Mobile Intervention for Suicidal Thoughts
Palo Alto (17 mi)Overseen byDimitris Kiosses, PhD
Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: Weill Medical College of Cornell University
No Placebo Group
Trial Summary
What is the purpose of this trial?This trial tests WellPATH-PREVENT, a tablet-based program, to help adults aged 50-90 manage emotions and reduce suicide risk. The program teaches recognizing emotional triggers and changing negative thoughts into positive ones.
What safety data exists for the mobile intervention for suicidal thoughts?The WellPATH app, part of the CRISP intervention, has been evaluated for feasibility and acceptability in middle-aged and older adults at high suicide risk. The studies indicate that the app is feasible and acceptable for use in emotionally-charged situations outside therapy sessions. However, specific safety data or adverse effects are not detailed in the provided research abstracts.45689
Do I have to stop taking my current medications for the trial?The trial does not specify if you need to stop taking your current medications. However, it does include patients who are on psychotropic medications and receiving community psychotherapy.
Is WellPATH-PREVENT a promising treatment for suicidal thoughts?Yes, WellPATH-PREVENT is a promising treatment for suicidal thoughts. It uses a mobile app to help people manage their emotions and thoughts outside of therapy sessions. This makes it easier for people to get help when they need it, which can be very important for preventing suicide. The app has been shown to be acceptable and feasible for people at high risk of suicide, making it a valuable tool in suicide prevention.3791011
What data supports the idea that Mobile Intervention for Suicidal Thoughts is an effective treatment?The available research shows that the WellPATH app, part of the Mobile Intervention for Suicidal Thoughts, was used in a 12-week program for middle-aged and older adults after they were hospitalized for suicide-related issues. The study found that the app was feasible and acceptable, suggesting it could help people manage their emotions outside of therapy sessions. While the research doesn't directly compare it to other treatments, the positive feedback indicates it might be a useful tool for those at risk of suicide.12489
Eligibility Criteria
This trial is for middle-aged and older adults aged 50-90 who have been hospitalized due to suicidal thoughts or attempts. Participants must be able to understand English, not suffer from severe cognitive impairments (MMSE > 24), psychotic disorders, dementia, or acute medical illnesses.Inclusion Criteria
I am between 50 and 90 years old.
Exclusion Criteria
I have been diagnosed with a psychotic disorder.
I have not had a severe illness or major surgery in the last 3 months.
I have been diagnosed with dementia.
Treatment Details
The study tests WellPATH-PREVENT, a mobile psychosocial intervention aimed at improving emotion regulation and reducing suicide risk in participants recently discharged after hospitalization for suicide-related issues.
3Treatment groups
Experimental Treatment
Active Control
Group I: Proof-of-Concept WellPATH-PREVENT (R61)Experimental Treatment1 Intervention
Group II: Optimized WellPATH-PREVENT (R33)Experimental Treatment1 Intervention
Group III: Attention Control Usual Care (R33)Active Control1 Intervention
The AC-UC group will parallel the delivery of the WellPATH-PREVENT intervention and will also include: a) meetings during hospitalization: a non-clinical member of the team will present the control tablet and explain its use; b) scheduled or requested meetings through zoom: to parallel the delivery of WellPATH-PREVENT. The tablet will still have a link to schedule a meeting with a non-clinician member of the team. The meetings will focus on issues that the patient may have in using the tablet. There will not be any therapeutic or psychological interaction between participants in the control group and the team. The experimental and the control group will also be under usual outpatient care, which is arranged during the hospitalization by the inpatient treatment team.
Find a clinic near you
Research locations nearbySelect from list below to view details:
New York Presbyterian Hospital/Weill Cornell MedicineNew York, NY
Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell MedicineWhite Plains, NY
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Who is running the clinical trial?
Weill Medical College of Cornell UniversityLead Sponsor
National Institute of Mental Health (NIMH)Collaborator
References
Behavioral treatments of suicidal behaviors. Definitional obfuscation and treatment outcomes. [2022]This chapter focuses on a review of randomized clinical trials of both psychosocial and behavioral interventions designed to directly reduce rates of suicide and parasuicidal behavior, including suicide attempts. It begins with an overview of the definitional difficulties in this field and then proceeds to an overview of treatment issues and a comprehensive review of treatment studies aiming to reduce suicidal behavior among suicidal individuals. Twenty studies are discussed. Eighteen studies randomly assigned subjects to the experimental and control condition; the other two studies assigned subjects in an alternating sequential fashion. Analyses showed that four psychosocial intervention studies and one pharmacotherapy study have reported efficacious results when compared to treatments-as-usual or placebo controls. From another perspective, when outpatient psychosocial interventions were examined, the strongest predictor of whether the experimental treatment would be more effective than the control was whether high-risk suicidal individuals were included. Psychosocial interventions appear to be most effective with the more high-risk individuals.
