MIRECC / CoE
16: Self Directed Technologies
Risk Management and Treatment » Technology-based Modalities
There is insufficient evidence to recommend for or against technology-based behavioral health treatment modalities for individuals with suicidal ideation. These include self-directed digital delivery of treatment protocols with minimal or no provider interaction (e.g., compact disc, web-based), and provider-delivered virtual treatment.
Neither for nor against
Grades and Definitions
- Strong for
- or "We recommend offering this option …"
- Weak for
- or "We suggest offering this option …"
- No recommendation
- or "There is insufficient evidence …"
- Weak against
- or "We suggest not offering this option …"
- Strong against
- or "We recommend against offering this option …"
Categories and Definitions
|Evidence Reviewed*||Recommendation Category*||Definition*|
|Reviewed||New-added||New recommendation following review of the evidence|
|New-replaced||Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence|
|Not changed||Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed|
|Amended||Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made|
|Deleted||Recommendation from the previous CPG that has been removed based on review of the evidence|
|Not reviewed||Not changed||Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed|
|Amended||Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made|
|Deleted||Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG|
|*Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72.|
Self-directed, technology-based behavioral health treatment modalities for individual with suicidal ideation were reviewed by the CPG Workgroup. Available research focused on electronic delivery of treatment protocols in lieu of face-to-face delivery, however none of the available studies assessed the effectiveness of telehealth as it is routinely practiced across the VA and DoD. This review found that at follow-up, no significant between-group differences were observed in reporting of suicidal ideation or suicide attempts, however at the post-intervention assessment there was evidence of a reduction in suicidal ideation.
This section includes links to recommended training resources about technology-based treatment modalities.Return to Resource Options
This section includes links to recommended webinars about technology-based treatment modalities.
- Dialectical Behavioral Therapy via Telehealth Presented by Dr. Sara J. Landes
- Digital Delivery of Treatment Protocols as Upstream and Downstream Suicide Prevention Strategies: State of the Science Presented by Drs. Lisa A. Brenner & Carolyn Greene
- Suicide Prevention 2.0 Clinical Telehealth Programe Presented by Dr. Jessica A. Walker
This section includes links to recommended articles about technology-based treatment modalities.
- Internet-Based Cognitive Behavioral Therapy to Reduce Suicidal Ideation: A Systematic Review and Meta-analysis. JAMA Network Open, 2020;3(4):e203933. doi:10.1001/jamanetworkopen.2020.3933. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765056
- 2013). The effect of a web-based depression intervention on suicide ideation: secondary outcome from a randomised controlled trial in a helpline. BMJ open, 3(6). e002886. https://doi.org/10.1136/bmjopen-2013-002886 (
- 2015). Web-Based Cognitive Behavioral Therapy Intervention for the Prevention of Suicidal Ideation in Medical Interns: A Randomized Clinical Trial. JAMA psychiatry, 72(12). 1192-1198. https://doi.org/10.1001/jamapsychiatry.2015.1880 (
- 2015). Online suicide risk screening and intervention with college students: a pilot randomized controlled trial. Journal of consulting and clinical psychology, 83(3). 630-636. https://doi.org/10.1037/a0038805 (
- 2017). Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis. Cognitive behaviour therapy, 46(5). 353-374. https://doi.org/10.1037/a0038805 (
- 2017). Effectiveness of online and mobile telephone applications ('apps') for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis. BMC psychiatry, 17(1). 297. https://doi.org/10.1186/s12888-017-1458-0 (
This section includes links to recommended podcasts that are relevant to technology-based treatment modalities.
- Rocky Mountain MIRECC Short Takes on Suicide Prevention
- Insomnia, Treatment, and Finding a Path to Better Sleep with Drs. Carolyn Green and Andrew Moon