A Friend is the First to Know:

Making Every Student a Leader in Preventing Suicide

NAIS 2018

Friday 3/6/18

8:15 - 9:15am

Presenters

Leilani Ahina, PsyD ( )

Sarah Slater, MSW ( )

Bennett Valencia, LCSW ()

Psychosocial Education Department, Punahou School, Honolulu, HI

Learning Objectives:

  1. Experience this suicide prevention curriculum as students would, while considering possible modifications for your school culture and environment.
  2. Leverage adolescent social connection and enlist their support in caring for students that are in need of support or intervention.
  3. Create support connections between students and adults to increase the likelihood of referral for reactive counseling.

Abstract

When a student is at risk or in crisis, who is the first to know? This workshop will simulate our engaging, interactive classroom curriculum aptly titled ‘A Friend is the First to Know.’ We address issues facing students that become aware of concerning information about a friend. Participants will learn an experiential model for facilitating this discussion through small and large group activities, which we will co-facilitate with student Peer Helpers. With you in the student role, this workshop demonstrates a curriculum that guide, teach, and empower students to be leaders in caring for their friends and accessing support.

Session Description

At school campuses around the world, friends and peers are usually the first to know about a low test score, relationship breakup, or an argument with parents. Friends also are likely to be the first to know about eating disorder behaviors, sexual assault, and warning signs of suicide posted on social media. While school counselors and other adult supports may be available to assist students, it is important for students to have the tools and to use the resources to address these situations effectively and to reach out for support from these resources.

A Friend is The First to Know is a one-hour curriculum that all freshmen experience as part of a psychosocial wellness curriculum at Punahou School (Honolulu, Hawaii). We have also facilitated this curriculum with parent and teacher groups to increase their awareness on these issues. This workshop will simulate our engaging, interactive classroom experience and help you identify possible modifications to fit your campus culture and available resources. Participants will learn an experiential model for facilitating this discussion through small and large group activities, which we will co-facilitate with student Peer Helpers.

This curriculum addresses a complex set of issues facing students that become aware of concerning information about a friend. This includes identification of what behaviors or situations might cause them concern for a friend, assessing their level of concern, and determining possible responses and use of available resources. Discussion also includes review of limits to confidentiality, and mandated reporting laws. Identification of formal and informal resources and sources of support, both on and off campus, are also emphasized. This curriculum can be used as a catalyst for conversations on a variety of behavioral and mental health issues facing students and their friends, empowering each student to be a leader among their peers.

A Friend is the First to Know

9th Grade Guidance Curriculum

(Co-facilitated with an upperclassmen Peer Helpers)

Punahou School

Honolulu, HI

Curriculum Goals:
1. To encourage students to think critically about what would cause them concern about a friend.
2. To engage students to dialogue with others about what levels of concern they would have regarding certain issues for friends, including those involving imminent risk.
3. To foster a school-wide safety net of support where students are active members in identifying concerns in themselves and others.
4. To engage students to actively seek out support from adults and to know when to do so. / TA Goals:
1. Review groundrules to set a more serious tone.
2. Share appropriately during stem and activity (be a role model – no personal stories).
3. Give disclaimer – remind freshman NOT to share names or specific info about who the friend is.
4. Respond to every student during stem with an open-ended question (WHO, WHAT, WHERE, WHEN, HOW, or WHY) followed by a reflection or a summary.

Materials Needed: One piece of scratch paper per person, One sheet of butcher paper per small group, and Markers

1. Review groundrules: Remind freshmen of the groundrules your class set at the beginning of the semester. Explain that over the next few cycles we will be talking about more serious things, like concerns we may have about others and what to do with those concerns. Ask freshmen to take these conversations more seriously if possible.

2. Divide students into 2-3 small groups and instruct them to bring a pen/pencil with them.

3. Opening Stem sentence (in small groups): My name is ______and I a time when I was worried about a friend was ______because ______.

*TA’s respond to every student in your small group with an open-ended question (WHO, WHAT , WHERE, WHEN, HOW, WHY) followed by a reflection OR a summary statement.