Successful Treatment of Suicidal Risk. [2022]In this article we focused on analyzing surveyed patient-generated responses based on two outcome questions derived from a suicide-specific framework called the Collaborative Assessment and Management of Suicidality (CAMS): Q1 - "Were there any aspects of your treatment that were particularly helpful to you? If so, please describe these. Be as specific as possible." Q2 - "What have you learned from your clinical care that could help you if you became suicidal in the future?"
Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. [2022]Online and mobile telephone applications ('apps') have the potential to improve the scalability of effective interventions for suicidal ideation and self-harm. The aim of this review was therefore to investigate the effectiveness of digital interventions for the self-management of suicidal ideation or self-harm.
Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART). [2023]This pilot study investigated the potential to utilize adaptive treatment strategies for treating moderate to severe suicidal risk among college students. This article will describe the unique study design and report on feasibility and acceptability findings. A 2-stage Sequential Multiple Assignment Randomized Trial (SMART) was conducted: In Stage 1, 62 suicidal college students were randomized to either a suicide-focused or a treatment-as-usual condition (4-8 weeks). Those deemed insufficient responders were re-randomized to one of two Stage 2 interventions-both suicide-focused but one comprehensive and multimodal and the other flexible and theoretically agnostic (4-16 additional weeks). Recruitment rates were high, treatment dropout levels were lower than expected for the setting, study dropouts were rare, and counselors were able to deliver suicide-focused approaches with fidelity. Treatment satisfaction was high among clients and moderately high among counselors. Findings from this pilot show that a SMART is highly feasible and acceptable to suicidal college students, counselors, and campuses.
Cognitive Reappraisal Intervention for Suicide Prevention (CRISP) for Middle-Aged and Older Adults Hospitalized for Suicidality. [2022]Middle-aged and older adults constitute a high suicide-risk group. Among adults aged 50 years old and older, suicide rates increased and suicide deaths almost doubled during the period from 2000 to 2015. Suicide rates are elevated for patients hospitalized for suicidality (i.e., active suicidal ideation or suicide attempt) and the 3 months post-hospitalization is the time of the highest suicide risk. Psychosocial interventions for middle-aged and older adults hospitalized for suicidality are sparse. In this article, we present the main aspects, stages, techniques and a clinical case study of Cognitive Reappraisal Intervention for Suicide Prevention (CRISP), a psychosocial intervention targeting cognitive reappraisal to reduce suicide risk in middle-aged and older adults who have been recently hospitalized for suicidal ideation or a suicide attempt. CRISP is based on the theory that hospitalization for suicidality is preceded by an emotional crisis ("perfect storm"); this emotional crisis is related to personalized (patient- and situation-specific) triggers; and identifying these personalized triggers and the associated negative emotions and providing strategies for an adaptive response to these triggers and negative emotions will reduce suicidal ideation and improve suicide prevention. CRISP therapists identify these triggers of negative emotions and use cognitive reappraisal techniques to reduce these negative emotions. The cognitive reappraisal techniques have been selected from different psychosocial interventions and the affective neuroscience literature and have been simplified for use with middle-aged and older adults. CRISP may fill a treatment need for the post-discharge high-risk period for middle-aged and older adults hospitalized for suicidality.
A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality versus Enhanced Care as Usual With Suicidal Soldiers. [2019]This study describes a randomized controlled trial called "Operation Worth Living" (OWL) which compared the use of the Collaborative Assessment and Management of Suicidality (CAMS) to enhanced care as usual (E-CAU). We hypothesized that CAMS would be more effective than E-CAU for reducing suicidal ideation (SI) and suicide attempts (SA), along with secondary behavioral health and health care utilization markers for U.S. Army Soldier outpatients with significant SI (i.e., > 13 on Beck's Scale for Suicide Ideation).
Mobile Health Technology Interventions for Suicide Prevention: Systematic Review. [2022]Digital interventions are proposed as one way by which effective treatments for self-harm and suicidal ideation may be improved and their scalability enhanced. Mobile devices offer a potentially powerful medium to deliver evidence-based interventions with greater specificity to the individual when the intervention is needed. The recent proliferation of publicly available mobile apps designed for suicide prevention underlines the need for robust evidence to promote safe practice.
