Practice Experiences for School Reintegration

NCT ID: NCT05934396

Last Updated: 2025-09-25

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

54 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-01

Study Completion Date

2024-12-20

Brief Summary

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This study is developing and refining a novel Virtual Reality (VR) supplement for inpatient treatment: the Practice Experiences for School Reintegration (PrESR) program. The PrESR will provide immersive school experiences for inpatient adolescents (with suicidal-related admissions) to practice skills in real-world settings with the guidance of a trained clinician within the confines of a hospital. This pilot study follows a Multiphase Optimization Strategy (MOST) to conduct a pilot optimization trial of the PrESR to inform the feasibility of training clinicians, the ability to recruit adolescent inpatient participants, and management of experimental conditions. This study is not powered to test hypotheses; however, in addition to assessing feasibility and acceptability, this pilot trial will assess candidate intermediary and outcome measures.

Detailed Description

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This study follows a multiphased optimization (MOST) research design; this clinical trial is considered to be a pilot optimization component of the MOST framework. For the present study, a prospective sample of adolescents hospitalized for suicidal thoughts and behaviors will be randomly selected into one of 8 experimental conditions (N=5-6 per group). Although the intervention for the pilot optimization trial will be implemented by a member of research staff, this study will also aim to recruit 2-5 clinicians to deliver the full intervention to a separate sample of adolescent patients to inform acceptability and feasibility of the intervention within their clinical workflow.

Conditions

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Suicide

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Enhanced Control

Cognitive Behavioral Therapy (CBT) Worksheets

Group Type ACTIVE_COMPARATOR

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Affect Regulation

Cognitive Behavioral Therapy (CBT) Worksheets; Safety Planning; Virtual Reality (VR) Enhanced Affect Regulation

Group Type ACTIVE_COMPARATOR

Safety Planning

Intervention Type BEHAVIORAL

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

VR Enhanced Affect Regulation

Intervention Type BEHAVIORAL

Participants will receive an overview of affect regulation in VR and then have the opportunity to practice using affect regulation in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Problem Solving

Cognitive Behavioral Therapy (CBT) Worksheets; Safety Planning; Virtual Reality (VR) Enhanced Problem Solving

Group Type ACTIVE_COMPARATOR

Safety Planning

Intervention Type BEHAVIORAL

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

VR Enhanced Problem Solving

Intervention Type BEHAVIORAL

Participants will receive an overview of problem solving in VR and then have the opportunity to practice using problem solving in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Affect Regulation + Problem Solving

Cognitive Behavioral Therapy (CBT) Worksheets; Safety Planning; Virtual Reality (VR) Enhanced Affect Regulation; VR Enhanced Problem Solving

Group Type ACTIVE_COMPARATOR

Safety Planning

Intervention Type BEHAVIORAL

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

VR Enhanced Affect Regulation

Intervention Type BEHAVIORAL

Participants will receive an overview of affect regulation in VR and then have the opportunity to practice using affect regulation in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

VR Enhanced Problem Solving

Intervention Type BEHAVIORAL

Participants will receive an overview of problem solving in VR and then have the opportunity to practice using problem solving in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Cognitive Restructuring

Cognitive Behavioral Therapy (CBT) Worksheets; Safety Planning; Virtual Reality (VR) Enhanced Cognitive Restructuring

Group Type ACTIVE_COMPARATOR

Safety Planning

Intervention Type BEHAVIORAL

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

VR Enhanced Cognitive Restructuring

Intervention Type BEHAVIORAL

Participants will receive an overview of cognitive restructuring in VR and then have the opportunity to practice using cognitive restructuring in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Affect Regulation + Cognitive Restructuring

Cognitive Behavioral Therapy (CBT) Worksheets; Safety Planning; Virtual Reality (VR) Enhanced Affect Regulation; VR Enhanced Cognitive Restructuring

Group Type ACTIVE_COMPARATOR

Safety Planning

Intervention Type BEHAVIORAL

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

VR Enhanced Affect Regulation

Intervention Type BEHAVIORAL

Participants will receive an overview of affect regulation in VR and then have the opportunity to practice using affect regulation in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

