FAST Highlights:

• Can be given in an interview format or paper-pencil format in 15 minutes
• Is designed for clients aged 16 or older
• Can be administered and scored in less than 20 minutes.
• Provides T scores for 11 levels of self-destructive thought, three composite scores (issues related to self-esteem, issues related to self-harm, and issues related to substance abuse), a total score, plus an additional sub scale of suicide risk based on 27 items found to be the strongest predictors of suicidality
• Can be used as a preliminary screening device for new clients or to evaluate changes in self-destructive thoughts over time
  

Dr. Firestone discusses insights which lead to development of FAST assessment tool

The Firestone Assessment of Self-destructive Thoughts (FAST), published by The Glendon Association, is based on the clinical theory of Robert Firestone. This approach, which integrates cognitive and psychodynamic concepts, assesses the levels of self-destructive thoughts a person is experiencing, along a specific Continuum of Negative Thought Patterns. Clinicians can learn valuable information about clients' levels of functioning along this continuum. The continuum begins with self-critical thoughts of everyday life (Level 1), progresses to self-abusive thoughts and vicious self-accusations (Level 5), then on to those thoughts leading to addictive behavior or substance abuse (Level 6), and finally to injunctions to carry out a suicidal plan. (Level 11).

The FAST consists of 84 items that clients endorse on a 5-point, Likert-type scale from "never" to "almost always." They consist of self-destructive thoughts taken directly from clinical material derived from a longitudinal study of clients' negative thought processes. The suicide risk sub scale provides a brief measure of a person's suicidal potential.

This instrument is useful as a screen for persons entering psychological treatment. FAST scores indicate areas in which the client is experiencing the greatest degree of distress. It will also serve as a brief pre-and post-therapy measure.

FASI

Most individuals at risk for committing suicide experience self-defeating and self-destructive thought processes that can be conceptualized as an internal dialogue or "voice." The FASI is based on voice therapy theory, which is a comprehensive approach to psychopathology and corresponding model of mental health. It is a short efficient subscale derived from the larger instrument, the Firestone Assessment of Self-Destructive Thoughts (FAST). Whereas the FAST assesses a broad range of self-destructive thoughts, the FASI more specifically determines an individual's suicidal risk.

Dr. Firestone discusses insights which lead to development of FAST assessment tool

One in five practicing clinical psychologists will lose a client to suicide, and the odds increase to one in two for psychiatrists. The signs and symptoms exhibited by a suicidal individual are diverse, and clinicians receive little training in how to deal effectively with these clients. Also, therapists often have difficulty empathizing with seriously suicidal clients.

The FASI yields significant information that helps a clinician establish whether or not the client is in imminent danger of self-harm and then decide upon the most suitable immediate action.

The FASI is a 27-item self-report questionnaire. Clients endorse the items on a 5-point Likert-type scale from never to most of the time. The scale incorporates a unique approach: instead of being asked to report symptoms, the client is asked to endorse how frequently he or she is experiencing various self-directed negative thoughts. This allows individuals to reflect on and report the contents of their negative thought process or "voice." Items presented in this form bring to light elements of a self-destructive process that have been partially or completly unconscious.

APPLICATION

• Provides a prompt, easy-to-administer and thorough clinical assessment strategy for evaluating suicidal risk.
• Allows quick assessment of client's imminent danger of self-harm.
• Aids the clinician in determining the most appropriate course of action for a client exhibiting a significant degree of self-destructive thoughts.