Objective: The relationship between trainer fidelity during a two-day suicide prevention program for counselors at crisis centers and counselors' behaviors during calls from individuals with suicidal thoughts was examined.
Methods: The study used two data sets from a randomized control trial of a suicide prevention program delivered by counselors at 17 crisis centers who had previously received training (train-the-trainer [TTT] approach). One data set examined counselors' behaviors by silently monitoring calls (N=764) to the crisis lines, and one assessed adherence to manual content and competence in delivery among trainers (N=34) by coding training videotapes. Multilevel modeling was used to account for nested data.
Results: Use of recommended behaviors by counselors was primarily related to trainers' competence in delivery of the program rather than adherence to the program content.
Conclusions: Trainer selection for competence may be particularly critical for group-based TTT programs involving experienced counselors and the use of experiential activities.
Keywords: Crisis Lines, Fidelity; Staff training/inservice, Suicide.