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VA research in action

Virtual Hope Box smartphone app to prevent suicide

July 25, 2018


The Virtual Hope Box app is a "demonstrably useful accessory to treatment," concluded VA and Department of Defense researchers who tested it in a controlled trial. (Photo by Mitch Mirkin)

Investigators from HSR&D's Center to Improve Veterans Involvement in Care at the VA Portland Health Care System partnered with the Department of Defense's Telehealth and Technology Center to develop and test the Virtual Hope Box (VHB) smartphone app. When using the virtual hope box, a 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, helpline numbers, and reminders of reasons for living. The app supports a mix of pre-loaded and user-created content, and can be customized according to the patient's specific needs.

In a randomized clinical trial, Veterans who used the VHB reported significantly greater ability to cope with unpleasant emotions and thoughts compared with a control group, and found the app to be more helpful than written educational materials.

The VHB was introduced to the public in February 2014. As of spring 2018, has been downloaded 400,000 times, with high positive feedback. VHB is one of only a few empirically-tested smartphone tools designed to support patients at risk for suicide. The project was awarded the DoD Innovation Award in 2014. VA is exploring additional ways to disseminate information about the app and recently incorporated VHB into a mandatory, national VA suicide prevention training program.

For more information about VHB, including clinician and Veteran guides, visit

Principal investigator: Nigel E. Bush, Ph.D.; National Center for Telehealth and Technology

Selected publications:

Bush NE, Dobscha SK, Crumpton R, et al. A Virtual Hope Box smartphone app as an accessory to therapy: proof-of-concept in a clinical sample of Veterans. Suicide Life Threat Behav. 2015 Feb;45(1):1-9.

Bush NE, Smolenski DJ, Denneson LM, et al. A Virtual Hope Box: randomized controlled trial of a smartphone app for emotional regulation and coping with distress. Psychiatr Serv. 2017 Apr 1;68(4):330-336.

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