Can Outcomes of a Chat-Based Suicide Prevention Helpline Be Improved by Training Counselors in Motivational Interviewing? A Non-randomized Controlled Trial

Wilco Janssen, Jeroen van Raak, Yannick van der Lucht, Wouter van Ballegooijen, Saskia Mérelle

Research output: Contribution to journalArticleAcademicpeer-review


Objective: To examine whether the outcomes of a chat-based suicide-prevention helpline could be improved by training counselors in motivational interviewing (MI).

Methods: In a pre- and post-test design, visitors of a chat-based suicide prevention helpline received either the Five-Phase Model (treatment as usual [TAU]) or MI. They completed a pre- and post-chat questionnaire on several suicide-related risk factors. Linear mixed modeling was used to estimate the effect of the condition. Furthermore, the treatment proficiency of newly trained counselors was assessed using MI-Scope.

Results: A total of 756 visitors and 55 counselors were included in this study. The visitors showed an improvement in suicidal ideation and psychological risk factors after a chat conversation. However, there were no significant differences between the MI and TAU conditions (β = 0.03, 95% CI [-0.23-0.30], p = 0.80). The treatment integrity indices showed that the counselors mostly used MI-consistent techniques but were unable to strategically employ these techniques to evoke enough change talk.

Conclusions: MI and TAU led to comparable outcomes in a chat-based suicide prevention helpline. The effectiveness of MI might improve by intensifying or improving the training of counselors, keeping the process of engaging more concise or offering visitors multiple sessions of MI.

Original languageEnglish
Article number871841
Pages (from-to)871841
JournalFrontiers in Digital Health
Publication statusPublished - 21 Jun 2022


  • chat
  • helpline
  • motivational interviewing (MI)
  • suicide prevention
  • training
  • treatment integrity

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