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      Can Outcomes of a Chat-Based Suicide Prevention Helpline Be Improved by Training Counselors in Motivational Interviewing? A Non-randomized Controlled Trial

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          Abstract

          Objective

          To examine whether the outcomes of a chat-based suicide-prevention helpline could be improved by training counselors in motivational interviewing (MI).

          Methods

          In a pre- and post-test design, visitors of a chat-based suicide prevention helpline received either the Five-Phase Model (treatment as usual [TAU]) or MI. They completed a pre- and post-chat questionnaire on several suicide-related risk factors. Linear mixed modeling was used to estimate the effect of the condition. Furthermore, the treatment proficiency of newly trained counselors was assessed using MI-Scope.

          Results

          A total of 756 visitors and 55 counselors were included in this study. The visitors showed an improvement in suicidal ideation and psychological risk factors after a chat conversation. However, there were no significant differences between the MI and TAU conditions (β = 0.03, 95% CI [−0.23–0.30], p = 0.80). The treatment integrity indices showed that the counselors mostly used MI-consistent techniques but were unable to strategically employ these techniques to evoke enough change talk.

          Conclusions

          MI and TAU led to comparable outcomes in a chat-based suicide prevention helpline. The effectiveness of MI might improve by intensifying or improving the training of counselors, keeping the process of engaging more concise or offering visitors multiple sessions of MI.

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          Most cited references55

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          A power primer.

          One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided here. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for eight standard statistical tests: (a) the difference between independent means, (b) the significance of a product-moment correlation, (c) the difference between independent rs, (d) the sign test, (e) the difference between independent proportions, (f) chi-square tests for goodness of fit and contingency tables, (g) one-way analysis of variance, and (h) the significance of a multiple or multiple partial correlation.
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            Intercoder Reliability in Qualitative Research: Debates and Practical Guidelines

            Evaluating the intercoder reliability (ICR) of a coding frame is frequently recommended as good practice in qualitative analysis. ICR is a somewhat controversial topic in the qualitative research community, with some arguing that it is an inappropriate or unnecessary step within the goals of qualitative analysis. Yet ICR assessment can yield numerous benefits for qualitative studies, which include improving the systematicity, communicability, and transparency of the coding process; promoting reflexivity and dialogue within research teams; and helping convince diverse audiences of the trustworthiness of the analysis. Few guidelines exist to help researchers negotiate the assessment of ICR in qualitative analysis. The current article explains what ICR is, reviews common arguments for and against its incorporation in qualitative analysis and offers guidance on the practical elements of performing an ICR assessment.
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              Computing Inter-Rater Reliability for Observational Data: An Overview and Tutorial.

              Many research designs require the assessment of inter-rater reliability (IRR) to demonstrate consistency among observational ratings provided by multiple coders. However, many studies use incorrect statistical procedures, fail to fully report the information necessary to interpret their results, or do not address how IRR affects the power of their subsequent analyses for hypothesis testing. This paper provides an overview of methodological issues related to the assessment of IRR with a focus on study design, selection of appropriate statistics, and the computation, interpretation, and reporting of some commonly-used IRR statistics. Computational examples include SPSS and R syntax for computing Cohen's kappa and intra-class correlations to assess IRR.
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                Author and article information

                Contributors
                Journal
                Front Digit Health
                Front Digit Health
                Front. Digit. Health
                Frontiers in Digital Health
                Frontiers Media S.A.
                2673-253X
                21 June 2022
                2022
                : 4
                : 871841
                Affiliations
                [1] 1113 Suicide Prevention , Amsterdam, Netherlands
                [2] 2Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
                [3] 3Department of Psychiatry , Amsterdam UMC, Amsterdam, Netherlands
                Author notes

                Edited by: Hugo López-Pelayo, Hospital Clínic de Barcelona, Spain

                Reviewed by: Markus Wolf, University of Zurich, Switzerland; Gallus Bischof, University of Lübeck, Lübeck, Germany

                *Correspondence: Wilco Janssen w.janssen@ 123456113.nl

                This article was submitted to Digital Mental Health, a section of the journal Frontiers in Digital Health

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fdgth.2022.871841
                9253377
                60b34395-37c4-47b9-84e0-116d28bf1db6
                Copyright © 2022 Janssen, Raak, Lucht, Ballegooijen and Mérelle.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 08 February 2022
                : 19 May 2022
                Page count
                Figures: 3, Tables: 5, Equations: 0, References: 58, Pages: 11, Words: 7950
                Categories
                Digital Health
                Original Research

                motivational interviewing (mi),suicide prevention,helpline,treatment integrity,training,chat

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