A Virtual Hope Box: Randomized controlled trial of a smartphone app for emotional regulation and coping with distress

Nigel E. Bush, Derek J. Smolenski, Lauren M. Denneson, Holly B. Williams, Elissa K. Thomas, Steven K. Dobscha

Research output: Contribution to journalArticle

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Abstract

Objective: The purpose of this study was to assess the impact of the Virtual Hope Box (VHB), a smartphone app to improve stress coping skills, suicidal ideation, and perceived reasons for living among patients at elevated risk of suicide and self-harm. Methods: The authors conducted a parallel-group randomized controlled trial with two groups of U.S. service veterans in active mental health treatment who had recently expressed suicidal ideation. Between March 2014 and April 2015, 118 patients were enrolled in the study. Participants were assigned to use the VHB (N=58) or to a control group that received printed materials about coping with suicidality (N=60) to supplement treatment as usual over a 12-week period. Three measures-the Coping Self-Efficacy Scale, Beck Scale for Suicidal Ideation, and Brief Reasons for Living Inventory-were collected at baseline (before randomization) and three, six, and 12 weeks. Secondary measures-the Interpersonal Needs Questionnaire, Perceived Stress Scale, and Columbia-Suicide Severity Rating Scale-were collected at baseline and 12 weeks. Results: VHB users reported significantly greater ability to cope with unpleasant emotions and thoughts (Coping Self-Efficacy Scale) at three (b=2.41, 95% confidence interval [CI]=.29-4.55) and 12 weeks (b=2.99, 95% CI=.08-5.90) compared with the control group. No significant advantage was found on other outcome measures for treatment augmented by the VHB. Conclusions: The VHB is a demonstrably useful accessory to treatment-an easily accessible tool that can increase stress coping skills. Because the app is easily disseminated across a large population, it is likely to have broad, positive utility in behavioral health care.

LanguageEnglish (US)
Pages330-336
Number of pages7
JournalPsychiatric Services
Volume68
Issue number4
DOIs
StatePublished - Apr 1 2017

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Hope
Randomized Controlled Trials
Suicidal Ideation
Psychological Adaptation
Self Efficacy
Suicide
Confidence Intervals
Control Groups
Aptitude
Veterans
Therapeutics
Random Allocation
Mental Health
Emotions
Outcome Assessment (Health Care)
Smartphone
Delivery of Health Care
Equipment and Supplies
Population

ASJC Scopus subject areas

  • Psychiatry and Mental health

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A Virtual Hope Box : Randomized controlled trial of a smartphone app for emotional regulation and coping with distress. / Bush, Nigel E.; Smolenski, Derek J.; Denneson, Lauren M.; Williams, Holly B.; Thomas, Elissa K.; Dobscha, Steven K.

In: Psychiatric Services, Vol. 68, No. 4, 01.04.2017, p. 330-336.

Research output: Contribution to journalArticle

Bush, Nigel E. ; Smolenski, Derek J. ; Denneson, Lauren M. ; Williams, Holly B. ; Thomas, Elissa K. ; Dobscha, Steven K./ A Virtual Hope Box : Randomized controlled trial of a smartphone app for emotional regulation and coping with distress. In: Psychiatric Services. 2017 ; Vol. 68, No. 4. pp. 330-336
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abstract = "Objective: The purpose of this study was to assess the impact of the Virtual Hope Box (VHB), a smartphone app to improve stress coping skills, suicidal ideation, and perceived reasons for living among patients at elevated risk of suicide and self-harm. Methods: The authors conducted a parallel-group randomized controlled trial with two groups of U.S. service veterans in active mental health treatment who had recently expressed suicidal ideation. Between March 2014 and April 2015, 118 patients were enrolled in the study. Participants were assigned to use the VHB (N=58) or to a control group that received printed materials about coping with suicidality (N=60) to supplement treatment as usual over a 12-week period. Three measures-the Coping Self-Efficacy Scale, Beck Scale for Suicidal Ideation, and Brief Reasons for Living Inventory-were collected at baseline (before randomization) and three, six, and 12 weeks. Secondary measures-the Interpersonal Needs Questionnaire, Perceived Stress Scale, and Columbia-Suicide Severity Rating Scale-were collected at baseline and 12 weeks. Results: VHB users reported significantly greater ability to cope with unpleasant emotions and thoughts (Coping Self-Efficacy Scale) at three (b=2.41, 95{\%} confidence interval [CI]=.29-4.55) and 12 weeks (b=2.99, 95{\%} CI=.08-5.90) compared with the control group. No significant advantage was found on other outcome measures for treatment augmented by the VHB. Conclusions: The VHB is a demonstrably useful accessory to treatment-an easily accessible tool that can increase stress coping skills. Because the app is easily disseminated across a large population, it is likely to have broad, positive utility in behavioral health care.",
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