Experience, training and recognition of suicide potential

More accurate clinical judgement has traditionally been considered an important product of training and experience. Although most training programmes are founded upon this premise, research findings have not always supported this. In fact a large body of literature has failed to demonstrate any relationship between the amount of clinical experience and training and the level of accuracy in clinical judgement. However, the conclusion that training and experience are unrelated to accuracy must be accepted cautiously, for it has largely been based on studies replete with serious methodological shortcomings. The aim of the present investigation was to minimize these problems while further examining this relationship with respect to the recognition of suicide potential, and the related question of confidence in judgement. The sample ultimately consisted of 185 individuals of varying levels of training and professional experience in psychology. Each subject completed a research instrument specially constructed to reflect the established body of knowledge concerning the prediction and occurrence of suicidal behaviour, and a Personal Information Questionnaire. The instrument was distributed either by post or through personal contact. The overall pattern of results is consistent with the weight of evidence from previous clinical judgement research indicating that experience and training are not significantly related to judgement performance. In contrast, the level of confidence in judgement was positively related to task-relevant experience and level of training. Indices of general experience were not strongly related to confidence. The design of this study did not permit an examination of how successful in clinical practice respondents are in identifying suicidal individuals. However, it did strongly suggest that some high-risk suicidal subgroups were more likely to be recognized than others. While stressing the need for caution in generalizing from the results of the present investigation, the trend for differential effects among indices of general and task-relevant experience suggest the need for additional studies involving these variables. A number of methodological issues and potential research strategies have been outlined.