The effectiveness of online cognitive behavioral therapy on suicidal thoughts, cognitive flexibility and despair (in individuals diagnosed with depression) WHO attempted suicide: A randomized controlled study

Aim: The aim of this study is to examine the effectiveness of individual cognitive behavioral therapy applied online to individuals with depression who attempt suicide on suicidal ideation, cognitive flexibility and hopelessness. Materials and Methods: The study was randomized controlled pre-test, 1st, 3rd and 6th month follow-up design. The research was carried out between June 2021 and November 2022. The sample of the study consists of 50 individuals with a diagnosis of depression, who applied to the psychiatry outpatient clinic of a state hospital, and who attempted suicide at least once in the last six months and received standard treatment. With the simple randomization method, 25 individuals were assigned to the intervention and control groups, and 20 sessions of individual Online Cognitive Behavioral Therapy were applied to the individuals in the intervention group. Research data were collected with self-reported Suicide Probability Scale, Cognitive Flexibility Inventory, Beck Hopelessness Scale, Beck Depression Scale and Beck Anxiety Scale. Descriptive statistics, t test for independent groups, Mann Whitney U, repeated measures ANOVA and Wilcoxon Signed Ranks Test were used in the analysis of the data. Results: In the 1st and 3rd month follow-up measurements after Online Cognitive Behavioral Therapy, the Suicide Probability Scale mean scores were significantly lower in favor of the intervention group (p=0.000). The effect of Online Cognitive Behavioral Therapy applied to the intervention group was found to be preserved at 1 and 3 months (F=26.132; p=0.000). The Online Cognitive Behavioral Therapy intervention group had a significant effect on the Suicide Probability Scale mean scores (F=72,589; p=0,000). Mean Cognitive Flexibility Inventory scores increased significantly in favor of the intervention group in the 1st, 3rd and 6th month follow-up measurements after Online Cognitive Behavioral Therapy (p=0.000). It was determined that the effect of Online Cognitive Behavioral Therapy applied to the intervention group on the Cognitive Flexibility Inventory mean scores was preserved at the 1st, 3rd and 6th months (F=31,260; p=0,000). The Online Cognitive Behavioral Therapy intervention group had a significant effect on the Cognitive Flexibility Inventory mean scores (F=223,568; p=0.000). In the 1st, 3rd and 6th month follow-up measurements after Online Cognitive Behavioral Therapy, Beck Hopelessness Scale mean scores decreased significantly in favor of the intervention group (p=0.000). It was determined that the effect of Online Cognitive Behavioral Therapy applied to the intervention group on Beck Hopelessness Scale mean scores was preserved at the 1st, 3rd and 6th months (F=7.199; p=0.000). The Online Cognitive Behavioral Therapy intervention group had a significant effect on the Beck Hopelessness Scale mean scores of the individuals (F=19,688; p=0.000). After Online Cognitive Behavioral Therapy, the Beck Depression Scale and Beck Anxiety Scale mean scores of the individuals in the intervention group decreased significantly (p=0.015; p=0.002). In the study, 4 individuals in the control group and 1 individual in the intervention group repeated the suicide attempt during the 6-month follow-up. Conclusion: It was determined that Online Cognitive Behavioral Therapy applied in this study decreased the risk of suicide, repeated suicide attempts, hopelessness and increased cognitive flexibility. Online Cognitive Behavioral Therapy has also been found to reduce the depression and anxiety levels of individuals, and their clinical course has also been improved.