Impact of clinician Virtual Human Interaction training in Emotional Self-Awareness on patients Suicidal Ideation and Suicide Crisis Syndrome: a Randomized Controlled Trial

临床医生虚拟人际互动训练对情绪自我意识对患者自杀意念和自杀危机综合症的影响：随机对照试验

• 批准号: 9906915
• 负责人: Igor Galynker
• 金额: $ 34.48万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-04 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9906915
• 关键词: Acute; Affect; Attention; Barbering; Caring; Cause of Death; Clinical Skills; Code; Communication; Control Groups; Coupled; Data; Dimensions; Double-blind trial; Educational Intervention; Educational process of instructing; Emotional; Emotions; Empathy; Equipment and supply inventories; Feedback; Feeling suicidal; Fostering; Goals; Human; Industry Standard; Intervention; Learning; Life; Mediating; Mediator of activation protein; Occupations; Online Systems; Outcome; Outpatients; Participant; Patient Education; Patients; Process; Questionnaires; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Risk Assessment; Role; Savings; Self Perception; Severities; Suicide; Suicide prevention; Syndrome; Testing; Therapeutic; Training; United States; Work; base; clinical encounter; evidence base; experimental group; follow-up; high risk; human old age (65+); improved; indexing; instrument; interactive multimedia; novel; programs; prospective; reducing suicide; response; skills; social; suicidal; suicidal behavior; suicidal patient; suicidal risk; suicide rate; virtual human

Project Summary/Abstract Despite years of research and intensified public attention, suicide rates continue to climb and suicide remains a leading cause of death for 18-65 year-olds in the United States. Half of suicide decedents see a clinician in the months prior to dying by suicide providing a unique opportunity for a potentially life-saving intervention. Working with suicidal patients is highly stressful for clinicians and often elicits powerful negative emotional responses that may adversely affect suicidal outcomes. Possible reasons lie in that negative emotional responses may result in less empathic communication and unwitting rejection of the patient, which are liable to damage the therapeutic alliance. Thus there is a need for clinician training in effective management of their negative emotions towards suicidal patients, which would result in the improvement of suicidal outcomes. To be impactful, the training must be web-based, scalable and easy to disseminate. In this project, we will adress this critical need and use Vitrual Human Interaction (VHI) to train outpatient clinicians in emotional self-awarenss (ESA), which includes both recognition of one's own negative emotional respones and ability to engage in verbal empathic communication with acutely suicidal patients. Further, we will establish if the VHI ESA training intervention for clinicians will be superior to the VHI Control condition of risk assessment in reducing their patients' suicidal ideation and the severity of their Suicide Crisis Syndrome. We will also determine if therapeutic alliance is a mediator of the relationship between clinicians' ESA and their patients' suicidal outcomes. For this purpose, we will use our established empathy- teaching platform and we will assess verbal empathy with the Empathic Communication Coding System, and will assess the impact of clinician training with our novel validated instruments: the Therapist Response Questionnaire – Suicide Form which assesses negative emotional responses to suicidal patients, and the Suicide Crisis Inventory, which predicts near-term suicidal behavior. If we are sucessful, the proposed work may have a broad impact on clinician training and practice by adding an ESA dimension to clinicians' training in evidence-based suicide risk assessment. Suicide is preventable and it is our goal to create an industry-standard platform to train clinicians in ESA, thereby improving their skills and confidence in interacting with suicidal patients, which can ultimately save lives.

项目总结/摘要 尽管经过多年的研究和公众的关注，自杀率仍在继续攀升， 自杀仍然是美国18-65岁人群的主要死因。半年 自杀死者在自杀前几个月看过临床医生， 这是一个潜在的拯救生命的干预机会。与自杀患者一起工作 给临床医生带来压力，并且经常引发强烈的负面情绪反应， 对自杀的结果有负面影响。可能的原因在于消极的情绪反应 可能导致较少的移情沟通和患者的无意拒绝，这是 可能会破坏治疗联盟因此，需要对临床医生进行有效的培训， 管理他们对自杀病人的负面情绪，这将导致 改善自杀结果。为了产生影响力，培训必须基于网络，可扩展 易于传播。 在这个项目中，我们将解决这一关键需求，并使用虚拟人机交互（VHI）来训练 门诊临床医生在情绪自我意识（ESA），其中包括识别一个人的 自己的负面情绪反应和能力，从事口头移情沟通， 有强烈自杀倾向的病人此外，我们将确定VHI ESA培训干预是否适用于 临床医生将上级VHI控制条件的风险评估，以减少他们的 患者的自杀意念和自杀危机综合征的严重程度。我们还将 确定治疗联盟是否是临床医生ESA和 病人自杀的后果为了这个目的，我们将用我们建立的同理心- 教学平台，我们将评估言语移情与移情沟通编码 系统，并将评估临床医生培训的影响与我们的新型验证仪器： 治疗师反应问卷-评估负面情绪的自杀表 对自杀患者的反应，以及自杀危机清单， 自杀行为如果我们成功的话，所提出的工作可能会对临床医生产生广泛的影响 通过在临床医生循证医学培训中增加ESA维度， 自杀风险评估自杀是可以预防的，我们的目标是建立一个行业标准， 平台，以培训临床医生在欧空局，从而提高他们的技能和信心，在互动 有自杀倾向的病人，这最终可以挽救生命。