scholarly journals Web-Based Eye Movement Desensitization and Reprocessing for Adults With Suicidal Ideation: Protocol for a Randomized Controlled Trial

10.2196/30711 ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. e30711
Author(s):  
Olga Winkler ◽  
Raman Dhaliwal ◽  
Andrew Greenshaw ◽  
Katie O'Shea ◽  
Adam Abba-Aji ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Suicidal Ideation ◽  
Eye Movement ◽  
Controlled Trial ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Web Based ◽  
Randomized Controlled ◽  
Suicidal Thoughts And Behaviors ◽  
The Impact

Background Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results. Objective The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups. Methods In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy. Results The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023. Conclusions The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population. Trial Registration ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047 International Registered Report Identifier (IRRID) DERR1-10.2196/30711

scholarly journals Web-Based Eye Movement Desensitization and Reprocessing for Adults With Suicidal Ideation: Protocol for a Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Olga Winkler ◽  
Raman Dhaliwal ◽  
Andrew Greenshaw ◽  
Katie O'Shea ◽  
Adam Abba-Aji ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Suicidal Ideation ◽  
Eye Movement ◽  
Controlled Trial ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Web Based ◽  
Randomized Controlled ◽  
Suicidal Thoughts And Behaviors ◽  
The Impact

BACKGROUND Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results. OBJECTIVE The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups. METHODS In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy. RESULTS The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023. CONCLUSIONS The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population. CLINICALTRIAL ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30711

scholarly journals Collaborative Assessment and Management of Suicidality (CAMS) compared to Enhanced Treatment as Usual (E-TAU) for suicidal patients in an inpatient setting: Study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Miriam Santel ◽  
Martin Driessen ◽  
Frank Neuner ◽  
Michaela Berg ◽  
Kristina Hennig-Fast ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Therapeutic Relationship ◽  
Controlled Trial ◽  
Psychiatric Clinic ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Randomized Controlled ◽  
Collaborative Assessment ◽  
Suicidal Patients ◽  
Suicidal Thoughts And Behaviors

Abstract Background: The Collaborative Assessment and Management of Suicidality (CAMS) is a therapeutic framework that has been shown to reduce suicidal ideation and overall symptom distress. CAMS has not been previously evaluated in a standard acute inpatient mental health care setting with only short treatment times for suicidal patients. In this randomized controlled trial (RCT) we investigate, if CAMS is more effective than Enhanced-Treatment as Usual (E-TAU) in reducing suicidal thoughts and behaviors. As secondary outcomes we are also investigating depressive symptoms, symptom relief in general, and quality of the therapeutic relationship. Methods/design: The trial is designed as a single-center, two-armed, parallel group observer-blinded randomized clinical effectiveness trial. We aim to recruit and randomize 60 participants with different diagnoses, who are admitted as inpatients due to acute suicidal thoughts or behavior in the Clinic of Psychiatry and Psychotherapy, Ev. Hospital Bethel in Bielefeld, Germany. The duration of treatment will vary depending on patients’ needs and clinical assessments between 10 and a maximum of 40 days. Patients are assessed at 4 time points (admission, discharge, 1 month, and 5 months after discharge). The primary outcome measure is the Beck Scale for Suicide Ideation. Other outcome measures are included, such as severity of psychiatric symptoms, depression, reasons for living, and the therapeutic relationship. Discussion: This effectiveness study is being conducted on an acute ward in a psychiatric clinic where patients have multiple problems and diagnoses. Treatment times are rather short and therapists have a high workload. The results of this study can be generalized to a typical hospital setting and similar results should be expected if CAMS is implemented in other psychiatric systems.

scholarly journals The effectiveness of a web-based decision aid for patients with hip osteoarthritis: study protocol for a randomized controlled trial.

2020 ◽  
Author(s):  
Lilisbeth Perestelo-Perez ◽  
Yolanda Alvarez-Perez ◽  
Amado Rivero-Santana ◽  
Vanesa Ramos-García ◽  
Andrea Duarte-Díaz ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Treatment Options ◽  
Hip Osteoarthritis ◽  
Decision Making Process ◽  
Web Based ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial ◽  
The Impact

Abstract Background: Osteoarthritis (OA) is a health condition sensitive to patient’s preferences and values regarding the benefits and risks of the different treatment options. In this sense, patient decision aids (PtDA) can play an important role in helping patients to incorporate their values, needs and preferences into the decision-making process, thus improving Person-Centred Care. Previous research has focused almost exclusively on knee OA, and therefore the aim of this study is to develop and evaluate the effectiveness of a PtDA for patients with hip OA.Methods: The general design consists of two phases: 1) design a web-based PtDA for patients with hip OA, following the recommended procedures: systematic review of safety/effectiveness of treatments, and an iterative process of development with the help of an Advisory Committee composed of health professionals and patients; 2) To evaluate the impact of the PtDA on hip OA patients’ decision-making process related with their treatment. For that aim, a multicenter randomized controlled trial will be carried out with 124 patients with hip OA in Tenerife (Spain) comparing intervention or usual care.Discussion: PtDAs have been recommended as a useful and effective resource for improving PCC in many health conditions. The intervention is intended to empower patients by fostering their active participation during the decision-making process about their treatment, and by ensuring they make informed decisions congruent with their values and preferences. This study will contribute to the scientific knowledge about effectiveness of PtDAs in hip OA, in order to improve the quality of health care offered to these patients.Trial registration: ClinicalTrials.gob (NCT04241978). Registered on 24 January 2020.

The impact of an empowerment intervention on people with schizophrenia: Results of a randomized controlled trial

2017 ◽  
Vol 63 (3) ◽  
pp. 212-223 ◽  
Author(s):  
Abdalhadi Hasan ◽  
Mahmoud Musleh
Keyword(s):  
Randomized Controlled Trial ◽  
Psychiatric Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Post Intervention ◽  
Treatment As Usual ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
The Impact

Aims: The aim of the study was to assess what empowerment intervention has on people with schizophrenia. Methods: A randomized controlled trial was carried out between November 2015 and May 2016 involving 112 participants who had been diagnosed with schizophrenia. Patients, who were 18 years and above diagnosed with Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V) schizophrenia or schizoaffective disorder from the outpatient mental health clinics in Jordan, were randomly assigned to take part in an intervention that consisted of receiving 6 weeks’ worth of information booklets, with face to face discussions, while receiving their usual medication or allocated treatment as usual. The participants were assessed at baseline, immediately after the intervention and at 3-month follow-up. The primary outcome was a change in the helplessness score. Secondary outcomes were psychiatric symptoms, recovery rate, empowerment and quality of life. Results: This study showed that people with schizophrenia in the intervention group showed more improvement in the helplessness score immediately post-intervention ( F = 74.53, p < .001) and at 3-month follow-up ( F = 75.56, p < .001), they reported significant improvements in all secondary outcomes. Conclusion: This study indicated that the empowering intervention was an effective intervention when integrated with treatment as usual.

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