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The goal of this research plan is to test the effectiveness of a brief, cognitive behavioral (CB) intervention to promote behavioral health treatment engagement among at-risk Veterans who call the Crisis Line but are resistant to behavioral health services.
The goal of this research plan is to test the effectiveness of a brief, cognitive behavioral (CB) intervention to promote behavioral health treatment engagement among at-risk Veterans who call the Crisis Line but are resistant to behavioral health services. This randomized controlled trial will recruit 80 Veterans who report current suicidal ideation at the time of the Crisis Line call and are resistant to seeking behavioral health treatment. Half of the participants will receive the brief, individualized CB intervention and half will receive standardized procedures from VA's Crisis Line (i.e., usual care). The effectiveness of the intervention will be tested on 1) attitudes toward behavioral health treatment rates, and 2) initiation of and adherence to treatment (assessed by the number of sessions attended). The investigators will also assess the impact of the intervention on suicidal ideation (SI) and explore the impact on the most common symptoms observed in Veteran suicide decedents (e.g., depression).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Usual care | No Intervention | No intervention. | |
| CB Intervention | Experimental | Cognitive Behavioral one-on-one single session administered by phone |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CB Intervention | Behavioral | The Cognitive Behavioral (CB) intervention is a brief, manualized, tailored one-on-one single session lasting 45-60 minutes and administered by phone. An individual format was chosen to reduce the potential discomfort of stigma of individual concerns in the presence of others. The intervention targets a change in the beliefs that influence whether or not someone enters mental health or substance use treatment. During the session, participants will be given a brief introduction to CBT and informed that CBT is based on the theory that cognitions (i.e., thoughts/beliefs), feelings and behaviors all interact with each other;101, 102 therefore, thoughts about certain situations or things influence behavior. Since thoughts are modifiable, changing thoughts about situations may change behavior. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Treatment Engagement (Number of Participants Entering Treatment) | The investigators will be asking about service utilization since baseline interview. Zero = no mental health treatment and 1 = received mental health treatment. | 30 days after baseline |
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Inclusion Criteria:
Inclusion criteria for the study are as follows:
Exclusion Criteria:
Exclusion criteria are being judged by the Crisis Line responder to show:
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| Name | Affiliation | Role |
|---|---|---|
| Tracy A. Stecker, PhD | White River Junction VA Medical Center, White River Junction, VT | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Canandaigua VA Medical Center, Canandaigua, NY | Canandaigua | New York | 14424 | United States | ||
| White River Junction VA Medical Center, White River Junction, VT |
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The trial implemented the intervention at the VA's National Crisis Line during a period of dynamic change at the Crisis Line including turnover of top leadership and major changes in procedures and personnel.
Our bottom line recruitment numbers were low.
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| ID | Title | Description |
|---|---|---|
| FG000 | Usual Care | No intervention. |
| FG001 | CB Intervention | Cognitive Behavioral one-on-one single session administered by phone CB Intervention: The Cognitive Behavioral (CB) intervention is a brief, manualized, tailored one-on-one single session lasting 45-60 minutes and administered by phone. An individual format was chosen to reduce the potential discomfort of stigma of individual concerns in the presence of others. The intervention targets a change in the beliefs that influence whether or not someone enters mental health or substance use treatment. During the session, participants will be given a brief introduction to CBT and informed that CBT is based on the theory that cognitions (i.e., thoughts/beliefs), feelings and behaviors all interact with each other;101, 102 therefore, thoughts about certain situations or things influence behavior. Since thoughts are modifiable, changing thoughts about situations may change behavior. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Usual Care | No intervention. |
| BG001 | CB Intervention | Cognitive Behavioral one-on-one single session administered by phone CB Intervention: The Cognitive Behavioral (CB) intervention is a brief, manualized, tailored one-on-one single session lasting 45-60 minutes and administered by phone. An individual format was chosen to reduce the potential discomfort of stigma of individual concerns in the presence of others. The intervention targets a change in the beliefs that influence whether or not someone enters mental health or substance use treatment. During the session, participants will be given a brief introduction to CBT and informed that CBT is based on the theory that cognitions (i.e., thoughts/beliefs), feelings and behaviors all interact with each other;101, 102 therefore, thoughts about certain situations or things influence behavior. Since thoughts are modifiable, changing thoughts about situations may change behavior. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Treatment Engagement (Number of Participants Entering Treatment) | The investigators will be asking about service utilization since baseline interview. Zero = no mental health treatment and 1 = received mental health treatment. | Only 7 of the 10 control participants and 4 of the 9 intervention participants completed follow-up assessments. | Posted | Count of Participants | Participants | 30 days after baseline |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Usual Care | No intervention. | 0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Tracy Stecker, PhD | MUSC | 843.792.7287 | stecker@musc.edu |
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| ID | Term |
|---|---|
| D013405 | Suicide |
| ID | Term |
|---|---|
| D016728 | Self-Injurious Behavior |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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|
| White River Junction |
| Vermont |
| 05009-0001 |
| United States |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| 10 |
| 0 |
| 10 |
| 0 |
| 10 |
| EG001 | CB Intervention | Cognitive Behavioral one-on-one single session administered by phone CB Intervention: The Cognitive Behavioral (CB) intervention is a brief, manualized, tailored one-on-one single session lasting 45-60 minutes and administered by phone. An individual format was chosen to reduce the potential discomfort of stigma of individual concerns in the presence of others. The intervention targets a change in the beliefs that influence whether or not someone enters mental health or substance use treatment. During the session, participants will be given a brief introduction to CBT and informed that CBT is based on the theory that cognitions (i.e., thoughts/beliefs), feelings and behaviors all interact with each other;101, 102 therefore, thoughts about certain situations or things influence behavior. Since thoughts are modifiable, changing thoughts about situations may change behavior. | 0 | 9 | 0 | 9 | 0 | 9 |
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