Integrating Technology into Collaborative Suicide Risk Assessment: Comparing Electronic and Paper-and-Pencil Versions of the Suicide Status Form.

摘要

The present study examined psychometric and experiential differences between paper-and-pencil and electronic versions of the Suicide Status Form (SSF), a measure used as part of the Collaborative Assessment and Management of Suicidality. Thirty-five graduate students and professionals in social work, clinical psychology, or counseling role-played a suicidal client in two consecutive intake sessions with SSF-trained therapists, one session with a paper version of the SSF and the other using a computer, in counterbalanced order.;Statistical equivalence analyses revealed that SSF ratings did not differ significantly between modalities except on two scales. Agitation was higher on the computer-based SSF for those who completed the computer version first. Additionally, participants rated their wish to live significantly higher on paper than computer. These findings are important because agitation is a significant warning sign of suicidal behavior, and the wish to live rating is part of an index score used to reliably classify different suicidal states, with implications for future suicidal behaviors.;Measures of working alliance, psychotherapy expectations, affective experience, and session experience were completed after each session and at the end. Clients' ratings significantly favored the paper SSF on 4 of these 15 experiential variables, but only when clients rated both versions at the end of the study. This measurement is an artifact of the within-subjects research design, and so findings might not generalize to clinical practice.;Overall, despite predominant equivalence of the versions, there were important findings favoring the paper SSF. CAMS clinicians using the SSF need to know about these subtle differences between versions, and SSF training should take these findings into account.;Additionally, a literature review is included on technology-based psychotherapy addressing the therapeutic alliance and its association with treatment outcome within face-to-face psychotherapy with adjunctive technology, videoconferencing-based psychotherapy, telephone-based psychotherapy, and internet-based psychotherapy with text communication. Results indicate equivalent alliance strength for tasks and goals, but mixed findings for bond; thus, aspects of the alliance may be differentially affected. Results are also mixed concerning the strength of the alliance-outcome relation. Conclusions are tentative due to methodological limitations and a lack of standardized measures, and research directions are suggested.