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Smartphone virtual 'Hope Box' could reduce suicidal thoughts

Aysha Crain, a social worker and research coordinator at the Portland (Ore.) VA Medical Center, displays a smartphone app called the Virtual Hope Box0 Aysha Crain, a social worker and research coordinator at the Portland (Ore.) VA Medical Center, displays a smartphone app called the Virtual Hope Box

The VA medical center in Portland, Ore., has become the test site for an interesting new approach to helping Veterans cope with thoughts of suicide: the "hope box."

"One tool we use in distress tolerance here as part of our Dialectical Behavior Therapy treatment is for Veterans to develop what we call a 'self-soothing box,'" explained Aysha Crain, a social worker and research coordinator at the Portland VA.

"This physical 'hope box' is a means for Veterans with suicidal thoughts to remember better times through favorite photos, gifts and notes, and by using distraction tools or games like Sudoku or crossword puzzles.

"We encourage our Veterans to try to keep their physical hope box with them," she continued. "That way, they'll have an option for managing distressing thoughts when they become overwhelming. The hope box can be any kind of container—a shoe box, envelope or plastic bag."

Of course, it's not necessarily private, convenient or easy to carry a shoebox around with you all the time. So technology has come to the rescue. A team led by Nigel Bush, a research psychologist at the Defense Department's National Center for Telehealth and Technology, has come up with a potential solution.

"They developed a virtual hope box smartphone application that we hope can serve the same purpose as our physical hope box," explained Dr. Steven Dobscha, chief of psychiatry at the Portland VA Medical Center. "It can be used conveniently and discreetly on a smartphone."

When using the virtual hope box, the Veteran sets up the app with photos of friends and family, sound bites and videos of loved ones and special moments, music, relaxation exercises, games and helpline numbers.

Now that initial development of the app has been completed, psychologists and social workers at the Portland VA are busy evaluating it.

How? They're introducing the app to about 25 Veterans enrolled in a research project being conducted in collaboration with Portland's Dialectical Behavior Therapy Program.

"We're in the testing phase," Dobscha said. "We're hopeful this pilot study will tell us if this is likely to be a tool that Veterans will use when they are struggling with suicidal thoughts."

Development and testing of the app is being supported by a grant from the Department of Defense, through the Military Suicide Research Consortium.


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