The Army has developed and updated a training aimed at suicide prevention that encourages Army personnel to engage with peers who may be dealing with challenges.
Ask, Care, Escort, Suicide Intervention (ACE-SI) is an enhanced version of ACE. It is the Army’s only suicide intervention training and is designed to encourage appropriate and deliberate intervention with at-risk individuals.
“ACE-SI prepares the individual to intervene in a crisis situation by teaching them to remain calm, ask directly about suicidal thoughts, express empathy and safely escort the individual to the appropriate helping agency or remain with them until emergency services arrive,” says Richard Gonzales, Walter Reed Army Institute of Research, Research Transition Office training specialist.
Gonzales goes on to state that ACE-SI also teaches the end user their roles in postvention (units’ response to a completed suicide) and reintegration (units’ responsibility for integrating individuals upon return from BH-related absences) situations.
ACE-SI training provides greater familiarity with ACE unit training and resources, which makes it the ideal candidate to train and reinforce suicide prevention within its organizations.
“This seven-hour training can be emotionally difficult for some of the trainees due to the sensitive nature of the topic,” says Gonzales. “The impact of suicide is far reaching, and many have been directly impacted by suicide loss. The conversations around the topic can evoke memories that are very painful and perhaps stir up unresolved issues,” says Gonzales.
According to Gonzales, due to the sensitive nature of the topic, it is recommended that there are two instructors for each training event. Having a second trainer in the room allows for a response capability while allowing the training to proceed as scheduled. It is also recommended that a behavioral health professional or chaplain be on call to respond should a participant feel a need to speak with someone.
According to Gonzales, the conversation tools are intended to facilitate a productive conversation that allows the person in crisis to feel heard and understood. These tools facilitate active listening, which is beneficial in almost any conversation where relationship and rapport are desired. This is critical in the intervention.
“The ACE-SI participant should practice using these conversation tools as well as the other communication principles (be direct, nonverbal communication) so that they are comfortable with them in the intervention and can focus on authentic engagement with the person in crisis rather than a checklist or memorized script,” says Gonzales. The conversation tools used within the ACE-SI training are as follows:
• Open-ended questions are those that will elicit more than a yes/no response; they allow someone to tell you more of their story than a close-ended question.
· Paraphrasing and clarifying can help you to convey that you heard what was said and want to make sure you understand.
• Affirmations are statements that recognize the strengths of the individual and highlight any behaviors that are in the direction of positive change.
• Reflective listening helps the person at risk know they have accurately told their story.
• Summarizing helps the at-risk person know they have been understood in the most helpful way by pulling together key elements of the conversation and identifying the most important matters at hand.
When asked some of the best ways leaders can show empathy without coming across as being sympathetic, Gonzales responds that sympathy in and of itself is not necessarily to be avoided. It’s more of an acknowledgment that someone is experiencing a difficult situation, which can be beneficial.
“It’s just important to be aware that having sympathy doesn’t necessarily facilitate connection,” says Gonzales. “Understanding the three types of empathy (cognitive, emotive and empathic action) can serve as a framework to evaluate our thoughts and emotions, which can help us stay empathetic during a crisis.”
Once Soldiers are trained, Army units will all have ACE-SI trainers whose responsibility is to be the commander’s eyes and ears as it pertains to suicide prevention and intervention.
“ACE-SI trainers are able to conduct ACE training, intervene in crisis and serve as a force multiplier in the commander’s effort to manage the unit’s procedural and humanitarian response to suicide-related events, including reintegration of Soldiers to the unit and postvention in the case of a completed suicide,” says Gonzales.
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