Single-Session Intervention for Suicidal Thoughts

Overseen By Shannon Sauer-Zavala, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Shannon E. Sauer-Zavala

Disqualifiers: Manic episode, Psychotic, Substance detox, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new one-time intervention called the Single-Session Mechanism-Focused Intervention (SSMFI). It aims to help individuals struggling with suicidal thoughts by addressing feelings of hopelessness and loneliness. The researchers aim to determine if this approach is effective immediately after a hospital stay, a period when individuals are most at risk for another attempt. Participants will either receive this new treatment or continue with the usual care provided in the hospital. The trial seeks individuals admitted to a psychiatric unit at Good Samaritan Hospital for suicidal thoughts or a recent attempt. Participants must communicate in English and provide contact details for follow-up. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could improve care for those at risk.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this intervention is safe for individuals with suicidal thoughts?

Research shows that very short programs to prevent suicide, such as the Single-Session Mechanism-Focused Intervention (SSMFI), can help reduce future suicide attempts. These programs also increase the likelihood of participants attending follow-up treatments. Although detailed safety data for SSMFI is not available, similar single-session programs have shown positive results with few issues. This suggests that SSMFI is likely safe and well-received. Studies on brief interventions usually report low rates of negative effects, making them a promising option for people at risk of suicide. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Most treatments for suicidal thoughts involve ongoing therapy or medication, which can take time to show results. However, the Single-Session Mechanism-Focused Intervention (SSMFI) is unique because it aims to provide relief in just one session. Researchers are excited about this approach because it targets the underlying mechanisms of suicidal thoughts directly and efficiently, potentially offering immediate support to individuals in crisis. This innovative method could significantly shorten the time needed to help those struggling, making it a promising option for rapid intervention.

What evidence suggests that this trial's treatments could be effective for suicidal thoughts?

Research shows that very short programs to prevent suicide can be helpful. Studies have found that these programs can lower the chances of future suicide attempts and help ensure that patients attend follow-up treatments. Participants in one-session programs reported feeling less hopeless immediately and continued to feel better a month later. Data from similar methods suggest a significant drop in suicidal behavior, with some studies noting a 76% decrease. This trial will evaluate the Single-Session Mechanism-Focused Intervention (SSMFI) as a promising option for those at risk, comparing it to Treatment as Usual. ^{1 2 3 6 7}

Who Is on the Research Team?

Shannon Sauer-Zavala, PhD

Principal Investigator

University of Kentucky

Are You a Good Fit for This Trial?

This trial is for adults admitted to the Adult Inpatient Unit at Good Samaritan Hospital who are experiencing suicidal thoughts or have recently attempted suicide. Participants must be 18 years old, speak English, and provide two contact methods for follow-up.

Inclusion Criteria

English speaking

I am admitted to the Adult Inpatient Unit at Good Samaritan Hospital.

I can provide two ways to be contacted for study follow-up.

Exclusion Criteria

Acutely psychotic

Actively detoxicating from substances

Current manic episode

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Intervention

Single Session Mechanism Focused Intervention (SSMFI) for suicidal thoughts and behaviors is administered on an inpatient unit

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in suicidal ideation, hopelessness, and social connectedness

1 month

Assessments at 1 week and 1 month post-intervention

What Are the Treatments Tested in This Trial?

Interventions

• Single-Session Mechanism-Focused Intervention (SSMFI)

Trial Overview The study compares a new Single Session Mechanism Focused Intervention (SSMFI) targeting hopelessness and social connectedness against the usual treatment for patients with suicidal thoughts/behaviors on an inpatient psychiatric unit.

How Is the Trial Designed?

Group I: Single-Session Mechanism Focused Intervention (SSMFI) Experimental Treatment 1 Intervention

Group II: Treatment as Usual Active Control 1 Intervention

Who Is Running the Clinical Trial?

Shannon E. Sauer-Zavala

Lead Sponsor

Trials

5

Recruited

400+

Published Research Related to This Trial

A scoping review identified 12 unique group therapies targeting suicidal thoughts and behaviors, showing that all reported reductions in suicide-related outcomes, although most studies lacked sufficient power to confirm effectiveness.

