Motivational Interviewing for Suicidal Thoughts
(MI-SI Trial)
Recruiting in Palo Alto (17 mi)
+3 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
Disqualifiers: Psychosis, Mania, Dementia, others
No Placebo Group
Approved in 1 jurisdiction
Trial Summary
What is the purpose of this trial?This trial tests a special type of counseling called MI-SI-R, which helps Veterans who are thinking about suicide find reasons to live. The study involves 470 high-risk Veterans who have had suicidal thoughts or attempts. The goal is to see if this counseling, combined with usual care, reduces suicide attempts and suicidal thoughts more effectively than usual care alone. Motivational interviewing to address suicidal ideation (MI-SI) has been previously tested for its acceptability and effectiveness in reducing suicidal thoughts among hospitalized veterans.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your healthcare provider.
What data supports the effectiveness of the treatment Motivational Interviewing for Suicidal Thoughts?
Research shows that Motivational Interviewing (MI) is effective in helping people change behaviors and has been used successfully in managing suicidal thoughts. Studies indicate that MI can reduce the severity of suicidal thoughts and increase engagement with mental health services, making it a promising approach for addressing suicidality.
12345Is Motivational Interviewing for Suicidal Thoughts safe for humans?
Research on Motivational Interviewing (MI) for addressing suicidal thoughts, including its use with hospitalized veterans and adolescents, suggests it is generally safe. The studies focus on enhancing motivation and self-efficacy (belief in one's ability to succeed) for safety plan use, and no specific safety concerns have been reported in these contexts.
23678How is the treatment Motivational Interviewing to Address Suicidal Ideation- Revised (MI-SI-R) different from other treatments for suicidal thoughts?
Motivational Interviewing to Address Suicidal Ideation- Revised (MI-SI-R) is unique because it focuses on enhancing a person's own motivation to change their behavior by exploring and resolving ambivalence (mixed feelings), which is different from traditional treatments that may not emphasize personal motivation as much. It is a patient-centered counseling style originally developed for issues like alcohol abuse and smoking cessation, now being adapted to help individuals with suicidal thoughts.
123910Eligibility Criteria
This trial is for Veterans over 18 who've recently attempted suicide or have severe suicidal thoughts. They must be English-speaking, able to understand the study, and give informed consent. It's not for those with active mania, current psychosis, dementia, or impaired decision-making capacity.Inclusion Criteria
I am 18 years old or older.
High-risk status confirmed by suicide attempt within a month on the Columbia-Suicide Severity Rating Scale or a score > 5 on the Scale for Suicidal Ideation
Admitted to an inpatient unit, referred by a suicide prevention coordinator, or identified as high-risk via data extraction
+3 more
Exclusion Criteria
Current psychosis
Active mania
Dementia
+2 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive Motivational Interviewing to Address Suicidal Ideation (MI-SI-R) in three sessions delivered in-person, virtually, or by telephone, along with Enhanced Usual Care (EUC) including safety plans, care coordination, and access to a 24-hour crisis hotline
3 sessions
3 visits (in-person, virtual, or telephone)
Follow-up
Participants are monitored for safety and effectiveness after treatment through telephone follow-up assessments
12 months
4 follow-up assessments (telephone) at 1, 3, 6, and 12 months
Participant Groups
The trial tests a revised motivational interviewing technique (MI-SI-R) against enhanced usual care in reducing suicide risk among Veterans. Participants are randomly assigned to one of these two approaches to compare effectiveness.
2Treatment groups
Experimental Treatment
Active Control
Group I: Motivational Interviewing to Address Suicidal Ideation- Revised (MI-SI-R)Experimental Treatment2 Interventions
Motivational Interviewing to Address Suicidal Ideation (MI-SI-R) was developed to help Veterans resolve ambivalence about living by increasing the motivation to live, and is delivered in three sessions in person, virtually, or by telephone.
Group II: Enhanced usual care (EUC)Active Control1 Intervention
Enhanced usual care (EUC) includes safety plans administered or reviewed by research therapists, care coordination, and access to a 24-hour crisis hotline.
Motivational Interviewing to Address Suicidal Ideation- Revised (MI-SI-R) is already approved in United States for the following indications:
🇺🇸 Approved in United States as Motivational Interviewing to Address Suicidal Ideation (MI-SI) for:
- Suicidal ideation in veterans at high risk for suicide
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
VA Portland Health Care System, Portland, ORPortland, OR
Ralph H. Johnson VA Medical Center, Charleston, SCCharleston, SC
VA Finger Lakes Healthcare System, Canandaigua, NYCanandaigua, NY
Canandaigua VA Medical Center, Canandaigua, NYCanandaigua, NY
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Who Is Running the Clinical Trial?
