Counseling for Depression and Suicide Risk

Overseen By Gillian Lashen, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon Health and Science University

Disqualifiers: Non-OHSU residents, fellows, faculty

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: Up to 6 months

4000 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to study whether distressed medical residents, fellows, and faculty health professionals benefit from completing online an anonymous and interactive screening of stress, depression, substance use, and suicidal thoughts. The screening and ability to interact online with a clinician anonymously are hypothesized to increase willingness to come for counseling in person. Suicide risk factors are expected to be lower once the distressed medical trainee or faculty member receives treatment.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Counseling, Behavioral Counseling, Dietary Counseling, Physical Activity Counseling for depression and suicide risk?

Research shows that counseling can effectively encourage physical activity, improve dietary habits, and enhance overall health behaviors, which are important for mental health. Patients reported high satisfaction with personalized counseling approaches, suggesting these methods could be beneficial for managing depression and reducing suicide risk. ^{1 2 3 4 5}

Is counseling generally safe for humans?

Counseling, including behavioral, dietary, and physical activity counseling, is generally considered safe for humans. Patients have reported satisfaction with the quality of care and support for lifestyle changes, indicating a positive experience without significant safety concerns. ^{3 6 7 8 9}

How is the treatment 'Counseling for Depression and Suicide Risk' different from other treatments for depression?

This treatment is unique because it combines behavioral, dietary, and physical activity counseling, focusing on lifestyle changes rather than medication. It uses motivational interviewing and shared decision-making to encourage behavior change, which is not typically emphasized in standard depression treatments. ^{7 9 10 11 12}

Research Team

Marie V Soller, MD

Principal Investigator

Oregon Health and Science University

Eligibility Criteria

This trial is for OHSU medical residents, fellows, and full-time School of Medicine faculty who may be experiencing stress, depression, substance use issues, or suicidal thoughts. The goal is to see if anonymous online screening can encourage them to seek in-person counseling.

Inclusion Criteria

OHSU medical residents, fellows, and full-time School of Medicine faculty

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Online screening

Treatment

Participants receive in-person counseling through the Resident and Faculty Wellness Program (RFWP) based on their responses to the Interactive Screening Program (ISP)

Up to 6 months

Varies based on individual needs

Follow-up

Participants are monitored for changes in psychological distress, burnout, and suicide risk after treatment

6 months

Treatment Details

Interventions

• Counseling

Trial Overview The study tests an online interactive screening tool designed to identify distress signs like depression and suicidal thoughts among medical professionals. It aims to determine if this approach increases their likelihood of pursuing further counseling.

Participant Groups

Group I: Counseling Experimental Treatment 1 Intervention

in-person counseling through RFWP to distressed respondents on the ISP and patients who seek counseling without completing the ISP

Who Is Running the Clinical Trial?

Oregon Health and Science University

Lead Sponsor

Trials

1,024

Recruited

7,420,000+

Findings from Research

The LINDA intervention, which provided individualized lifestyle counseling to 1,537 young women over 1.5-2.5 years, resulted in a 37% improvement in health behaviors related to physical activity, meal regularity, and sleep compared to 31% in the control group.

Participants who received targeted support for physical activity and sleep showed significant improvements, with 30% increasing their activity levels and 36% going to bed earlier, indicating the effectiveness of personalized counseling in promoting healthier lifestyles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

LINDA - a solution-focused low-intensity intervention aimed at improving health behaviors of young females: a cluster-randomized controlled trial. Valve, P., Lehtinen-Jacks, S., Eriksson, T., et al.[2021]

A multifaceted counseling intervention led by a physical therapist showed potential to improve physical activity levels in individuals with rheumatoid arthritis (RA), with a notable increase of 14.3 minutes per day in moderate/vigorous physical activity (MVPA) for RA participants.

The intervention also significantly reduced pain levels by an average of 4.05 points, indicating its effectiveness in symptom management for those with inflammatory arthritis, although further research is needed to explore its impact on different conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial. Li, LC., Feehan, LM., Xie, H., et al.[2020]

The Physical Activity Counseling trial involved 15 patients receiving intensive counseling from a physical activity counselor after initial guidance from their primary care provider, focusing on increasing physical activity over a 3-month period.

Patients reported high satisfaction with the intervention, appreciating the personalized approach and the effective strategies provided to help them overcome barriers to physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interdisciplinary physical activity counseling in primary care: a qualitative inquiry of the patient experience. O'Sullivan, TL., Fortier, MS., Faubert, C., et al.[2010]

Counseling patients to increase physical activity, especially when combined with written materials and behavior change strategies, has been shown to effectively boost activity levels, as evidenced by a review of 13 studies, including 6 randomized controlled trials.

However, the studies lacked long-term data on the sustainability of these interventions and did not establish reliable evaluation tools, indicating a need for further research to assess the lasting impact and cost-effectiveness of such counseling strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does counseling help patients get active? Systematic review of the literature. Petrella, RJ., Lattanzio, CN.[2022]

A short-term intensive nutritional counseling program significantly improved glycemic control in 75% of patients with type 2 diabetes, compared to only 31.6% in the conventional treatment group, highlighting the efficacy of structured dietary interventions.