4. Continuum Activity:

a. Explain the purpose of the continuum activity and give disclaimer (in small groups): Friends probably know us the best and visa versa. Today we will be creating a list of things that would cause us to worry about a friend. DISCLAIMER: At one time or another we have all probably been concerned for a friend. In creating your list, please leave out any information that would disclose the identity of your friend and instead think about the bigger issues that concerned you.

b. Brainstorm sesh (individually): Everyone grab a pen/pencil and then give each student a piece of blank scratch paper. Please brainstorm, in silence, as many things as you can think of that would cause you to feel worried or concerned for a friend. (Brainstorming is a state where we generate ideas without editing or judging - we simply accept what pops into our head and then write it down.) Please do not write anything down that would reveal another person’s identity.

c. Create the continuum on butcher paper (in small groups): Once the brainstorming sesh is done, place a piece of butcher paper and some pens in the middle of each small group. Draw a long horizontal line on the butcher paper labeling one end "mildly concerning" and the other end "extremely concerning." Explain that the line on the butcher paper represents their level of concern for a friend, with less concerning problems on one end and extremely concerning problems on the other. Faculty draw an example of the continuum on the board. OPTION: Create a second substance use continuum to gauge where substance use concerns might fall separate from other concerns.

d. Facilitate a discussion of the items (in small groups): Within your small group, ask each student to share one item they wrote on their list with the group and where on the continuum they would place it. With each item addressed, facilitate a discussion, encouraging the group to come to a consensus on where each item falls on the continuum. For example, you might ask, "Why did you place this concern here on the continuum?"When the group decides where the item should fall on the continuum, have someone write down the item in the appropriate place on the butcher paper.

e. Create the continuum on the board: When each group is done creating their continuum on butcher paper, have them select at least 3 mild concerns, 3 medium concerns, and 3 extreme concerns to place on the continuum on the board. Choose two people to write these concerns on the continuum on the board (one to read them and one to write them).

f. Facilitate a discussion of the items (with the large group): Ask the class to look at the finished continuum. You might ask: “Are there any items on the brainstorming sheets that aren’t on the continuum but should be?” And then ask: "Does anyone disagree with the placement of items? Would anyone like to suggest that any items be moved?" Call on groups to hear their reasoning for placing the item where they did. If there is general agreement among the class to move the item, then move the item. When the class is satisfied enough with their continuum, then ask the following debrief questions:

i. Which of these problems would concern you enough to have a heart-to

heart talk (to express your concern) with your friend?

*Have the class decide where to draw a line intersecting the continuum as a point where they would have a heart to heart talk with a friend and write "Heart to Heart Talk" on the board.

ii. Which of these problems requires a stronger response than a heart-to-heart? What would your stronger response look like? What might you do? Be specific.

Some ideas of what you can do when a friend needs help:

· You can talk (or write) to your friend yourself.

· You and other friends can talk with your friend.

· You can withdraw from your friend, explaining that you simply don’t want to be around them when they’re being so self-destructive and, at the same time, committing to doing all that you can to help them if they want to stop being self-destructive.

· You can talk to your parents or someone at school about your concern, without revealing your friend’s name.

· You can talk with an adult and reveal your friend’s name.

iii. At what point would you seek out the support of an adult, and whom, exactly, would you seek out?

***IMPORTANT FOLLOW-UP QUESTIONS:

1. What might make it hard to seek out help from an adult? What if your friend’s safety or someone else’s safety was at risk?

2. Which concerns would warrant an immediate response, one that could not wait until tomorrow? Faculty highlight situations involving imminent risk that require an immediate response (suicide, homicide, child abuse…)

3. What are some resources on campus you can use if you are extremely concerned for a friend?

4. What does seeing a psychosocial counselor look like?

5. How might the conversation go?

6. What are the limits of confidentiality?

*Have the class decide where to draw a line intersecting the continuum as a point where they would seek out an adult for help and write “Seek Help of Adult” on the board.

*TA’s may share personal experiences of meeting with a psychosocial counselor, but disclose appropriately (i.e. do not disclose why you saw the counselor, but what the experience of seeing a counselor was like for you) – see your faculty if you have questions.

When should I be extremely concerned about my friend? (Read over this BEFORE class to remind freshmen.)

· If my friend is in danger of being hurt by others or is in danger of hurting him/herself.

· If my friend is taking risks that could lead to physical injury, brain damage, addiction, or harm to self/others.

· If my friend is showing warning signs of depression, such as sadness/low mood, low energy, problems concentrating, eating, or sleeping, withdrawn from friends/ family, thoughts of suicide, irritability, feelings of worthlessness or hopelessness lasting for more than two weeks.

· If my friend is being dishonest with him/herself about these risks or is not seeing him/herself clearly.

· If my friend simply does not know what to do about a problem or situation that is dangerous or very difficult emotionally.

2. Closing Stem Sentence (in small or large group if time, otherwise share with a partner): My name is ______and someone I would go to for help for a friend is ______because______.

3. Wrapping up the activity: Helping friends is always difficult because there is a fine line between helping and hurting. Sometimes that line is not black and white and is hard to determine. It is very important to have someone who you can trust in this situation so you can get some advice. There are many resources on campus including counselors and deans if your friends run into trouble along the way. We hope that your journey is a smooth one but if not, there are plenty of people that are willing to help! Thanks for your time and attention today.