VR Enhanced Cognitive Restructuring

Intervention Type BEHAVIORAL

Participants will receive an overview of cognitive restructuring in VR and then have the opportunity to practice using cognitive restructuring in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Cognitive Restructuring + Problem Solving

Cognitive Behavioral Therapy (CBT) Worksheets; Safety Planning; Virtual Reality (VR) Enhanced Cognitive Restructuring; VR Enhanced Problem Solving

Group Type ACTIVE_COMPARATOR

Safety Planning

Intervention Type BEHAVIORAL

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

VR Enhanced Cognitive Restructuring

Intervention Type BEHAVIORAL

Participants will receive an overview of cognitive restructuring in VR and then have the opportunity to practice using cognitive restructuring in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

VR Enhanced Problem Solving

Intervention Type BEHAVIORAL

Participants will receive an overview of problem solving in VR and then have the opportunity to practice using problem solving in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Affect Regulation + Cognitive Restructuring + Problem Solving

Cognitive Behavioral Therapy (CBT) Worksheets; Safety Planning; Virtual Reality (VR) Enhanced Affect Regulation; VR Enhanced Cognitive Restructuring; VR Enhanced Problem Solving

Group Type ACTIVE_COMPARATOR

Safety Planning

Intervention Type BEHAVIORAL

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

VR Enhanced Affect Regulation

Intervention Type BEHAVIORAL

Participants will receive an overview of affect regulation in VR and then have the opportunity to practice using affect regulation in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

VR Enhanced Cognitive Restructuring

Intervention Type BEHAVIORAL

Participants will receive an overview of cognitive restructuring in VR and then have the opportunity to practice using cognitive restructuring in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

VR Enhanced Problem Solving

Intervention Type BEHAVIORAL

Participants will receive an overview of problem solving in VR and then have the opportunity to practice using problem solving in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Cognitive Behavioral Therapy (CBT) Worksheets

Intervention Type BEHAVIORAL

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Interventions

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Safety Planning

Prior to discharge and following the conclusion of all Virtual Reality (VR) sessions, the participant will develop a safety planning intervention for school settings in collaboration with relevant individuals (e.g., the researcher, a school professional).

Intervention Type BEHAVIORAL

VR Enhanced Affect Regulation

Participants will receive an overview of affect regulation in VR and then have the opportunity to practice using affect regulation in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Intervention Type BEHAVIORAL

VR Enhanced Cognitive Restructuring

Participants will receive an overview of cognitive restructuring in VR and then have the opportunity to practice using cognitive restructuring in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Intervention Type BEHAVIORAL

VR Enhanced Problem Solving

Participants will receive an overview of problem solving in VR and then have the opportunity to practice using problem solving in a brief immersive experience designed to mimic difficult school experiences. Each session begins with goal setting prior to the VR experience and concludes with a debrief summary following the VR experience.

Intervention Type BEHAVIORAL

Cognitive Behavioral Therapy (CBT) Worksheets

The researchers will provide instructions for participants to complete a packet of worksheets teaching introduction to cognitive behavioral therapy (CBT), affect regulation, cognitive restructuring, and problem solving.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

Adolescent Participants:

* current hospitalization for suicidal thoughts and behaviors
* ages 13-18
* expected return to school following discharge
* ability to speak, read, and understand English sufficiently to complete study procedures,
* consent of a parent/legal guardian (in English or Spanish; for minor participants)
* adolescent assent or consent (in English)
* clinician approval.

Hospital professionals:

* Works as a clinician at the hospital site who delivers treatment including CBT to hospitalized adolescents,
* Hospital professional consent (in English)
* consent of patient's parent/legal guardian (in English or Spanish; for minor participants)
* adolescent patient assent or consent (in English).

Exclusion Criteria

Adolescent Participants

* evidence of active psychosis,
* evidence of intellectual disability
* Risk for Cyber-sickness (greater than or equal to 50th percentile as measured on the Motion Sickness Susceptibility Questionnaire)
Minimum Eligible Age

13 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marisa Marraccini, PhD

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina, Chapel Hill

Locations

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UNC Adolescent Psychiatry Inpatient Unit

Chapel Hill, North Carolina, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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5K23MH122775

Identifier Type: NIH

Identifier Source: secondary_id

View Link

20-3464

Identifier Type: -

Identifier Source: org_study_id

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