Increased fiber intake was associated with better blood glucose control, suggesting that dietary adjustments, particularly in fiber consumption, play a crucial role in managing hyperglycemia in diabetes patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Importance of nutritional counseling and dietary fiber content on glycemic control in type 2 diabetic patients under intensive educational intervention]. Carvalho, FS., Pimazoni Netto, A., Zach, P., et al.[2019]

Counseling is an effective professional approach in healthcare to encourage physical activity, focusing on client-centeredness and cooperative interactions.

The study categorizes counseling into three types based on the depth of engagement: single contact advice, repeated topic discussions, and structured counseling sessions, each requiring different levels of practitioner skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What is counseling all about--basics in the counseling of health-related physical activity. Nupponen, R.[2019]

Dietary counseling in healthcare settings is more effective when delivered through team-based care and supported by electronic tools, enhancing communication between providers and patients.

Techniques like motivational interviewing and shared decision-making are crucial for encouraging behavior change, as they help patients actively participate in their health decisions using established psychological theories.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Providing Nutritional Care in the Office Practice: Teams, Tools, and Techniques. Kushner, RF.[2018]

Behavioral counseling interventions can significantly reduce preventable health issues, but there are critical research gaps that hinder their effective implementation in clinical practice.

The paper highlights specific examples, such as alcohol misuse screening in adolescents and child maltreatment screening, to illustrate these gaps and offers recommendations for researchers and funders to enhance the evidence base for these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding Research Gaps and Priorities for Improving Behavioral Counseling Interventions: Lessons Learned From the U.S. Preventive Services Task Force. Kurth, AE., Miller, TL., Woo, M., et al.[2015]

The risk counseling intervention improved participants' self-efficacy regarding diet and physical activity, with significant increases in confidence levels for making healthier choices.

Participants also reported a heightened awareness of their risks for colon cancer and heart attacks, suggesting that the intervention effectively raised risk perception, even though it did not significantly change behavioral intentions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of integrated risk counseling for cancer and cardiovascular disease in African Americans. Halbert, CH., Bellamy, S., Bowman, M., et al.[2022]

WIC nutritionists who felt confident in their motivational interviewing (MI) skills reported higher self-efficacy in counseling clients from different cultural backgrounds, particularly regarding physical activity and nutrition.

Improving social and physical self-concepts, along with MI skills, could enhance the counseling effectiveness of nutritionists, especially when working with diverse populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing skills are positively associated with nutritionist self-efficacy. Marley, SC., Carbonneau, K., Lockner, D., et al.[2021]

Behavioral activation (BA) combined with nutrition counseling showed significant reductions in depression scores and body weight among 14 obese patients with major depressive disorder over a 12-week period, with 10 participants achieving full remission.

The study suggests that BA may be a promising approach for treating both obesity and depression, highlighting the need for further research through randomized controlled trials to confirm its efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Initial investigation of behavioral activation therapy for co-morbid major depressive disorder and obesity. Pagoto, S., Bodenlos, JS., Schneider, KL., et al.[2011]

In a study involving 2,798 non-diabetic individuals at high risk for type 2 diabetes, only 4% reported depressive symptoms, but those individuals had higher body mass index and waist circumference compared to those without depressive symptoms.

The effectiveness of lifestyle counseling on improving cardio-metabolic risk and glucose homeostasis was similar for both individuals with and without depressive symptoms, suggesting that those with depression can still benefit from lifestyle interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do depressive symptoms have an impact on the effectiveness of lifestyle counseling in prevention of type 2 diabetes? One-year follow-up of FIN-D2D. Rautio, N., Jokelainen, J., Oksa, H., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

LINDA - a solution-focused low-intensity intervention aimed at improving health behaviors of young females: a cluster-randomized controlled trial. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Interdisciplinary physical activity counseling in primary care: a qualitative inquiry of the patient experience. [2010]

4. Canada pubmed.ncbi.nlm.nih.gov

Does counseling help patients get active? Systematic review of the literature. [2022]

5. Brazil pubmed.ncbi.nlm.nih.gov

[Importance of nutritional counseling and dietary fiber content on glycemic control in type 2 diabetic patients under intensive educational intervention]. [2019]

6. Ireland pubmed.ncbi.nlm.nih.gov

What is counseling all about--basics in the counseling of health-related physical activity. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Providing Nutritional Care in the Office Practice: Teams, Tools, and Techniques. [2018]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Understanding Research Gaps and Priorities for Improving Behavioral Counseling Interventions: Lessons Learned From the U.S. Preventive Services Task Force. [2015]

9. United States pubmed.ncbi.nlm.nih.gov

Effects of integrated risk counseling for cancer and cardiovascular disease in African Americans. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Motivational interviewing skills are positively associated with nutritionist self-efficacy. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Initial investigation of behavioral activation therapy for co-morbid major depressive disorder and obesity. [2011]

12. England pubmed.ncbi.nlm.nih.gov

Do depressive symptoms have an impact on the effectiveness of lifestyle counseling in prevention of type 2 diabetes? One-year follow-up of FIN-D2D. [2022]