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。一半的人 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 一个可能挽救生命的干预的机会。与有自杀倾向的病人一起工作是非常重要的 给临床医生带来压力，并经常引发强烈的负面情绪反应，可能 会对自杀结果产生负面影响。可能的原因在于消极的情绪反应 可能会导致较少的同理心交流和对患者的无意拒绝，这是 可能会损害治疗联盟。因此，有必要对临床医生进行有效的培训 管理他们对自杀患者的负面情绪，这将导致 自杀结局的改善。要想产生影响，培训必须是基于网络的、可扩展的 而且很容易传播。 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 临床医生将优于风险评估的VHI控制条件，以减少他们的 患者自杀意念与自杀危机综合征严重程度的关系我们还将 确定治疗联盟是否是临床医生ESA和ESA之间关系的中介 他们的病人的自杀结果。为此，我们将利用我们既定的同理心- 教学平台，我们将使用移情交际编码来评估言语移情 系统，并将使用我们的新验证工具评估临床医生培训的影响： 治疗师反应问卷--评估负面情绪的自杀问卷 对自杀患者的反应，以及预测近期自杀危机的清单 自杀行为。如果我们成功了，拟议的工作可能会对临床医生产生广泛的影响 在循证临床医师培训中增加ESA维度的培训与实践 自杀风险评估。自杀是可以预防的，我们的目标是创建一个行业标准 为临床医生提供ESA培训平台，从而提高他们在互动中的技能和信心 有自杀倾向的病人，这最终可以拯救生命。

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.