QPR in the Classroom: Resource Guide

Thank for choosing to use the QPR Gatekeeper Training for Suicide Prevention in your classroom. This online educational program may be used in a variety of ways, including as a clinical lab or a homework assignment. The program is provided online by the Department of Educational Outreach at Eastern Washington University.

For assistance with questions regarding access to the online gatekeeper training program (User IDs, passwords, service functions, and account management), please call Eastern Washington University at 509-359-2269 or 1-800-331-9959.

For technical assistance with classroom applications or other matters, please contact Brian Quinnett, National Training Director, at …..

Before you begin
Suicide is not an easy topic to discuss. In general, students have very little knowledge about suicide, its causes, and how it can be prevented. However, students are vitally interested in the subject. Many students will have known someone who attempted or died by suicide, and studies have shown that a substantial number of young people have experienced suicidal thoughts and feelings. Based on health risk surveys of both high school students and college youth, you may assume at least some students in your classroom have thought about suicide. Some may even have attempted suicide.

Your willingness to encourage or assign students to complete QPR training helps reduce the fear, stigma, and shame associated with suicidal behavior. By increasing suicide awareness and understanding you are helping to address an important public health problem. Your classroom discussion of this topic will help create a new culture of openness and discussion regarding suicide, and your leadership may help save lives.

Instructor resources
This guide is designed to assist you in conducting post-QPR online training with one or more follow up classroom sessions designed to better understanding and prevent suicide. The following modules include:
- Instructor orientation
- How students access training
- How to track student completion of QPR training
- How to evaluate training aggregate outcomes (if desired)
- How to conduct a post-training QPR practice session
- How to provide referral and crisis response action steps to students
- Recommendations on review of QPR training
- Classroom suicide prevention resources

Instructor orientation
QPR is usually taught face-to-face in small classroom settings by Certified QPR Instructors. However, demand for QPR training exceeds the supply of Certified Instructors. By blending the expertise of qualified teaching professionals with the online QPR training program, many more students can receive this life-saving training.

For an orientation to QPR, its theory and practice, we invite you to fully explore this web site and read the QPR Theory paper (link to paper)

For an orientation to developing social policy and the current status of suicide prevention in America, we invite you to read and/or review the following publications and web sites:
- National Strategy for Suicide Prevention
- Institute of Medicine: Reducing Suicide, a National Imperative
- SPRC – college white paper
- www.AFSP.org
- www.sucidology.org
- Brian ? others?

How students access training
(Brian, write something in printable handout sheet on how to access the online training. Price will be $19.95).

How to track student completion of QPR training
The QPR online gatekeeper training program has been engineered to assure the integrity of educational content each student receives. Students should be instructed to print their Certificate of Course Completion and bring it to class as proof that they have successfully passed the 15-item quiz.

When announcing the assignment you may say, “When you have completed your QPR training and successfully passed the exam, a computer-dated Certificate of Course Completion with your name on it will appear on your computer screen. Please print two copies of this certificate; retain one for your files and bring the other to class.”

How to evaluate training aggregate outcomes (if desired)
Should you wish to aggregate results from student QPR training, a complete confidential database of student demographics, pre-post survey results, quiz scores, action items endorsed, and evaluations may be secured by the assignment of a unique organizational code. This unique class code, determined by you, captures all data entered by students using this code. You may contact Eastern Washington University for additional information and cost to access the database (see assistance above).

How to conduct a post-training QPR practice session
Practicing the QPR intervention in the classroom is strongly recommended. If you devote a classroom session to review and practice the QPR intervention, please ask that students first complete the QPR online training and read the QPR booklet and card (these are mailed directly to students shortly after they have completed all eight modules of the QPR training).

Be sure to have your referral sources ready as QPR is most successful when students know to where and to whom they are supposed to refer or accompany someone in crisis.

To build upon the success of the online QPR training, we recommend or more of the following classroom sessions be held:

A. Q&A/Referral only option (minimum 30 minutes):
Conduct a 30-minute post-training question and answer period for all those who have completed the online QPR training. Following a welcome and introduction, allow:
- 10 to 15 minutes for questions and answers
- Review local policy and procedures regarding how referrals are made
- Your institutions crisis response plan
- Distribute any hard-copy handouts for related materials, including additional reading, web sites or assignments.

If you do not have a crisis plan, you download and print a sample here/ click link

B. Q&A, Referral and Practice Session option (minimum 45-60 minutes):
In addition to the Q&A above, and if you are qualified and familiar with role-plays, conduct a practice role-play session. A printable catalogue of role-plays is provided here (click/link to role plays). You may create your own role-plays per our recommended format.

