背景:数字格式有可能增强对有自杀意念的个体的护理可及性。然而,数字自助干预措施面临着局限性,包括减少自杀意念的小效应,低坚持,和安全问题。
目标:因此,我们旨在通过将视频治疗与基于网络的自助模块混合,开发一种远程混合认知行为治疗干预,专门针对自杀意念.本文的目的是描述协作开发过程以及由此产生的干预和治疗原理。
方法:首先,我们从为有自杀意念或行为的人设计的既定治疗手册中编制干预成分,从而开发了11个基于网络的模块草案。第二,我们进行了定性研究,涉及5名持牌心理治疗师和3名专门针对有自杀意念的个人的非专业咨询师,他们审查了这些模块草稿。数据是使用大声思考方法和半结构化访谈收集的,并进行了定性内容分析。感兴趣的4个先验主要类别是对有自杀意念的个体的混合护理,基于Web的模块的内容,模块的可用性,和布局。从面试笔录中归纳地出现了子类别。最后,根据以前的治疗手册和定性发现,我们开发了远程混合治疗计划。
结果:参与者建议治疗师应与患者彻底准备基于网络的疗法,以根据每个人的需求定制疗法。与会者强调,基于网络的模块应以简单的方式解释概念,传达同理心和验证,并包括安全计划的提醒。此外,与会者强调需要一个简单的导航和布局。考虑到这些建议,我们开发了完全远程混合认知行为治疗干预措施,包括12个视频治疗课程和多达31个基于网络的模块.该治疗涉及合作开发个性化治疗计划,以解决个体自杀司机。
结论:这种远程治疗利用了数字格式的高度可访问性,同时结合了与治疗师的完整会话。在随后的试点试验中,我们将寻求有经验的个人和治疗师的意见,以测试治疗的可行性。
BACKGROUND: Digital formats have the potential to enhance accessibility to care for individuals with suicidal ideation. However, digital self-help interventions have faced limitations, including small effect sizes in reducing suicidal ideation, low adherence, and safety concerns.
OBJECTIVE: Therefore, we aimed to develop a remote blended cognitive behavioral therapy intervention that specifically targets suicidal ideation by blending video therapy with web-based self-help modules. The objective of this paper is to describe the collaborative development process and the resulting intervention and treatment rationale.
METHODS: First, we compiled intervention components from established treatment manuals designed for people with suicidal ideation or behavior, resulting in the development of 11 drafts of web-based modules. Second, we conducted a qualitative
study, involving 5 licensed psychotherapists and 3 lay counselors specialized in individuals with suicidal ideation who reviewed these module drafts. Data were collected using the think-aloud method and semistructured interviews, and a qualitative content analysis was performed. The 4 a priori main categories of interest were blended care for individuals with suicidal ideation, contents of web-based modules, usability of modules, and layout. Subcategories emerged inductively from the interview transcripts. Finally, informed by previous treatment manuals and qualitative findings, we developed the remote blended treatment program.
RESULTS: The participants suggested that therapists should thoroughly prepare the web-based therapy with patients to tailor the therapy to each individual\'s needs. Participants emphasized that the web-based modules should explain concepts in a simple manner, convey empathy and validation, and include reminders for the safety plan. In addition, participants highlighted the need for a simple navigation and layout. Taking these recommendations into account, we developed a fully remote blended cognitive behavioral therapy intervention comprising 12 video therapy sessions and up to 31 web-based modules. The treatment involves collaboratively developing a personalized treatment plan to address individual suicidal drivers.
CONCLUSIONS: This remote treatment takes advantage of the high accessibility of digital formats while incorporating full sessions with a therapist. In a subsequent pilot
trial, we will seek input from individuals with lived experience and therapists to test the feasibility of the treatment.