Can Outcomes of a Chat-Based Suicide Prevention Helpline Be Improved by Training Counselors in Motivational Interviewing? A Non-randomized Controlled Trial.

Objective: To examine whether the outcomes of a chat-based suicide-prevention helpline could be improved by training counselors in motivational interviewing (MI). Methods: In a pre- and post-test design, visitors of a chat-based suicide prevention helpline received either the Five-Phase Model (treatment as usual [TAU]) or MI. They completed a pre- and post-chat questionnaire on several suicide-related risk factors. Linear mixed modeling was used to estimate the effect of the condition. Furthermore, the treatment proficiency of newly trained counselors was assessed using MI-Scope. Results: A total of 756 visitors and 55 counselors were included in this study. The visitors showed an improvement in suicidal ideation and psychological risk factors after a chat conversation. However, there were no significant differences between the MI and TAU conditions (ß = 0.03, 95% CI [-0.23-0.30], p = 0.80). The treatment integrity indices showed that the counselors mostly used MI-consistent techniques but were unable to strategically employ these techniques to evoke enough change talk. Conclusions: MI and TAU led to comparable outcomes in a chat-based suicide prevention helpline. The effectiveness of MI might improve by intensifying or improving the training of counselors, keeping the process of engaging more concise or offering visitors multiple sessions of MI.

Eye movements reduce vividness and emotionality of "flashforwards".

Earlier studies have shown that eye movements during retrieval of disturbing images about past events reduce their vividness and emotionality, which may be due to both tasks competing for working memory resources. This study examined whether eye movements reduce vividness and emotionality of visual distressing images about feared future events: "flashforwards". A non-clinical sample was asked to select two images of feared future events, which were self-rated for vividness and emotionality. These images were retrieved while making eye movements or without a concurrent secondary task, and then vividness and emotionality were rated again. Relative to the no-dual task condition, eye movements while thinking of future-oriented images resulted in decreased ratings of image vividness and emotional intensity. Apparently, eye movements reduce vividness and emotionality of visual images about past and future feared events. This is in line with a working memory account of the beneficial effects of eye movements, which predicts that any task that taxes working memory during retrieval of disturbing mental images will be beneficial.