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

自杀的想法和行为是近50%的精神病患者住院的主要原因。 住院的青少年学校是青少年回归的主要环境之一 住院治疗，使他们成为青少年从自杀想法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危险因素，但到目前为止， 被自杀青少年的治疗干预所忽视。K23职业生涯的主要目标 发展奖是支持申请人成为一个独立的调查员推进自杀 预防干预措施将原本孤立的两个系统-精神病院和学校-连接起来。的 具体的培训目标是量身定制，以支持申请人的发展作为一个干预科学家：（1）建立 在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）发展研究技能，学习创新的设计和方法，用于开发，优化， 和评估自杀青少年的干预措施;（3）获得可修改的学校变量的知识， 情感和认知标记作为青少年自杀念头改变的机制 和行为，并将这些变量的措施纳入干预研究;（4）制定 有能力在伦理方面考虑对高危青少年人群进行研究。的 申请人将通过应用经验实现这些目标;基于导师的监督培训;正式 研究生课程和短期课程;参加研究研讨会、学术讨论会和科学研讨会。 会议.为确保实现这些目标，指导小组包括高层干预 在预防自杀的新方法学方面具有专业知识的研究人员：大卫戈德斯通博士， 桃乐茜·埃斯珀，罗伯特·胡伯，还有大卫·威里克。这项研究的目的是发展和完善一部小说 虚拟现实（VR）辅助住院治疗：学校重返社会的实践经验 （PrESR）方案。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，在经过培训的临床医生的指导下，在现实世界中学习技能。具体 本研究的目的，在多阶段优化策略（MOST）研究设计的指导下，包括：（1）完善 PrESR模型;（2）迭代开发PrESR以增强认知行为治疗（CBT）技能 住院期间的实践;以及（3）进行PrESR的试点优化试验，在住院期间使用CBT技能 住院干预，以证明（A）PrESR增加CBT技能获得的潜力， 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的自杀预防优先事项一致，并调整现有和新的 PrESR旨在优化将学到的技能转化为真实的生活的过程， 为了防止青少年自杀，

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.