The Effectiveness of the Safety Planning Intervention for Adults Experiencing Suicide-Related Distress: A Systematic Review. [2022]The safety planning intervention (SPI) is gaining momentum in suicide prevention practice and research. This systematic review sought to determine the effectiveness of the SPI for adults experiencing suicide-related distress. Systematic searches of international, peer-reviewed literature were conducted in six databases (Cochrane Trials, Embase, Emcare, Medline, PsycINFO and Web of Science), including terms for safety planning, suicide, and suicide-related outcomes. A total of 565 results were included for screening. Result screening (title/abstract and full-text), data extraction and critical appraisal were conducted in duplicate. Twenty-six studies met the inclusion criteria. Studies were primarily quantitative (n = 20), largely with general adult or veteran samples; a small number of studies explored the perspectives of staff and significant others. Half of the studies included the SPI as a standalone intervention, while the other half examined the SPI in combination with other interventions. Most interventions were delivered in-person, with a hard-copy safety plan created, while a smaller number explored internet-based interventions. Primary measures included: suicidality (ideation, behavior, deaths; 10 studies), suicide-related outcomes (depression, hopelessness; 5 studies) and treatment outcomes (hospitalizations, treatment engagement; 7 studies). The evidence supports improvements in each of these domains, with complementary findings from the remaining quantitative and qualitative studies suggesting that the SPI is a feasible and acceptable intervention. While positive, these findings are limited by the heterogeneity of interventions and study designs, making the specific impact of the SPI difficult to both determine and generalize. Conversely, this also points to the flexibility of the SPI.HighlightsThe Safety Planning Intervention (SPI) is a valuable indicated intervention for general adult and veteran populations experiencing suicide-related distress, primarily in face-to-face, clinical settings.Quantitative findings indicate associations between the SPI and improvements in suicidal ideation and behavior, decreases in depression and hopelessness, along with reductions in hospitalizations and improvements in treatment attendance.Qualitative studies suggest the SPI is acceptable and feasible, with areas for development.SPIs have been shown to be adaptable to the clinical area in its modality (digital or paper-based), delivery (face-to-face or online), facilitation (clinician or self-administered) and multiplicity (as stand-alone or combined intervention).
An Emotion Regulation Tablet App for Middle-Aged and Older Adults at High Suicide Risk: Feasibility, Acceptability, and Two Case Studies. [2022]The unique features of technological applications may improve the treatment of people at risk of suicide. In this article, we present feasibility and acceptability data as well as two case studies demonstrating the use of WellPATH, a tablet app that aims to help suicidal patients during emotionally-charged situations outside of therapy sessions. The WellPATH app was part of a 12-week psychotherapy intervention (CRISP - Cognitive Reappraisal Intervention for Suicide Prevention) for middle-aged and older adults after their discharge from a suicide-related hospitalization.
SERO - A New Mobile App for Suicide Prevention. [2022]Mobile apps indicate a positive effect on suicidal ideation and potential impact on suicide attempts. As part of the SERO suicide prevention program, Lucerne Psychiatry in collaboration with partner organizations aims to reduce suicides and suicide attempts in its service area, and to improve the self-management of suicidal individuals with a mobile app. The concept for such an app was developed in a trialog with health professionals, persons at risk and their relatives and its functions were compared to six known essential app-based strategies for suicide prevention, such as the development of a safety plan, access to support networks and tracking of mood. We present the concept and architecture for the app and discuss potential added value, which may result from the intertwining of the strategies within the app, which will be available in its first version in late 2022.
Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. [2023]Here we present the findings of the pilot phase of the SmartCrisis 2.0 Randomized Clinical Trial. This pilot study aimed to explore the feasibility and acceptability of a safety plan contained in a smartphone app. Our sample consisted patients with a history of recent suicidal behaviour who installed a smartphone-based safety plan. To explore the satisfaction with of the safety plan, two patient satisfaction surveys were conducted: one qualitative and one quantitative. To explore the objective use of the safety plan, we gained access to texts contained in the safety plans completed by the patients. Participation rate was 77%, while 48.9% patients completed both satisfaction surveys at the end of the pilot phase. N = 105 successfully installed the safety plan. In a scale from 1 to 10, users rated the usefulness of the security plan at 7.4, the usability at 8.9, the degree to which they would recommend it to others at 8.6 and the overall satisfaction with the project including evaluations at 9.6. The most widely completed tab was warning signs. Feeling sad or lonely was the warning sign most commonly reported by patients. The second most completed tab was internal coping strategies. Walking or practicing any other exercise was the strategy most commonly resorted to. Our smartphone-based safety plan appears to be a feasible intervention. Data obtained from this pilot study showed high participation rates and high acceptability by patients. This, together with the general satisfaction with the project, supports its implementation in the clinical practice.