The findings suggest that suicide-focused group therapies are generally feasible and acceptable, highlighting the need for more rigorous randomized controlled trials to better assess their efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide-Focused Group Therapy. Chalker, SA., Martinez Ceren, CS., Ehret, BC., et al.[2022]

The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based intervention that enhances the therapeutic alliance between clinicians and suicidal patients, focusing on collaborative assessment and treatment planning.

CAMS utilizes the Suicide Status Form (SSF) to assess and track suicidal risk, and has been supported by multiple studies, including one randomized clinical trial, with two more currently underway to further validate its efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Collaborative Assessment and Management of Suicidality (CAMS): an evolving evidence-based clinical approach to suicidal risk. Jobes, DA.[2022]

Mindfulness-based cognitive therapy (MBCT) is a promising intervention for preventing the reactivation of suicidal thoughts in individuals with a history of depression, as it helps them develop awareness and acceptance of their thoughts.

The therapy combines mindfulness practices with cognitive techniques, allowing participants to view their thoughts as transient mental events rather than absolute truths, which may reduce the risk of suicidal crises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior. Williams, JM., Duggan, DS., Crane, C., et al.[2022]

The intervention designed for adolescents at risk of suicide is based on effective strategies used for suicidal adults, focusing on reducing suicide risk and addressing emotional distress and interpersonal issues.

This program consists of five intensive weekly sessions followed by three months of email follow-up, aiming to provide immediate support and foster hope for both adolescents and their parents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultra-brief crisis interpersonal psychotherapy based intervention for suicidal children and adolescents. Klomek, AB., Catalan, LH., Apter, A.[2021]

The START trial is a pilot study involving 70 participants with serious mental illnesses, such as bipolar disorder and schizophrenia, aimed at evaluating a brief cognitive behavioral intervention designed to reduce suicidal ideation over a 6-month period.

The intervention includes both in-person sessions and mobile phone interactions, focusing on early warning signs and recovery planning, which may enhance engagement and effectiveness in suicide prevention for individuals with psychotic disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Brief Mobile-Augmented Suicide Prevention Intervention for People With Psychotic Disorders in Transition From Acute to Ongoing Care: Protocol for a Pilot Trial. Depp, C., Ehret, B., Villa, J., et al.[2023]

The Attempted Suicide Short Intervention Program (ASSIP) is a brief therapy designed for individuals who have attempted suicide, focusing on building a therapeutic alliance and incorporating narrative interviewing and safety planning.

In a randomized controlled trial, ASSIP was found to be highly effective in significantly reducing the risk of suicide reattempts, highlighting its potential as a valuable intervention in clinical suicide prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Novel Therapy for People Who Attempt Suicide and Why We Need New Models of Suicide. Michel, K., Valach, L., Gysin-Maillart, A.[2018]

The article reviews various ultra-brief and brief suicide-specific interventions, highlighting their potential to quickly stabilize individuals at risk of suicide, which is crucial given the rising suicide rates.

Several interventions, such as the Safety Planning Intervention and Cognitive Therapy for Suicide Prevention, have shown promising evidence for effectiveness, indicating a need for continued research to optimize these approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief and Ultra-Brief Suicide-Specific Interventions. Stanley, B., Brodsky, B., Monahan, M.[2023]

In a study of 92 suicidal patients, those who received care showed significant improvements in overall symptoms and a reduction in suicidal ideation over time.

The study found that specific ratings on the Suicide Status Form (SSF), particularly regarding overall risk, hopelessness, and self-hate, played a crucial role in predicting changes in suicidal thoughts, highlighting the importance of these factors in treatment planning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical improvements of suicidal outpatients: Examining suicide status form responses as predictors and moderators. Jobes, DA., Kahn-Greene, E., Greene, JA., et al.[2015]

The Safety Planning Intervention (SPI) is a structured six-step action plan designed to help individuals at risk of suicide by enhancing their coping strategies and social support, and by removing access to means of self-harm.

Research shows that SPI is highly effective in reducing suicidal behavior, making it a valuable tool in various settings such as emergency rooms and outpatient clinics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[SAFETY PLANNING INTERVENTION FOR SUICIDE PREVENTION]. Perlstein, J., Katzir, N., Lotan, A., et al.[2022]

The Safety Planning Intervention (SPI) is effective in reducing suicidal ideation and behavior, as well as improving depression and treatment engagement among adults experiencing suicide-related distress, based on a systematic review of 26 studies.

