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Evaluation ViewAttendees 5

Suicide and Self-Injury
Session Type:: Symposia

Symposium 62 - Bridging Treatment and Daily Life: Future Directions, Stakeholder Perspectives, and Evaluation of Ecological Momentary Interventions for Self-Injurious Thoughts and Behaviors

Sunday, November 23, 2025
12:00 PM - 1:00 PM CST
Location: Strand 13A&B, Level 2
CE: 1

Keywords: Self-Injury, Suicide, Technology / Mobile Health
Level of Familiarity: Moderate
Recommended Readings: Ammerman, B. A., & Law, K. C. (2022). Using intensive time sampling methods to capture daily suicidal ideation: A systematic review. Journal of Affective Disorders, 299, 108-117. https://doi.org/10.1016/j.jad.2021.10.121,   Coppersmith, D. D., Dempsey, W., Kleiman, E. M., Bentley, K. H., Murphy, S. A., & Nock, M. K. (2022). Just-in-time adaptive interventions for suicide prevention: Promise, challenges, and future directions. Psychiatry, 85(4), 317-333. https://doi.org/10.1080/00332747.2022.2092828,   Kiekens, G., Claes, L., Kleiman, E. M., Luyckx, K., Coppersmith, D. D., Fortgang, R. G., ... & Nock, M. K. (2024). The short-term course of nonsuicidal self-injury among individuals seeking psychiatric treatment. JAMA Network Open, 7(10), e2440510-e2440510. https://doi.org/10.1001/jamanetworkopen.2024.40510,   Kleiman, E. M., Glenn, C. R., & Liu, R. T. (2023). The use of advanced technology and statistical methods to predict and prevent suicide. Nature reviews psychology, 2(6), 347-359. https://doi.org/10.1038/s44159-023-00175-y,   Turner, B. J. (2022). Detecting and managing non‐suicidal self‐damaging behaviors. World Psychiatry, 21(3), 461-462. https://doi.org/10.1002/wps.21022

Suicidal and non-suicidal self-injury (NSSI), collectively termed self-injurious thoughts and behaviors (SITBs), are a major global public health concern (Han et al., 2018; Moran et al., 2024; Turner, 2022). Despite decades of research, preventing and treating SITBs remains challenging due to their highly dynamic nature (Kiekens et al., 2024; Kleiman et al., 2023). Recent advancements in Ecological Momentary Assessment (EMA) have provided real-time insights into SITBs (Ammerman et al., 2022), improving our understanding of their daily fluctuations and real-time risk factors. Building on this progress, Ecological Momentary Interventions (EMIs) and Just-In-Time Adaptive Interventions (JITAIs) have emerged as innovative, technology-driven approaches that can deliver timely, personalized, and context-sensitive interventions (Coppersmith et al., 2022). These interventions provide a unique opportunity to bridge the gap between structured treatment and daily life.

This symposium will explore key aspects of EMI and JITAI development, intervention design, and preliminary evaluation of their clinical implementation for SITBs. The first presentation will introduce the Adaptive Time Interval System (ATIS), a reinforcement learning-based approach designed to optimize EMA scheduling and improve real-time suicide risk detection. The second presentation will present findings from a pilot randomized controlled trial (RCT) evaluating a CBT-based skills training intervention for individuals transitioning from inpatient psychiatric care to outpatient settings, a period of heightened suicide risk. The third presentation will examine how developmental patterns and severity impact fluctuations in affect before and after NSSI, identifying differential affective mechanisms that can inform personalized EMIs. Finally, the fourth presentation will explore stakeholder perspectives on EMIs and JITAIs, incorporating qualitative data from treatment-seeking individuals and mental health professionals to guide the future development and integration of these digital interventions in clinical practice.

