Dead Poets' Society: The Moderating Effect of Exposure to Suicide on the Training – Self-Efficacy Relationship in Social Work Students
Jonathan B. Singer, LCSW, University of Pittsburgh.
Introduction: Although exposure to suicide through the media and personal relationships is a known risk factor for attempts and completion, there has been no comparable research on the influence of exposure to suicide in general on clinicians. Research in other professions (e.g. psychiatry and counseling) on suicide intervention has demonstrated that clinician self-efficacy is positively correlated with both training and amount of exposure to suicidal clients. There has not been comparable research with social workers, possibly because nearly all measures have been developed for use with other professions. This study had two purposes: 1) Test the hypothesis that students' exposure to suicide moderates the relationship between amount and type of training in the treatment and management of suicide, and students' perceived self-efficacy in working with suicidal clients; and 2) Test a theoretically derived self-efficacy measure for social workers. Methods: A correlational hypothesis-testing survey study design was used to investigate the hypothesis. Self-efficacy theory was used to develop a 19-item scale. Exploratory Factor Analysis (EFA) was performed to identify the factor structure of the self-efficacy scale. Participants were 151 Masters in Social Work students, of which 131 were direct practice and 20 were administration and planning (A&P). Because the A&P students were unlikely to perform clinical services, they were excluded from the analysis. This study was IRB approved. Results: Results supported the main hypothesis. The correlation between training (IV) and self-efficacy (DV) was highly significant (r=.417, p<.001) while the correlation between exposure (moderator) and self-efficacy was moderately significant (r=.216, p=.013), and the correlation between exposure and training (r=.118, p=.181) was not significant. The moderating effect of exposure on the relationship between training and self-efficacy was significant and accounted for approximately 3% of the variance (F(1, 127)=5.323, p=.023, R2Δ=.032.). For students with low levels of exposure, the relationship between training and self-efficacy was more significant (R2=.283, ß=.35, p<.001) than for direct practice students with high levels of exposure (R2=.058, ß=.24, p=.052). Results of the scale analysis suggested a high internal consistency reliability (Cronbach's α=.96). A scree plot analysis in the EFA suggested a one-factor solution – self-efficacy (eigenvalue=11.4, total variance explained=60%). Discussion: Results suggest that higher levels of exposure to suicide and suicidal behaviors may contribute to students' increased confidence in their abilities to intervene with suicidal clients. Two interpretations are: 1) Exposure to suicide in general is valuable in increasing the likelihood that students will recognize risk factors and engage suicidal clients in suicide assessments. 2) Conversely, exposure might overcompensate for low levels of training, resulting in students believing they do not need further training or consultation, resulting in lower quality of care. Both interpretations are consistent with self-efficacy theory and suggest directions for future research, clinical supervision and training of social work students. The self-efficacy scale holds promise as one of the few suicide-focused, theoretically-derived, social work-specific measures that can be used with all levels of experience. Recommendations for future use will be discussed.