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

项目摘要/摘要 尽管经过多年的研究和公众的密切关注，自杀率仍在继续攀升， 自杀仍然是美国18-65岁人群的主要死亡原因。一半的自杀 死者在自杀前几个月去看临床医生提供了一个独特的机会 可能拯救生命的干预措施。与有自杀倾向的患者一起工作压力很大 并经常引起强烈的负面情绪反应，这可能会对 自杀的结果。可能的原因在于，消极的情绪反应可能会导致 同理心交流和对病人的无意拒绝，这些都容易损害 治疗联盟。因此，有必要对临床医生进行有效管理他们的培训 对自杀患者的负面情绪，这将导致自杀倾向的改善 结果。为了产生影响，培训必须是基于网络的、可扩展的和易于传播的。 在这个项目中，我们将解决这一关键需求，并使用虚拟人类交互(VHI)进行培训 门诊医生的情绪自我认知(ESA)，其中包括对一个人的 自己的消极情绪反应和与他人进行言语交流的能力 有自杀倾向的病人。此外，我们将确定VHI ESA培训干预是否 临床医生将优于VHI控制条件的风险评估，以减少他们的患者 自杀意念与其自杀危机综合症的严重程度。我们还将确定是否 治疗联盟是临床医师ESA与患者ESA关系的中介 自杀的结果。为此，我们将利用我们建立的移情教学平台和 我们将使用共情交流编码系统评估言语共鸣，并将评估 使用我们的新型验证工具对临床医生培训的影响：治疗师的反应 自杀问卷--评估自杀患者的负面情绪反应的自杀表 还有自杀危机清单，它预测了近期的自杀行为。如果我们成功了， 拟议的工作可能会通过增加ESA对临床医生的培训和实践产生广泛的影响 临床医生在循证自杀风险评估方面的培训。自杀就是 是可预防的，我们的目标是创建一个行业标准的平台来培训ESA临床医生， 从而提高他们与自杀患者互动的技能和信心，这可以 最终拯救生命。

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.