Background Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results. Objective The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups. Methods In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy. Results The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023. Conclusions The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population. Trial Registration ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047 International Registered Report Identifier (IRRID) DERR1-10.2196/30711

No abstract

No abstract

BACKGROUND Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results. OBJECTIVE The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups. METHODS In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy. RESULTS The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023. CONCLUSIONS The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population. CLINICALTRIAL ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30711

BACKGROUND The COVID-19 pandemic has resulted in rapid changes to healthcare delivery, including a shift away from in-person to virtually delivered psychotherapy. While these changes ensured timely psychotherapy provision, many concerns exist, including, but not limited to legal, clinical, cultural, practical, and privacy and/or security issues. OBJECTIVE This scoping review systematically mapped existing peer-reviewed research on synchronous, therapist-delivered virtual psychotherapy for individuals with a diagnosed mental illness. Data were analyzed through the lens of the Alberta Quality Matrix of Health (HQM). METHODS Relevant studies were identified using seven online databases. The search process was documented and reported in adherence to PRISMA for Searching (PRISMA-S) extension. Two reviewers independently charted the data for each publication considered. Results were described according to the six HQM dimensions: acceptability, accessibility, appropriateness, effectiveness, efficiency, and safety. RESULTS From 13 209 publications, 48 studies were included. Many studies measured treatment effectiveness (n=48, 100%) and acceptability (n=29, 60.4%), reporting that virtual delivery of psychotherapy was comparable to in-person delivery. Safety (n=5, 10.4%) was measured in fewer studies, while treatment accessibility, appropriateness, and efficiency were not measured in any of the included studies and only mentioned in certain studies as a future direction, hypothesis, or potential outcome. CONCLUSIONS Although treatment acceptability and effectiveness are the main aspects of healthcare quality investigated, there is a lack of research surrounding treatment accessibility, appropriateness, efficiency, and safety. Future research should address these dimensions of quality to ensure that quality care is provided to those receiving virtual psychotherapies. CLINICALTRIAL No trial registration was required for this scoping review.