Treating Suicidality Remotely: a randomized controlled trial of brief cognitive behavioral therapy for suicide prevention via chat or phone

Suicide is a major societal problem, but there are almost no interventions that
have been shown to prevent suicide attempts. Most interventions studied to date
have at most a modest effect on suicidal thoughts, not suicidal behavior. This
is especially true for online interventions: not a single online intervention
has proven to prevent suicide attempts, while online interventions could make
an important contribution to suicide prevention due to their reach and
accessibility. 113 Suicide Prevention therefore offers free and anonymous
cognitive behavioral therapy for suicide prevention (CBT-SP) via chat and
phone, a short-term intervention that has shown offline (not online) to
significantly reduce suicide attempts.

Therefore, the main purpose of this study is to investigate whether this online
intervention can indeed help prevent suicide attempts. In addition, we want to
examine whether the intervention affects thoughts of suicide, quality of life
and broader psychological problems. Finally, we want to examine more thoroughly
than before whether or not the intervention has adverse effects, and
qualitatively and quantitatively explore on what people think of the
intervention.

This is a randomized controlled trial in which participants are randomly
assigned to either online CBT-SP or 113's online selfhelp
course. For the occasion, people in the control group receive feedback on the
lessons they complete during the self-help
course not by mail, but in a conversation with a therapist. This means they are
offered the same number of sessions as
participants in the experimental condition, with the difference that half of
these sessions are completed without the presence of a
therapist.

Brief cognitive behavioral therapy for suicide prevention, consisting of 12
sessions with a therapist via chat or phone.
113 Suicide Prevention's online self-help course, consisting of 6 lessons each
reviewed with a therapist via chat or phone.

compared to the regular treatment at 113, the extra burden consists of
participating in 3 assessments of about 45 to 60 minutes, in which several
interviews and questionnaires are administered. Furthermore, contrary to the
usual practice at 113, people cannot participate in the study anonymously.
There are other risks, such as the risk that the intervention is not effective,
but people would also be exposed to these risks if they would engage in the
interventions outside the study.