The SPI is adaptable and can be delivered in various formats (in-person or online) and as a standalone or combined intervention, making it a flexible tool in suicide prevention practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of the Safety Planning Intervention for Adults Experiencing Suicide-Related Distress: A Systematic Review. Ferguson, M., Rhodes, K., Loughhead, M., et al.[2022]

Safety planning is a crucial intervention for adolescents at risk of suicide, but many do not utilize their plans after leaving psychiatric hospitals, highlighting a need for improved strategies.

The article proposes enhancing safety planning with motivational interviewing techniques to boost adolescents' motivation and confidence in using their safety plans, aiming to reduce the risk of recurrent suicidal crises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing motivation and self-efficacy for safety plan use: Incorporating motivational interviewing strategies in a brief safety planning intervention for adolescents at risk for suicide. Micol, VJ., Prouty, D., Czyz, EK.[2023]

Cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) have been identified as effective psychotherapeutic treatments for individuals who have attempted suicide, based on recent Cochrane reviews and meta-analyses.

Despite the effectiveness of these therapies, the overall impact is small, and there are significant methodological issues in the research, indicating a need for better empirical support and wider dissemination of suicide-specific psychotherapy programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Psychotherapy after a suicide attempt-current evidence and evaluation]. Teismann, T., Gysin-Maillart, A.[2022]

A meta-analysis of 6 studies involving 3536 participants found that safety planning-type interventions (SPTIs) significantly reduce suicidal behavior, with a relative risk of 0.570 compared to control groups, indicating they are effective in preventing suicide attempts.

However, the same analysis showed no significant effect of SPTIs on reducing suicidal ideation, suggesting that while SPTIs are beneficial for preventing actions, additional strategies may be necessary to address thoughts of suicide.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety planning-type interventions for suicide prevention: meta-analysis. Nuij, C., van Ballegooijen, W., de Beurs, D., et al.[2022]

Citations

1. withpower.com withpower.com/trial/phase-suicidal-ideation-2024-72a9c

Single-Session Intervention for Suicidal Thoughts Fortunately, very brief suicide prevention interventions, are effective in reducing future suicide attempts and increasing the likelihood of attending follow-up ...

2. reporter.nih.gov reporter.nih.gov/project-details/10821337

Neural Mechanisms and Predictors of an Ultra-Brief ... Data from the current team indicates that a single session of crisis response planning (CRP) reduces suicide behavior by 76%; however, it is unknown how CRP ...

3. centerwatch.com centerwatch.com/clinical-trials/listings/NCT05816317/randomized-controlled-trial-of-a-single-session-mechanism-focused-intervention-for-suicidal-thoughts-and-behaviors?page=5&id=894&slug=suicide

Randomized Controlled Trial of a Single-session ... Additionally, single-session interventions (not suicide specific) have been shown to reduce hopelessness immediately and at a one-month follow- ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S2215036624003997

Underlying mechanisms and efficacy of a suicide-focused ... We aimed to test both the underlying mechanisms and efficacy of a suicide-focused therapy, cognitive behavioural suicide prevention for psychosis (CBSPp).

5. researchgate.net researchgate.net/publication/364682934_Therapeutic_Mechanism_and_Effectiveness_of_the_Single-Session_Suicide_Crisis_Intervention_yicidanyuanzishaweijichuyudezhiliaojizhiheyouxiaoxing

Therapeutic Mechanism and Effectiveness of the Single- ... Research has shown that single-session suicide interventions can effectively reduce suicide risk. The objective of this study was to develop a ...

6. reporter.nih.gov reporter.nih.gov/project-details/11141246

Suicide Care Research Center - NIH RePORTER Randomized controlled trial of a single-session mechanism-focused intervention for suicidal thoughts and behaviors. 743, 5F31MH135623-02Project Numberf.

7. researchgate.net researchgate.net/publication/355141519_An_online_single-session_intervention_for_adolescent_self-injurious_thoughts_and_behaviors_Results_from_a_randomized_trial

An online, single-session intervention for adolescent self ... The main outcomes were suicide, suicide attempts, suicidal ideation, depression and hospitalization. ... An online, single-session intervention ...