Spijker2014 - Effectiveness of Online Self-Help for Suicidal Thoughts, Results of a Randomised Controlled Trial
- Date read: 2023-03-28
- Subject: Suicide ICBT
- Bibtex: @spijker2014
- Bibliography: Spijker, B. A. J. van, Straten, A. van, & Kerkhof, A. J. F. M. (2014). Effectiveness of Online Self-Help for Suicidal Thoughts: Results of a Randomised Controlled Trial. PLOS ONE, 9(2), e90118. https://doi.org/10.1371/journal.pone.0090118
- Six modules:
- Repetitive character of suicidal thoughts (ref 16)
- Suicidal thoughts as self-protection, worry and suicidal thinking. Counting suicidal thoughts, worry postponement, positive worrying, attentive breathing, distraction.
- Regulating intense emotions
- Module 2 teaches subjects to recognize and prevent an upcoming crisis. An important message is that seemingly unbearable thoughts can be tolerated. Main goal is that subjects learn to tolerate and regulate intense emotions in a crisis situation.
- Identifying automatic thoughts
- Module 3 explains the ‘ABC model’ which states that emotions (Consequences) are caused by a persons Belief about an Activating event (the trigger). Exercises focus on identifying automatic thoughts.
- Thinking patterns
- Module 4 describes common distortions in thinking. Exercises deal with recognizing and changing them.
- Thought challenging
- Module 5 is about challenging negative thoughts by evaluating evidence for and against the validity. Exercises also focus on formulating thoughts in a more detailed and neutral way.
- Relapse prevention
- Module 6 explains the possibility of relapse. Also, attention is given to the picture of the future and possible future setbacks. Exercises focus on making a relapse prevention plan and on formulating a more realistic picture of the future.
- One module per week, six automated e-mails with motivation to continue
- “Ideally subjects need to spend at least 15 minutes twice a day to perform the exercises. Every week, an automated e-mail is sent as a reminder of the new module and as motivation to complete it.”
- FAQ function on the site
- Primary outcome was Beck Scale for Suicidal Ideation (BSS)
- Power calculation: Expected effect size of 0.35 and 20-30% dropout
- Observed effect size = 0.28 (0.03 to 0.54), p = 0.036
So, mainly emphasis on cognitive techniques and emotion regulation. How about behavioral activation or more functional analysis?