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American Indian Life Skills Development

Ages 11-19

Rating: Level 2

Intervention

The American Indian Life Skills Development curriculum is a school-based, culturally tailored, suicide-prevention curriculum for American Indian adolescents. Tailored to American Indian norms, values, beliefs, and attitudes, the curriculum is designed to build self-esteem; identify emotions and stress; increase communication and problem-solving skills; and recognize and eliminate self-destructive behavior, including substance abuse. The curriculum provides American Indian adolescents with information on suicide and suicide-intervention training and helps them set personal and community goals.

Each lesson in the curriculum contains standard skills training techniques for providing information about the helpful or harmful effects of certain behaviors, modeling of target skills, experimental activities, behavior rehearsal for skill acquisition, and feedback for skills refinement. The curriculum can be delivered three times a week over 30 weeks, during the school year or as an after-school program.

Evaluation

The research design was nonrandom, quasi-experimental with two conditions: an intervention and a no-intervention condition. A multimethod approach was used to assess the effectiveness of the curriculum. It included a pretest and posttest self-report survey of risk factors associated with suicide, behavioral observations of suicide intervention skills targeted in the curriculum judged by two American Indian graduate students, and peer ratings of classmates’ skills and abilities relevant to suicide intervention. Freshman students enrolled in a required language arts class were eligible for the study, and juniors were included to increase the sample size. Sophomores were expressly excluded because of their participation in a program pilot test the previous year.

Sixty-nine students were assigned to the intervention condition, 59 students to the no-intervention condition. The sample was 64 percent female and 36 percent male. A pretest indicated that 81 percent of the sample was in the moderate to severe range on the Suicide Probability Scale. Forty percent of students reported that a relative or friend had committed suicide, while 18 percent reported having personally attempted suicide. Moreover, 79 percent of those students who attempted suicide in the past had attempted two times or more, 70 percent had tried within 6 months of the pretest, 17 percent had required medical attention, and 22 percent had informed no one about the attempt. Posttests were conducted 8 months after the pretest.

Outcome

Overall, the evaluation produced evidence to suggest the curriculum succeeded in creating a healthier psychological profile. Students exposed to the curriculum scored better (lower) than the no-intervention group at posttest on suicide probability and hopelessness, and the intervention group showed greater ability to perform problem-solving and suicide intervention skills in a behavioral assessment. However, the evaluators noted potential threats to validity owing to the coexistence of the two groups throughout the intervention.

Risk Factors

Individual

  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use
  • Life stressors
  • Mental disorder/Mental health problem/Conduct disorder

Family

  • Family history of the problem behavior/Parent criminality
  • Family management problems/Poor parental supervision and/or monitoring

School

  • Negative attitude toward school/Low bonding/Low school attachment/Commitment to school

Peer

  • Peer rejection

Protective Factors

Individual

  • Perception of social support from adults and peers
  • Social competencies and problem-solving skills

School

  • Strong school motivation / Positive attitude toward school

Community

  • Presence and involvement of caring, supportive adults

Peer

  • Good relationships with peers

Endorsements

  • SAMHSA: Model Programs

References

Bee–Gates, Donna, Beth Howard–Pitney, and Teresa LaFromboise. 1996. “Help-Seeking Behavior of Native American Indian High School Students.”Professional Psychology: Research and Practice 27(5):495–99.

Howard–Pitney, Beth, Teresa LaFromboise, Mike Basil, Benedette September, and Mike Johnson. 1992. “Psychological and Social Indicators of Suicide Ideation and Suicide Attempts in Zuni Adolescents.” Journal of Consulting and Clinical Psychology 60(3):473–76.

LaFromboise, Teresa, and Beth Howard–Pitney. 1993. “The Zuni Life Skills Development Curriculum: A Collaborative Approach to Curriculum Development.” American Indian and Alaska Native Mental Health Research: The Journal of the National Center 4:98–121.

———. 1995a. “Suicidal Behavior in American Indian Female Adolescents.” In S.S. Canetto and D. Lester (eds.). Women and Suicidal Behavior. New York, N.Y.: Springer Publishing Co., 157–73.

———. 1995b. “The Zuni Life Skills Development Curriculum: Description and Evaluation of a Suicide Prevention Program.” Journal of Counseling Psychology 42(4):479–86.

Yoder, K.A., Whitbeck, L.B., Hoyt, D.R., & LaFromboise, T. (2006). Suicidal ideation among American Indian youth. Archives of Suicide Research, 10. 177-190

LaFromboise, T.D. (2006). American Indian youth suicide prevention. Prevention Researcher, 13, 16-18.

LaFromboise, T.D., & Lewis, H.A. (in press). The Zuni Life Skills Development Program: A school/community-based suicide prevention. Suicide and Life-Threatening Behavior.

LaFromboise, T. D., Medoff, L., Harris, A., & Lee, C. (2007). Psychological and cultural correlates of suicidal ideation among American Indian early adolescents on a Northern Plains reservation. Research in Human Behavior, 41, 119-143.

Contact

Teresa LaFromboise, Ph.D., Associate Professor
Stanford University
485 Lasuen Mall
Stanford, CA 94305
Phone: (650) 723-2109
Fax: (650) 725-7412
E-mail: lafrom@stanford.edu
Web site: http://griefnet.org/library/reviews/a/amerindianskR.html

Technical Assistance Provider

Madonna Seelhammer, Director
PO Box 2036
Inver Groves, MN 55076
Phone: (651) 270-2939
E-mail: meseelhammer@gmail.com