Kognito At-Risk in Primary Care


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Kognito Interactive

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Kognito At-Risk in Primary Care is a one-hour, online training simulation that teaches primary care providers to: 1) Screen patients using evidence-based tools to assess substance use and mental health (including suicidal ideation, depression, post-traumatic stress, and generalized anxiety disorder); 2) Engage in collaborative treatment planning with patients and build treatment plans that integrate mental health services; 3) apply motivational interviewing techniques to build trust and increase patient adherence to treatment plans; and 4) apply best practices in follow-up care. Training includes interactive role-plays with animated virtual patient avatars that act and respond like real patients in distress. The program is divided into 5 modules of 6-18 minutes. Successful completion of the training results in 1.50 nationally recognized CME /CNE credits.

Designation as a “Program with Evidence of Effectiveness”

SPRC designated this intervention as a “program with evidence of effectiveness” based on its inclusion in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP). 

Outcome(s) Reviewed (Evidence Rating)*

  • Knowledge, Attitudes, and Beliefs About Mental Health (Effective)

A posttest immediately following the training found a statistically significant improvement in primary care clinician’s knowledge and skills about how to screen and address mental health issues among patient populations, compared with control group participants. Longer-term changes (e.g., changes in practice, improved patient outcomes) were not assessed.

Read more about this program’s ratings.


* NREPP changed its review criteria in 2015. This program was reviewed under the post-2015 criteria. To help practitioners find programs that fit their needs, NREPP reviews the evidence for specific outcomes, not overall programs. Each outcome was assigned an evidence rating of Effective, Promising, or Ineffective. A single program may have multiple outcomes with different ratings. When considering programs, we recommend (a) assessing whether the specific outcomes achieved by the program are a fit for your needs; and (b) examining the strength of evidence for each outcome.

Implementation Essentials

  • Primary care settings that use Kognito At-Risk in Primary Care should have established protocols for managing patients who may be at risk for suicide.

2012 NSSP Objectives Addressed: 

Objective 7.2: Provide training to mental health and substance abuse providers on the recognition, assessment, and management of at-risk behavior, and the delivery of effective clinical care for people with suicide risk.

Objective 9.3: Promote the safe disclosure of suicidal thoughts and behaviors by all patients.