Effectiveness of a CBT Online-based Program to Reduce Suicide Ideation Among School Adolescents

The online intervention comprises 8 modules of cognitive behavioral therapy (CBT) delivered at schools by psychologists over 10 weeks. Contents: engagement and problem identification, emotional recognition and distress tolerance, identification of negative automatic thinking, help seeking and activity scheduling, problem solving, and cognitive restructuring, and a wrap up session. Two activities per module. Using a message board, the participant could communicate with research therapists who also check completed activities and respond with personalized messages. The face-to-face intervention comprises 4 CBT-based sessions to help the students in three aspects: i) close support and monitoring in case of an increase of symptomatology; ii) motivation to persist with the CBT; and iii) support the interaction between the students and CBT. Additionally, participants will be referred to a primary care clinic to receive treatment as usual.

Treatment as usual consists of identification and assisted referral to a primary care clinic where trained psychologists will assess the symptomatology and propose a course of actions, from initiation of psychotherapy to referral to a General practitioner to initiate medication if needed. Psychoterapy in primary care clinics consists of a range of 4-8 sessions twice a month. Most of the content of the psychotherapy are based on Cognitive-Behavioral Model. When needed, general practioners may suggest using medication, which normally are SSRI anditepressant (e.g., Fluoxetine, Sertraline). Medical check-up is conducted every month or every two months.