Written Exposure Therapy for Suicide Prevention (WET-S): A Randomized Clinical Trial
Abstract
Objectives and Rationale for the Proposed Study: The primary objective of this study is to evaluate the efficacy of a novel, brief, scalable, cognitive behavioral therapy, Written Exposure Therapy for Suicide Prevention (WET-S), in reducing the incidence and severity of self-injurious thoughts and behaviors (SITBs) in active-duty military Service Members, Veterans, and adult military beneficiaries following a psychiatric hospitalization due to suicidal ideation, suicide plans, or a suicide attempt. Fiscal Year 2021 Traumatic Brain Injury and Psychological Health Research Program Clinical Trial Award Focus Area to Be Addressed by the Proposed Project: WET-S strategically aligns Focus Areas of Treat and Prevent in its focus not only on reducing (i.e., treating) the severity of suicidal ideation among individuals hospitalized for suicide-related concerns, but also preventing the incidence of suicidal behavior and rehospitalization for suicide-related concerns in the post-discharge period. Problem or Question to Be Addressed: Military Service Members admitted to inpatient psychiatry for SITBs represent an at-risk group for continued SITBs and rehospitalizations in the post-discharge period. Recognizing the elevated risk of suicide among Service Members with a recent psychiatric hospitalization, the U.S. Department of Defense Strategy for Suicide Prevention highlights the importance of developing, testing, and implementing evidence-based protocols to decrease suicide risk in the post-hospitalization period. Echoing this strategy, a greater focus on mitigating risk during the transition from crisis care (e.g., inpatient psychiatry) into follow-up settings (e.g., outpatient psychiatry) is among the key operational priorities outlined in The White House’s 2021 interagency national strategy for preventing military Service Members and Veterans. Yet, there is an absence of evidence-based interventions designed to be delivered on inpatient psychiatric units to reduce the risk of post-discharge self-injurious thoughts and behaviors. To address this gap, our group developed WET-S, which is based on the written disclosure paradigm. Applicability and Impact of the Research: Numerous research studies indicate that written disclosure, in which an individual writes about a personally stressful experience and the related thoughts and feelings, yields improvements across physical and psychiatric domains. However, no study has adapted the written exposure paradigm specifically to target the amelioration of distress associated with suicidal crises and examined whether doing so reduces the risk of subsequent SITBs and suicide-related hospitalizations. Pilot data from our research group indicate that WET-S is well-positioned to fill this need. How the Research Will Improve the Understanding, Prevention, and/or Treatment of TBI and/or Psychological Health Conditions: A recent systematic review and meta-analysis found that no current psychosocial interventions delivered on inpatient psychiatric units reduce the risk of SITBs in the post-discharge period. Thus, WET-S has the potential to have a considerable impact on the treatment and prevention of suicidal thoughts and behaviors among military personnel. Potential Clinical Applications, Benefits, and Risks of the Study: Because the risk of SITBs following discharge from inpatient psychiatry is markedly elevated, it is imperative that military healthcare providers who work on inpatient psychiatry units are equipped with scalable, evidence-based interventions that demonstrably reduce the risk of SITBs in the post-discharge period. Moreover, although WET-S must be delivered by a clinician, it is easy to train and thus offers a relatively low-cost yet high-yield therapeutic approach for military healthcare settings. How the Proposed Project Will Benefit Service Members, Veterans, and/or Military Beneficiaries: If WETS demonstrates success in reducing suicidal ideation severity and p
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2211059
Entities
People
- Brian P Marx
Organizations
- Boston University Medical Campus
- United States Army