Abstract：
BACKGROUND: Clinician collaboration can help high-risk individuals to manage their suicidal crises. However, limited research has directly examined how higher patient-clinician collaboration during assessment and intervention can effectively reduce suicidal ideation. This novel randomized clinical trial compared a high vs. low level of patient-clinician collaboration by pairing commonly used assessment (Structured Interview vs. Narrative Assessment) and intervention approaches (Safety Planning Intervention vs. Crisis Response Planning). We hypothesized that the interventions involving higher (than lower) patient-clinician collaboration during assessment (Narrative Assessment) or intervention (Crisis Response Planning) would lead to larger reductions in suicidal ideation.
METHODS: Eighty-two participants with a history of suicide ideation and/or attempts were randomly assigned to one of the four interventions varying in patient-clinician collaboration. After attrition, sixty-six participants completed the study. Suicidal ideation via ecological momentary assessment was measured 14 days before and 14 days after treatment.
RESULTS: Although the severity of suicidal ideation decreased in all groups, the two groups that included highly collaborative assessment had larger pre-post reductions in suicidal ideation (Narrative Assessment+Safety Plan; dwithin = 0.26, and Narrative Assessment+Crisis Response Plan; dwithin = 0.19) than the groups that included a checklist-based assessment (Structured Interview).
CONCLUSIONS: Longer follow-up periods with a larger sample would have provided an understanding of the durability of intervention effects.
CONCLUSIONS: Results suggest that the inclusion of higher patient-clinician collaboration techniques during suicide risk assessment can effectively reduce suicidal thoughts. Thus, clinician-led collaborative risk assessment approaches can enhance the effects of safety planning-type interventions among patients with elevated risk for suicide versus checklist-based assessment approaches.
METHODS: Eighty-two participants with a history of suicide ideation and/or attempts were randomly assigned to one of the four interventions varying in patient-clinician collaboration. After attrition, sixty-six participants completed the study. Suicidal ideation via ecological momentary assessment was measured 14 days before and 14 days after treatment.
RESULTS: Although the severity of suicidal ideation decreased in all groups, the two groups that included highly collaborative assessment had larger pre-post reductions in suicidal ideation (Narrative Assessment+Safety Plan; dwithin = 0.26, and Narrative Assessment+Crisis Response Plan; dwithin = 0.19) than the groups that included a checklist-based assessment (Structured Interview).
CONCLUSIONS: Longer follow-up periods with a larger sample would have provided an understanding of the durability of intervention effects.
CONCLUSIONS: Results suggest that the inclusion of higher patient-clinician collaboration techniques during suicide risk assessment can effectively reduce suicidal thoughts. Thus, clinician-led collaborative risk assessment approaches can enhance the effects of safety planning-type interventions among patients with elevated risk for suicide versus checklist-based assessment approaches.
摘要：
背景：临床医生合作可以帮助高危人群控制自杀危机。然而,有限的研究直接研究了评估和干预期间更高的患者-临床医生合作如何有效减少自杀意念.这项新的随机临床试验比较了一种高与通过配对常用评估，患者与临床医生的合作水平较低(结构化访谈与叙事评估)和干预方法(安全规划干预与危机应对计划)。我们假设，在评估（叙事评估）或干预（危机应对计划）期间，涉及更高（比更低）的患者-临床医生合作的干预措施将导致自杀意念的更大减少。
方法：82名有自杀意念和/或尝试史的参与者被随机分配到患者-临床医生合作不同的四种干预措施之一。减员后，66名参与者完成了研究.在治疗前14天和治疗后14天通过生态瞬时评估测量自杀意念。
结果：尽管所有组的自杀意念的严重程度都有所下降，与包括基于检查表的评估(结构化访谈)的组相比,包括高度协作评估的两组(叙事评估+安全计划;DIN=0.26,和叙事评估+危机应对计划;DIN=0.19)的自杀意念在事后减少幅度更大.
结论：使用更大的样本进行更长的随访时间将有助于了解干预效果的持久性。
结论：结果表明，在自杀风险评估中纳入更高的患者-临床医生合作技术可以有效减少自杀念头。因此，与基于清单的评估方法相比,临床医生主导的协作风险评估方法可以增强安全计划型干预措施在自杀风险升高患者中的效果.
方法：82名有自杀意念和/或尝试史的参与者被随机分配到患者-临床医生合作不同的四种干预措施之一。减员后，66名参与者完成了研究.在治疗前14天和治疗后14天通过生态瞬时评估测量自杀意念。
结果：尽管所有组的自杀意念的严重程度都有所下降，与包括基于检查表的评估(结构化访谈)的组相比,包括高度协作评估的两组(叙事评估+安全计划;DIN=0.26,和叙事评估+危机应对计划;DIN=0.19)的自杀意念在事后减少幅度更大.
结论：使用更大的样本进行更长的随访时间将有助于了解干预效果的持久性。
结论：结果表明，在自杀风险评估中纳入更高的患者-临床医生合作技术可以有效减少自杀念头。因此，与基于清单的评估方法相比,临床医生主导的协作风险评估方法可以增强安全计划型干预措施在自杀风险升高患者中的效果.
