agreement) in real time. We are hitting between 88% and 100% interrater agreement in 8 of 9 interrater agreement subsections, and I’ve learned this is quite good.
I joined the H.O.P.E lab in May and I am grateful for all that I have already learned and experienced in just a few short months. Attending the AARC conference was an experience I will especially hold close to my heart as I was able to attend sessions, network and learn more about other research currently being conducted in the counseling field which sparked ideas for my future research.
In addition to learning opportunities, I was able to present what we have been working so hard at for many months. The H.O.P.E. lab has also obtained an artificial intelligence (AI) grant to eventually replicate our coding abilities; this idea came from networking and through our presentations at the AARC conference. Overall, this was an exciting and rewarding opportunity.