Collaborative Assessment and Management of Suicidality (CAMS): Adherence to a Flexible Clinical Framework
The Collaborative Assessment and Management of Suicidality framework (CAMS; Jobes, 2006) has amassed more consistent empirical support to date than most other suicide-focused psychosocial approaches for actively treating adult patients. This support has led to multiple variations of CAMS training being delivered to mental health practitioners across several settings. However, no research has examined the extent to which such training impacts participants' self-reported adherence to the CAMS therapeutic philosophy and recommended CAMS practice behaviors, or whether adherence varies as a function of contextual variables (i.e., the type of training received, therapist factors, and primary work setting/agency support). The present study was designed to address this gap, using an online survey of 120 practitioners who completed some form of CAMS training or read the CAMS manual with the intention of applying it in clinical practice. Results indicated moderate to high adherence to the CAMS therapeutic philosophy, which is comparable to other studies gauging the impact of suicide-focused training. Similarly, participants reported relatively high adherence to CAMS practice, in line with other suicide-focused training studies and, in fact, higher than findings on adherence to interventions for other psychiatric issues. Older and more experienced clinicians, those with doctoral degrees, and those whose work was guided more from a CBT perspective had higher adherence to the CAMS therapeutic approach. Additionally, adherence to CAMS philosophy as measured by comfort using CAMS-consistent statements was higher for men, those with more of a CBT orientation, clinicians who received more intensive training, and those working in outpatient or Veterans Administration medical centers as opposed to counseling centers. Finally, therapist confidence in using CAMS with patients was positively related to both adherence types. On the whole, adherence to philosophy and practice did not vary consistently as a function of any contextual variable, which suggests that practitioners receiving CAMS training can successfully subscribe to the CAMS therapeutic philosophy and implement CAMS-specific practices regardless of their broader contexts. Future investigations of CAMS training should assess self-reported CAMS-related attitudes and beliefs before and immediately after training, as well as actual behavior change in clinical practice.
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