The goals for this practice session are to focus on how to ask the Suicide Question in a sensitive, yet direct manner and then proceed to practice the Persuade and Refer steps.
Students are reminded to use active listening skills to learn about the nature of the crisis with the end goal of persuading the person to accept help and a referral. A QPR intervention is not a clinical suicide risk assessment interview. Rather, it is a CPR equivalent in recognizing suicide warning signs and how to use active listening and gentle persuasion to help move the suicidal “actor” to acceptance of professional services.
A PowerPoint file is included here (link) to assist in the practice session. This 45-60 minute session should include the following:
• A welcome and brief outline of what will be accomplished in the meeting (2-3 minutes)
• A brief Q&A regarding the student’s experience of the online training program (up to 15 minutes)
• A thorough review of local referral resources, emergency, and crisis response systems (5-10 minutes)
• A role-play experience of not less than 20 minutes (10 minutes per person in both roles)
• Discussion of role-play experience (3-5 minutes after each role-play)
• Distribution of any hard-copy handouts
• The instructor remains to answer any residual questions or assist with referrals (time will vary). The instructor is the last person to leave the classroom

Conducting the Role-Plays
STEP 1: Have students pair up and create some space between the paired couples.
STEP 2: Ask students to decide who will be the distressed person and who will be the gatekeeper for the first role-play, and have this person raise his or her hand. You will reverse this experience after the first role-play.
STEP 3: Pass out role-plays to the distressed person and instruct everyone that the gatekeeper does not read the role-play.
STEP 4: Once the distressed person has read the role-play to him or herself say to the audience: “You will be allowed 15-minutes to a) listen to the problem, b) detect a suicide warning sign and c) complete a QPR intervention and referral.”
Then say, “The distressed person will now read the top part of the role-play to the potential gatekeeper (which describes who he or she is the problems he or she is dealing) with and “will NOT READ the lower one-half of the role-play to the potential gatekeeper (list of risk and protective factors).”
STEP 5: Say, “You have 15-minutes. Please begin.”
STEP 6: At 12 minutes, announce they have 3 minutes left. At 14 minutes, announce they have 1 minute left.
STEP 7: Allow students to process their experience according to the PowerPoints provided here. In debriefing the role-play, it is useful to share your experiences with others if you so choose. You may wish to read the actual role-play scenario at this point.
OPTIONAL STEP 8: If you are using the evaluation form to be completed by a third person observer of the role-play exercise (see below), instruct the observer to complete the Structured Role-Play Evaluation Form at the end of the role-play exercise and share results with both students. You may choose to share observer’s findings with the entire group.
Repeat steps 1-7 for the second role-play.

Structured Role-Play Evaluation Form
Please note that practice is an important step in the development of any skill, including the QPR intervention. In addition to the post-test quiz in the online training program, we also provide you a quantitative measuring tool to determine how well participants conduct their QPR intervention the role-play environment (click here for tool). This tool allows other participants to act as observing evaluators to measure skills. Depending on your time and mission, you may wish to provide this assessment as part of post QPR online training experience.

Pre-practice session options
We encourage you to have your students practice with peers prior to the post-training practice session. The online QPR training program includes a downloadable generic role-play which may be printed and, following instructions, practiced with a colleague, friend or peer. This role-play will allow participants the opportunity to try different ways of asking questions in an environment that is safe, while still allowing them the opportunity to find an approach that best suits their conversational and interactive style. The more practice they experience, the more comfortable the act of asking the suicide question will be.

TAKE HOME MESSAGE
The important message here is that students must find a way to become comfortable in asking the suicide question. Without doing this there is little they can do to help someone considering suicide. Addressing the subject of suicide with someone who has been afraid to talk about his or her suicidal feelings and thoughts is the iron key that opens the golden door to hope.
All the real, immediate, underlying, historical and cultural reasons why suicide is under consideration can only be learned through the establishment of a relationship based on hope and trust. If this door is not somehow opened, the suicidal sufferer is seldom helped and often left with a greater sense of despair and hopelessness.

Recommendations on review of QPR training
Students have access to their QPR Gatekeeper Training for Suicide Prevention program for 3-years from date of purchase. The QPR Institute recommends annual review of the core training slides. Also, the QPR online training program undergoes frequent upgrades in content, videos, and cultural, ethic and language options. Students should be reminded to keep their access codes handy as they may encounter a crisis situation and need to refresh their training.

Classroom suicide prevention resources
For a budget sensitive option to add to the QPR online training, a best-selling free e-book may be downloaded or read online by students. Suicide: the Forever Decision is available on the Institute’s home page and has become a classic in the field. Instructors interested in assigning this book to students may request a free quiz and scoring master from the QPR Institute (see technical assistance above).

Students aiming for the helping professions will find very useful the new and revised third edition of Dr. Paul Quinnett’s Therapy of Hope: Counseling Suicidal People being published this spring by Eastern Washington University Press. Get your copy from the local bookstore or online from the publisher at http://www.ewu.edu/ewupress/.

Professors wanting review copies for classroom use should send a request for a desk copy to ewupress@mail.ewu.edu from their university address or on university letterhead.

Recommendations for annual review
Students have access to QPR gatekeeper training program for three years from date of purchase. We recommend an annual review of the QPR core training slides.

Classroom suicide prevention materials
A variety of suicide prevention fact sheets, statistics, overviews and clinical findings can be found at the web sites listed above. As students are often interested in local or state statistics, these can be retrieved from you local county health office or the Department of Public Health, Injury Prevention Division of your state. Your student counseling center may also have relevant material or helpful ideas and input. They may even be invited to your classroom to explain to students how to make referrals.

We especially recommend the National Institute of Mental Health (www.nimh.gov) for the most recent relevant research summaries and breaking news.

We also recommend the free subscription to Suicide Prevention Resource Center’s weekly news report on suicide prevention activities and updates. (www.sprc.org).

Thank you for participating in National Strategy for Suicide Prevention.

Staff and Faculty