JMIR Publications

ABSTRACT

Background:

There is evidence that adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. EMDR is an evidence-based trauma focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. There is preliminary evidence that EMDR can be used as an acute intervention in suicidal patients, including in those with major depressive disorder (MDD). Additionally, due to social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR online and, in the absence of formal evaluations of online EMDR, informal reports indicate good results.

Objective:

The primary objective of this randomized trial is to investigate whether remotely delivered EMDR targeting experiences associated with suicidal thinking reduces suicidal thoughts. The secondary objectives include the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on any adverse events in the EMDR group to explore whether targeting suicidal ideation (SI) with EMDR is safe. Finally, we will compare drop-out rates between treatment groups.

Methods:

In this randomized controlled trial, 80 adults who express SI and meet study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual (TAU) or TAU alone. EMDR sessions will focus on the most distressing and intrusive memories associated with SI. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to number of post-treatment emergency room visits, hospitalizations and overall healthcare utilization in the year before and after therapy.

Results:

The protocol has been approved by the University of Alberta Research Ethics Board (protocol identification number Pro00090989). Funding for the study has been granted by the Mental Health Foundation. Recruitment started May 2021 and the anticipated completion date is early 2023.

Conclusions:

Results of this trial will contribute to knowledge about whether online delivery of EMDR a safe and efficacious treatment for addressing suicidal ideation. Clinical Trial: ClinicalTrials.gov Identification Number: NCT04181047