Motivational Interviewing to Address Suicidal Ideation: A Randomized Controlled Trial in Veterans

Objective Although the months following discharge from psychiatric hospitalization are a period of acute risk for veterans, there is a dearth of empirically supported treatments tailored to veterans in acute psychiatric hospitalization. Method We conducted a randomized controlled trial to test the efficacy of Motivational Interviewing to Address Suicidal Ideation ( MI ‐ SI ) that explored and resolved ambivalence, and a revised MI ‐ SI ( MI ‐ SI ‐R) that resolved ambivalence, on suicidal ideation ( SI ) in hospitalized veterans who scored > 2 on the Scale for Suicidal Ideation. Participants were randomized to receive MI ‐ SI plus treatment as usual ( TAU ), MI ‐ SI ‐R+ TAU , or TAU alone. MI ‐ SI + TAU and MI ‐ SI ‐R+ TAU included two in‐hospital therapy sessions and one telephone booster session. Participants completed follow‐up assessments over 6 months. Results Participants in all groups experienced reductions in the presence and severity of SI , but there were no significant differences among the groups. For the presence of SI , results were in the hypothesized direction for both MI ‐ SI + TAU conditions. Conclusions Results are nondefinitive, but the effect size of both versions of MI ‐ SI + TAU on the presence of SI was consistent with prior MI findings. Exploratory analyses suggest MI ‐ SI ‐R may be preferable to MI ‐ SI . More intensive MI ‐ SI ‐R with a greater number of follow‐ups may increase its effectiveness.