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Randomized Controlled Trial
. 2018 Feb 14;20(2):e15.
doi: 10.2196/jmir.8595.

Effectiveness of a Web-Based Self-Help Program for Suicidal Thinking in an Australian Community Sample: Randomized Controlled Trial

Bregje Aj van Spijker  1 , Aliza Werner-Seidler  2 , Philip J Batterham  1 , Andrew Mackinnon  2 , Alison L Calear  1 , John A Gosling  1 , Julia Reynolds  1 , Ad Jfm Kerkhof  3   4 , Daniela Solomon  2 , Fiona Shand  2 , Helen Christensen  2
Affiliations
Randomized Controlled Trial

Effectiveness of a Web-Based Self-Help Program for Suicidal Thinking in an Australian Community Sample: Randomized Controlled Trial

Bregje Aj van Spijker et al. J Med Internet Res. .

Abstract

Background: Treatment for suicidality can be delivered online, but evidence for its effectiveness is needed.

Objective: The goal of our study was to examine the effectiveness of an online self-help intervention for suicidal thinking compared to an attention-matched control program.

Methods: A 2-arm randomized controlled trial was conducted with assessment at postintervention, 6, and, 12 months. Through media and community advertizing, 418 suicidal adults were recruited to an online portal and were delivered the intervention program (Living with Deadly Thoughts) or a control program (Living Well). The primary outcome was severity of suicidal thinking, assessed using the Columbia Suicide Severity Rating Scale.

Results: Intention-to-treat analyses showed significant reductions in the severity of suicidal thinking at postintervention, 6, and 12 months. However, no overall group differences were found.

Conclusions: Living with Deadly Thoughts was of no greater effectiveness than the control group. Further investigation into the conditions under which this program may be beneficial is now needed. Limitations of this trial include it being underpowered given the effect size ultimately observed, a high attrition rate, and the inability of determining suicide deaths or of verifying self-reported suicide attempts.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12613000410752; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=364016 (Archived by WebCite at http://www.webcitation.org/6vK5FvQXy); Universal Trial Number U1111-1141-6595.

Keywords: psychosocial interventions; randomized controlled trial; suicide.

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Conflict of interest statement

Conflicts of Interest: BAJvS and AJFMK are authors of the Dutch Web-based program described in this manuscript. BAJvS and AJFMK are also authors of and receive royalties from an adapted paper version of the self-help program published under the title Piekeren Over Zelfdoding [38]. BAJvS, AJFMK, and HC are authors of the English translation of the Web-based program described in this manuscript.

Figures

Figure 1
Figure 1
Participant flow diagram.
See this image and copyright information in PMC

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