Telehealth-Delivered Brief Cognitive Behavioral Therapy to Prevent Suicides in People with Physical Disabilities

The long-term goal of this research is to develop an adaptation of Brief Cognitive Behavioral Therapy for Suicide Prevention, a psychotherapy with demonstrated efficacy in reducing suicide attempts, to increase access to mental health care and decrease suicides among people with physical disabilities (PWD). The primary objective of the proposed pilot study is to test the processes and preliminary outcomes of administering a video-based, telehealth-administered adaptation of the intervention (called BCBT-PWD) with specialized content for PWD. We will utilize feedback from PWD throughout the intervention to iteratively improve the accessibility, feasibility, and content of BCBT-PWD while simultaneously assessing preliminary effectiveness.

We will administer BCBT-PWD to four groups of 15 PWD in order to: (Aim 1) Assess feasibility, acceptability, and preliminary effectiveness of BCBT-PWD; (Aim 2; Exploratory) Examine if adaptations/modifications are associated with differential treatment response. In line with Aim 1, we anticipate that: (H1) PWD will endorse BCBT-PWD and the accompanying assignments and digital materials as satisfactory through self-report responses to the Client Satisfaction Questionnaire; (H2) BCBT-PWD will demonstrate acceptability among PWD, as indicated by number of sessions attended and degree of homework completion; (H3) PWD will report statistically significant reductions in disability- and suicide-related cognitions and suicide ideation from baseline to follow-up. In line with Aim 2, we anticipate that (H4) each iterative implementation and refinement of BCBT-PWD based on quantitative and qualitative feedback from PWD will be associated with increased rates of treatment completion and larger reductions in disability-related cognitions and suicide ideation.  

We will recruit a national sample of PWD with past-week suicidal ideation or a past-month suicide attempt to enroll in BCBT-PWD. We will test our hypotheses through multiple remote administrations of self-repot surveys (Scale for Suicide Ideation; Suicide Cognitions Scale, Questionnaire on Disability Identity Opportunity; Systems Usability Scale; Client Satisfaction Questionnaire) and interviews (Self-Injurious Thoughts and Behaviors Interview- Revised), and objective data (homework completion and treatment completion rates).

This proposed research is positioned to decrease barriers to mental healthcare access among PWD and will be the first study of any empirically-supported treatment for reducing suicides in PWD. The results of this research will allow inform future effectiveness and efficacy trials of BCBT-PWD.