Practice Experiences for School Reintegration: An Immersive Virtual Reality Program to Enhance Skill Development of Adolescents Hospitalized for Suicidal Thoughts and Behaviors

自杀想法和行为是近50%的人住院治疗的主要原因 住院的青少年。学校是青少年重返校园的主要环境之一 住院，使其成为青少年从自杀念头和行为中恢复的关键背景。 学校压力是自杀和再次住院的重要风险因素，但到目前为止， 被自杀青少年的治疗干预所忽视。这个K23职业生涯的主要目标 发展奖是为了支持申请者成为一名独立的自杀者 预防干预连接了两个原本孤立的系统--精神病院和学校。这个 具体的培训目标是为了支持申请者作为干预科学家的发展：(1)建立 智能使用技术和教学设计方面的专业知识，以加强对高风险的干预 青少年；(2)培养研究技能，学习创新设计和方法，以开发、优化、 和评估对自杀青少年的干预措施；(3)了解可更改的学校变量和 情感和认知标记物作为青少年自杀念头变化机制的研究 和行为，并将这些变量的测量纳入干预研究；以及(4)发展 在高危青少年人群中进行研究的伦理考虑能力。这个 申请者将通过应用经验实现这些目标；基于导师的监督培训；正式 研究生水平的课程和短期课程；参加研究研讨会、学术讨论会和科学研究 开会。为了确保实现这些目标，指导团队包括高层干预。 在适用于自杀预防的新方法方面拥有专业知识的研究人员：David Goldston博士， 多萝西·埃斯佩拉奇、罗伯特·胡巴尔和大卫·怀里克。这项拟议的研究旨在开发和完善一部小说 虚拟现实(VR)在住院治疗中的补充：学校重组的实践体会 (PrESR)计划。PrESR将为住院青少年提供身临其境的学校体验 在医院范围内，在训练有素的临床医生的指导下，在现实世界中的设置中的技能。具体的 在多阶段优化策略(MOST)研究设计的指导下，该研究的目标包括：(1)改进 PrESR模型；(2)迭代开发PrESR以提高认知行为疗法(CBT)技能 住院期间练习；以及(3)利用住院期间使用的CBT技能对PrESR进行试点优化试验 住院干预以证明(A)PrESR在增加CBT技能获得和 利用和(B)培训临床医生、招募参与者和管理实验的可行性 条件。与NIMH预防自杀以及定制现有和新的优先事项保持一致 干预措施以优化结果，PrESR旨在优化将所学技能转化为现实生活 环境，以防止青少年自杀。

Suicidal thoughts and behaviors are a primary reason for psychiatric hospitalization for nearly 50% of hospitalized adolescents. Schools are one of the primary environments adolescents return to following hospitalization, making them a critical context for adolescent recovery from suicidal thoughts and behaviors. School stressors serve as important risk factors for both suicide and re-hospitalization, but, until now, have been overlooked by treatment interventions for suicidal adolescents. The primary goal of this K23 Career Development Award is to support the applicant to become an independent investigator advancing suicide prevention interventions that bridge two systems otherwise isolated – psychiatric settings and schools. The specific training goals are tailored to support the applicant’s development as an intervention scientist: (1) build expertise in intelligent use of technology and instructional design to enhance interventions for high risk adolescents; (2) develop research skills to learn innovative designs and approaches for developing, optimizing, and evaluating interventions for suicidal adolescents; (3) gain knowledge of modifiable school variables and the affective and cognitive markers serving as mechanisms of change in adolescents with suicidal thoughts and behaviors and incorporate measures of these variables in intervention research; and (4) develop competency in ethical considerations for conducting research with high risk adolescent populations. The applicant will achieve these goals through applied experiences; mentor-based supervised training; formal graduate level coursework and short courses; and participation in research seminars, colloquia and scientific meetings. To ensure the attainment of these goals, the mentorship team includes senior level intervention researchers with expertise in novel methodologies applicable to suicide prevention: Drs. David Goldston, Dorothy Espelage, Robert Hubal, and David Wyrick. The proposed study aims to develop and refine a novel Virtual Reality (VR) supplement for inpatient treatment: the Practice Experiences for School Reintegration (PrESR) program. The PrESR will provide immersive school experiences for inpatient adolescents to practice skills in real-world settings with the guidance of a trained clinician within the confines of a hospital. The specific aims of the study, guided by a multiphasic optimization strategy (MOST) research design, include: (1) refine the PrESR model; (2) iteratively develop the PrESR to enhance cognitive behavioral therapy (CBT) skill practice during hospital stay; and (3) conduct a pilot optimization trial of the PrESR with CBT skills used during inpatient interventions to demonstrate (A) the potential of the PrESR to increase CBT skill acquisition and utilization and (B) the feasibility of training clinicians, recruiting participants, and managing experimental conditions. Consistent with NIMH’s priorities for suicide prevention, and for tailoring existing and new interventions to optimize outcomes, the PrESR aims to optimize the translation of learned skills into real life environments in order to prevent youth suicide.