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Firestone Assessment of Self-Destructive Thoughts™
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Measure a broad range of self-destructive behavior patterns
with the FAST and screen for suicide intent with the FASI.
New documentaries address suicide from the perspective of
three individuals who attempted it. See below for details.
The FAST is an 84-item self-report measure that is derived from 20 years
of clinical research into self-attacking attitudes, or introjects, that
restrict
or impair an individual's psychological development.
The FAST was designed to capture different symptoms that are
characteristic
of suicidal individuals including hopelessness, depression, anxiety, and
suicide ideation. In addition to providing a means of assessing these
characteristics,
the FAST is a measure of a broad range of self-destructive behavior
patterns.
With the FAST, the clinician can identify the level at which the client
is
experiencing the highest frequency (intensity) of self-destructive
thoughts.
Utilizing this information, clinicians can direct their interventions
toward the
area(s) in which clients are experiencing psychological pain, thereby
potentially averting the acting out of the corresponding
self-destructive behavior. This
aspect of the scale is particularly important in the case of suicide,
for which immediate, appropriate intervention may be lifesaving.
Clinicians also are able
to identify and address less extreme types of self-destructive thoughts
before
they lead to or precipitate a suicidal crisis.
The FAST is organized into 11 levels of self-destructive thoughts (i.e.,
from
Level 1-Self-depreciating thoughts of everyday life to Level
11-Injunctions to
carry out suicide plans).
The FASI is a brief suicide screener that clinicians can administer when
they
wish to assess only suicide intent. This subset of the FAST consists of
27 items from Levels 7-11 of the FAST. These 27 items, which compose the
Suicide Intent Composite of the FAST, are the most predictive of suicide
risk.
Special Features
• The measure incorporates a unique approach. Instead of asking a client
to report beliefs or symptoms he or she is experiencing, the client is
asked to endorse how frequently he or she is experiencing
self-critical/self-depreciating thoughts in the form of an internal
dialogue or voice (i.e., negative thoughts directed toward oneself).
Endorsing items in this format allows the client to
reflect on and report the contents of his/her negative thought process
or voice. When items are presented in this form, they bring to light
elements of a self-destructive process that have been partially or
completely unconscious.
• For both the FAST and FASI, the scale raw scores are summed and
normative scores are provided in the form of T scores and percentiles.
The FAST contains
five composite scores: Self-Defeating, Addictions, Self-Annihilating,
Suicide
Attempt, and Total Score.
• The clinician can use the FAST to stimulate discussion in therapy
sessions regarding significant issues in a client's life that neither
the client nor the
clinician might have been aware of prior to the administration of the
measure. Clients have reported that reading and endorsing the items made
them aware
of self-limiting and/or self-destructive thoughts that had not
previously been
part of their conscious awareness. Responses to the measure also alert
the clinician to patterns of self-destructive behavior that need to be
investigated.
Reliability and Validity
• Internal consistency reliability coefficients for the composite scores
that
include multiple levels range from .95-.97. The internal consistency
estimates
for the levels range from .76-.91, with a median alpha of .84. The
test-retest correlations range from .63-.94, with an average of .82.
• The coefficients for all composites constructed from level scores
(i.e., Self-Defeating Composite, Self-Annihilating Composite, Total
Score) range from
.95-.97.
• A number of procedures were implemented to establish the validity of
the
FAST: (a) expert reviews, (b) factor analytic studies, (c) correlations
with other measures of self-destructive thoughts or behaviors, (d)
studies of specificity
and sensitivity of the test to discriminate a variety of clinical
groups, and (e) studies of special clinical groups.
• The original 220-item pool for the FAST consisted of verbatim
statements
made by clients during Voice Therapy groups. The most suicidal voices or
thoughts consisted of self-statements reported by individuals who had
made serious suicide attempts and who were actively suicidal. The
remainder
consisted of negative thoughts reported by clients with a variety of
patterns
of self-destructive behavior, including substance abuse.
• The FAST Total Score had its highest correlations with the Suicide
Ideation subscale of the Suicide Probability Scale (SPS; Cull & Gill,
1988; r = .76), the
Beck Depression Inventory® (BDI®), and the Beck Suicide Inventory (BSI).
These findings support the contention that the Total Score is a measure
of
suicide ideation and depression, or the self-destructive thoughts at the
highest end of the continuum.
FAST/FASI Materials
The FAST and FASI materials consist of the Professional Manual, the FAST
Rating Form, the FAST Scoring Summary/Profile Form, and the FASI Rating
Form/Scoring Summary/Profile Form.
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Voices of Suicide: Learning From Those Who Lived
This compelling documentary for mental health professionals explores what was happening in the minds of three people who narrowly survived suicide attempts.
Their unusually articulate personal accounts reveal the contents of an insidious thought process or "inner voice" that urged them toward the ultimate act of self-destruction.
Their accounts, in conjunction with interviews from world-renowned experts in the field, including Drs. Alan Schore, Israel Orbach, David Jobes, David Rudd, Robert Firestone and Lisa Firestone, provide clinicians with insight into the relationship between early developmental experiences and later suicidal behavior.
Particular attention is paid to the significant role of disassociation, which may originally serve as a survival mechanism, but in later life facilitates the "acquired ability" for an individual to attempt suicide. 61 minutes
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Understanding and Preventing Suicide
"My real purpose for wanting to make this film about suicide for the public is to educate all people about what to look for in their friends, their family members, their loved ones, their coworkers, their fellow students that could alert them to the fact that this person is in trouble, that they need help."
- Dr. Lisa Firestone, Director of Research and Education at The Glendon Association
This powerful new film for the general public highlights the lives of three individuals, Kevin, Susan, and Trish, who made serious suicide attempts and lived. Listen to their remarkable stories and journeys to recovery. Learn from experts in suicide prevention and treatment.
30 minutes |
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