This symposium is relevant to those interested in the advancement of evidence-based, technology-driven interventions for individuals with SITBs and aligns with ABCT’s mission to enhance the accessibility, effectiveness, and implementation of CBT-interventions in daily life. Featuring an international panel of researchers at both senior and early career stages, it presents data from Canada, Europe, and the United States. Presentations showcase a multi-method approach, integrating quantitative methodologies (reinforcement learning, intensive longitudinal assessment, RCTs) with qualitative research (stakeholder interviews). Findings will provide critical insights for clinicians, researchers, and scientist-practitioners working to refine SITB interventions. The discussant will draw on his expertise as a scientist-practitioner and will outline the next empirical steps needed to enhance EMIs and JITAIs for SITBs. He will also address ethical and pragmatic considerations, along with the opportunities and challenges of integrating these interventions into cognitive-behavioral treatments.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. After this session, attendees will be able to explain how EMIs and JITAIs help bridge the gap between treatment and daily life for SITBs.
  2. Describe how reinforcement learning and adaptive assessment strategies enhance real-time risk detection and intervention timing.
  3. Gauge the effectiveness of a CBT-based EMI in reducing suicidal ideation during the high-risk post-hospitalization period.
  4. Differentiate momentary affective dynamics by developmental patterns and severity to inform EMI designs for emotion regulation.
  5. Summarize key stakeholder perspectives on the utility, focus, and design of EMIs and JITAIs for SITBs.

Presentations:

  • 12:04 PM - 12:18 PM CST
    (SYM 62) Optimizing the Timing of Momentary Assessment: The Development of ATIS

    Speaker: Brooke Ammerman, Ph.D. (she/her/hers) – University of Wisconsin-Madison

    Co-author: Ross Jacobucci, Ph.D. – University of wisconsin-Madison

  • 12:18 PM - 12:32 PM CST
    (SYM 62) Pilot RCT of a Smartphone-based Inpatient-to-outpatient Suicide Prevention Intervention

    Speaker: Evan M. Kleiman, Ph.D. – Rutgers University

    Co-author: Mariah Hawes-Sousa, Ph.D. – Rutgers University

    Co-author: Elizabeth Edershile, Ph.D. (she/her/hers) – Rutgers, The State University of New Jersey

    Co-author: Matthew Flics, Research Assistant (he/him/his) – Massachusetts General Hospital

    Co-author: Hannah R. Krall, B.S. – Rutgers University

    Co-author: Emma Yoon, BS (she/her/hers) – Rutgers, The State University of New Jersey

    Co-author: Meirong You, PhD (she/her/hers) – Faulkner Hospital

    Co-author: Ana Gonzalez, Ph.D. (she/her/hers) – Faulkner Hospital

    Co-author: Adina Nenner, Ph.D. (she/her/hers) – Faulkner Hospital

    Co-author: Christopher AhnAllen, Ph.D. (he/him/his) – Harvard Medical School Psychiatry

    Co-author: Kate H. Bentley, Ph.D. (she/her/hers) – Massachusetts General Hospital/Harvard Medical School

  • 12:32 PM - 12:46 PM CST
    (SYM 62) Exploring the Intersection Between Momentary and Developmental Dynamics in Non-suicidal Self-injury

    Speaker: Geneva Mason, B.A. (she/her/hers) – University of Victoria

    Co-author: Jessica Ryan, M.Sc. – University of Victoria

    Co-author: Brianna J. Turner, Ph.D. (she/her/hers) – University of Victoria

  • 12:46 PM - 1:00 PM CST
    (SYM 62) Stakeholder Perspectives on Ecological Momentary and Just-in-time Adaptive Interventions for Individuals Who Self-injure and Seek Treatment

    Speaker: Glenn Kiekens, Ph.D. (he/him/his) – Tilburg University

    Co-author: Mirthe Luijsmans, MSc – Contextual Psychiatry, KU Leuven

    Co-author: Ruth Tatnell, PhD – Faculty of Health/School of Psychology, Deakin University

    Co-author: Marlies Houben, PhD – Department of Medical and Clinical Psychology, Tilburg University

    Co-author: Thomas Vaessen, PhD – Faculty of Behavioural, Management and Social Sciences, Twente University

    Co-author: Inez Myin-Germeys, PhD – Center for contextual psychiatry, kU Leuven

    Co-author: Laurence Claes, Ph.D. – KU Leuven