Exploring the Feasibility and Acceptability of an Autobiographical Memory-Based Intervention for People With Suicidality: A Case Series
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Suicidal Ideation
- Sponsor
- Lancaster University
- Enrollment
- 3
- Locations
- 1
- Primary Endpoint
- Acceptability - Qualitative Feedback
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The study involves a short therapy intervention for people who are experiencing thoughts of suicide. The intervention will focus upon different memories from the person's life. These memories will vary in the emotions they evoke - some memories will be associated with neutral emotions, whereas others will bring up positive emotions. The intervention will have a particular focus upon memories of times when the participants have moved away from thinking about suicide, with the aim of reinforcing memories of what helped them to reconnect with life. The intervention will also introduce relaxation techniques, in addition to involving a safety planning component. The project aims to consider whether this intervention is acceptable and feasible for this population.
Detailed Description
This study is looking at whether an autobiographical memory-based intervention is acceptable and suitable for people with thoughts of suicide within a secondary mental health population. Autobiographical memory involves the recollection of past events in a person's own life, and this has been linked to a person's sense of identity, goals, and orientation in the present. Memories linked to negative emotions have been shown to be durable, accessible, and easily and vividly remembered. The power that memories of suicidal ideation and suicide attempts hold is therefore concerning. This intervention aims to support participants to more readily access positive and neutral autobiographical memories, using memory tasks and worksheets. By focusing upon individuals' moves away from suicidal thinking, it also aims to shift the focus onto remembering what led people to reconnect with life. The study is an experimental case series using a non-concurrent A-B multiple baseline design, in which the participants first attend 3-5 baseline sessions prior to attending 6 intervention sessions. Sessions are one-to-one. The initial baseline session and all intervention sessions will take place face-to-face. The follow-up baseline sessions can be conducted in-person, online via Microsoft Teams, or via telephone, depending on participant preference. The initial baseline session will involve assessing risk and updating participants' safety plan. The intervention involves 6 sessions of approximately one hour. The first session will focus upon familiarisation to concepts in the intervention, using imagery-based metaphors to support understanding. Sessions 2-4 will focus on different memories - neutral, positive, and memories of moves away from suicidal thinking. Memory tasks will broadly follow the 5 stages outlined in the broad-minded affective coping (BMAC) procedure, but with a focus on these specific memories. In the final 2 sessions, participants will have a choice around which memory to focus on. The final session will also involve post-intervention planning. Outcome measures will be completed in all baseline and intervention sessions. The study aims to recruit 5-7 participants from community mental health teams (CMHTs) in which supervisory support can be arranged. The intervention will be conducted by the principle investigator (AP), a trainee psychologist, under the supervision of clinical psychologists within the CMHTs (JK and NI) who are also members of the research team.
Investigators
Alexandra Powell
Trainee Clinical Psychologist
Lancaster University
Eligibility Criteria
Inclusion Criteria
- •Individual has experienced suicidal ideation and/or suicidal behaviours within the previous 3 months. This will be screened for by asking the questions:
- •Have you had thoughts or images of ending your life within the past three months? or
- •Have you attempted to end your life within the past 3 months?
- •Currently under a Community Mental Health Team (CMHT) within which supervisory support can be arranged.
Exclusion Criteria
- •Moderate/severe learning disability
- •Organic cerebral disease/injury which significantly affects language comprehension or expression
- •Non-English speaking
- •Acute psychosis which would affect engagement
- •Receiving psychological treatment or participating in another research intervention
- •At imminent risk of acting upon thoughts of suicide or of harm to others. This will be screened for by assessing for the presence of active intent or plans to harm themselves or others within the next month. If these individuals consent to be contacted again after a month, the researcher will consider approaching them again to assess for changes to imminent risk. If the individual met the eligibility criteria at this point, the individual would be invited to take part in the study.
- •A history of violence or harm to others to a degree in which clinicians have assessed one-to-one sessions to be unsafe
- •Currently within an inpatient setting or open to a home-based treatment team.
Outcomes
Primary Outcomes
Acceptability - Qualitative Feedback
Time Frame: Up to 14 weeks
Qualitative feedback around the acceptability of the intervention - collected at the end of the Adverse Effects in Psychotherapy Scale with the question 'If you would like to describe your experience of taking part in the study in your own words, please use the following space'.
Feasibility - rates of recruitment, attendance, and completion
Time Frame: Up to 14 weeks
To assess whether the intervention is feasible within this population, the investigators will consider the proportion of participants approached who met the eligibility criteria, and proportion of these who consent to taking part in the study. The investigators will also collect data on attendance rates, where reasonable attendance will be set as ≥ 3 sessions out of the 6-session intervention, in accordance with the criteria set out in a similar case series study. Therapy completion rates will also be recorded, where the investigators will look at the number of participants who completed the final set of therapy measures.
Acceptability - Therapeutic Alliance
Time Frame: Up to 14 weeks
This is to consider the therapeutic relationship between the practitioner and participant. Measured using the Working Alliance Inventory - Short Revised, scored out of 60 where a high score indicates strong alliance.
Acceptability - Adverse effects
Time Frame: Up to 14 weeks
This is to assess for any negative outcomes of the intervention. Measured using the Adverse Effects in Psychotherapy questionnaire, with statements scored on a 5 point scale from 'not at all' to 'very much'
Acceptability - Clinical Global Impression
Time Frame: Up to 14 weeks
This is a measure of the practitioner's overall clinical impression of the participant during the session. This is measured using the Clinical Global Impressions Scale, where severity is scored on a scale of 1-7 (where 7 indicates a negative impression/change).
Acceptability - Overall
Time Frame: Up to 14 weeks
The overall acceptability of the intervention will be measured using an adapted Acceptability Scale. This includes measures of multiple key areas which are important for an intervention to be classified as acceptable by a participant. Statements are assessed on a 5 point scale from 'strongly disagree' to 'strongly agree'.
Secondary Outcomes
- Suicidality(Up to 14 weeks)
- Entrapment(Up to 14 weeks)
- Perceived Burdensomeness / Thwarted Belonging(Up to 14 weeks)