VA Office of Research and DevelopmentLead Sponsor
Syracuse VA Medical CenterCollaborator
Portland VA Medical CenterCollaborator
Ralph H. Johnson VA Medical CenterCollaborator
References
Motivational interviewing in the assessment and management of suicidality. [2022]Motivational Interviewing (MI) can be effectively applied to clinical crises and suicidal patients. A case example of a suicidal patient demonstrates traditional management combined with two evidence-based practices: MI and Collaborative Assessment and Management of Suicidality. The case example illustrates some benefits and limitations of the application of these innovative approaches in a difficult area of clinical practice. A rationale for further clinical use is advanced.
Motivational Interviewing and the Transtheoretical Model of Change: Under-Explored Resources for Suicide Intervention. [2022]Motivational interviewing (MI) is a robust evidence-based intervention that has been used to evoke intrinsic motivation to change behaviors. MI as an intervention focuses on facilitating movement through the stages of the transtheoretical model of change. A study by Coombs et al. (Substance abuse treatment and the stages of change: Selecting and planning interventions, Guilford Press, New York, 2001) demonstrated that suicidal individuals move through such stages toward suicidal behavior, yet research and applications of MI for suicide have been minimal. In hopes of generating increased exploration of MI for suicidality, this article reviews the theoretical rationale and existing empirical research on applications of MI with suicidal individuals. Potential uses of MI in suicide risk assessment/crisis intervention, as well as an adjunct to longer-term treatment, are discussed.
An open trial of motivational interviewing to address suicidal ideation with hospitalized veterans. [2022]The purpose of this open trial was to test the acceptability of motivational interviewing to address suicidal ideation (MI-SI) for psychiatrically hospitalized veterans with suicidal ideation, estimate its pre-post effect size on the severity of suicidal ideation, and examine the rate of treatment engagement after discharge.
The effect of motivational interviewing-based training on the rate of using mental health services and intensity of suicidal ideation in individuals with suicide attempt admitted to the emergency department. [2020]Unless mental health care is provided to suicide attempters after discharge from the emergency department, suicide prevention opportunities may be lost. The purpose of this study was to determine the effect of motivational interviewing (MI)-based training on using mental health services and reducing the severity of suicidal thoughts.
Using Motivational Interviewing to Address Tobacco Cessation: Two Standardized Patient Cases for Pediatric Residents. [2020]Motivational interviewing (MI) is a well-established evidence-based method of working with patients to promote health behavior change. Standardized patient (SP) simulation allows trainees to practice and receive feedback on clinical and communication skills and may be useful in applying MI techniques to address tobacco use and exposure.
Enhancing motivation and self-efficacy for safety plan use: Incorporating motivational interviewing strategies in a brief safety planning intervention for adolescents at risk for suicide. [2023]Suicide is one of the leading causes of death among adolescents in the United States, and risk for recurring suicidal thoughts and behavior remains high after discharge from psychiatric hospitals. Safety planning, a brief intervention wherein the main focus is on identifying personal coping strategies and resources to mitigate suicidal crises, is a recommended best practice approach for intervening with individuals at risk for suicide. However, anecdotal as well as emerging empirical evidence indicate that adolescents at risk for suicide often do not use their safety plan during the high-risk postdischarge period. Thus, to be maximally effective, we argue that safety planning should be augmented with additional strategies for increasing safety plan use to prevent recurrent crises during high-risk transitions. The current article describes an adjunctive intervention for adolescents at elevated suicide risk that enhances safety planning with motivational interviewing (MI) strategies, with the goal of increasing adolescents' motivation and strengthening self-efficacy for safety plan use after discharge. We provide an overview of the intervention and its components, focusing the discussion on the in-person individual and family sessions delivered during hospitalization, and describe the theoretical basis for the MI-enhanced intervention. We then provide examples of applying MI during the process of safety planning, including example strategies that aim to elicit motivation and strengthen self-efficacy for safety plan use. We conclude with clinical case material and highlight how these strategies may be incorporated into the safety planning session. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
The role of therapist MI skill and client change talk class membership predicting dual alcohol and sex risk outcomes. [2020]We investigated the technical model of motivational interviewing (MI) in a dual-outcome intervention (i.e., alcohol, sexual risk; N = 164; 57% female).
An example of implementing a safety protocol in remote intervention and survey research with college students. [2023]This article draws attention to the need for open evaluation and reporting on safety protocols in survey and intervention research. We describe a protocol for responding to those who indicate increased risk of self-harm (i.e. suicidality or potentially lethal alcohol use) as an example and report on the outcome of our procedures.
Motivational interviewing for smoking cessation. [2022]Motivational Interviewing (MI) is a directive patient-centred style of counselling, designed to help people to explore and resolve ambivalence about behaviour change. It was developed as a treatment for alcohol abuse, but may help smokers to a make a successful attempt to quit.
Learning motivational interviewing in a real-life setting: a randomised controlled trial in the Swedish Prison Service. [2022]Motivational interviewing (MI) is a client-centred, directive counselling style for helping people to explore and resolve ambivalence about behaviour change and shown to decrease drug and alcohol use. A five-session semi-structured MI intervention [Beteende, Samtal, Förändring (BSF; Behaviour, Counselling, Change)] was implemented in Swedish prisons.