Collaboration matters: A randomized controlled trial of patient-clinician collaboration in suicide risk assessment and intervention.

BACKGROUND: Clinician collaboration can help high-risk individuals to manage their suicidal crises. However, limited research has directly examined how higher patient-clinician collaboration during assessment and intervention can effectively reduce suicidal ideation. This novel randomized clinical trial compared a high vs. low level of patient-clinician collaboration by pairing commonly used assessment (Structured Interview vs. Narrative Assessment) and intervention approaches (Safety Planning Intervention vs. Crisis Response Planning). We hypothesized that the interventions involving higher (than lower) patient-clinician collaboration during assessment (Narrative Assessment) or intervention (Crisis Response Planning) would lead to larger reductions in suicidal ideation. METHODS: Eighty-two participants with a history of suicide ideation and/or attempts were randomly assigned to one of the four interventions varying in patient-clinician collaboration. After attrition, sixty-six participants completed the study. Suicidal ideation via ecological momentary assessment was measured 14 days before and 14 days after treatment. RESULTS: Although the severity of suicidal ideation decreased in all groups, the two groups that included highly collaborative assessment had larger pre-post reductions in suicidal ideation (Narrative Assessment+Safety Plan; dwithin = 0.26, and Narrative Assessment+Crisis Response Plan; dwithin = 0.19) than the groups that included a checklist-based assessment (Structured Interview). LIMITATIONS: Longer follow-up periods with a larger sample would have provided an understanding of the durability of intervention effects. CONCLUSION: Results suggest that the inclusion of higher patient-clinician collaboration techniques during suicide risk assessment can effectively reduce suicidal thoughts. Thus, clinician-led collaborative risk assessment approaches can enhance the effects of safety planning-type interventions among patients with elevated risk for suicide versus checklist-based assessment approaches.

A day in the life of a college student during the COVID-19 pandemic: An experience sampling approach to emotion regulation.

COVID-19 has contributed to unexpected stressors in daily life, and emotion regulation is an important area of research during and post-pandemic to gain knowledge of the effect of the pandemic on emotion regulatory processes. We adopted an ecologically valid approach to collect 10 experience sampling events within the same day to examine how college students regulated their emotions on a typical weekday during the pandemic and the simultaneous hedonic association of these strategies on their affective experience. Several emotion regulation strategies (including acceptance, calming, reappraisal, problem solving, and social sharing) were associated with increased positivity or reduced negativity that may be better for psychological health. In contrast, other emotion regulation strategies (including rumination, experiential avoidance, catastrophizing, lack of clarity, self-blaming, and other-blaming) were associated with increased negativity or reduced positivity that may worsen psychological health. In these findings, self-reported stress was a crucial contextual moderator to consider while understanding the relationship between emotion regulation strategies and experienced affect. The current study documents variability in affect in response to stressors experienced by college students even within a single day and provides a real-world perspective on the emotion regulation strategies that were adaptive and maladaptive in the context of the COVID-19 pandemic.