CBT + Support Team for Suicide Prevention

Recruiting at 1 trial location

Overseen By Christina Magness

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Agitation, Psychosis, Cognitive impairment, others

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

Compensation: Varies

Number of Visits: 18

Duration: 12 weeks

36 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new approach to prevent suicide in Black teens who visit an emergency department with suicidal thoughts or behaviors. It combines Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP), which includes 12 therapy sessions, with a support team of caring adults chosen by the teen. The goal is to determine if this combination is both practical and beneficial for participants. Teens who identify as Black, have experienced suicidal thoughts or behaviors, and can provide an emergency contact may be suitable for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could shape future interventions for Black teens facing similar challenges.

Do I need to stop my current medications to join the trial?

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

What prior data suggests that this combination of interventions is safe for Black adolescents with suicidal thoughts or behaviors?

Research has shown that Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) is a safe and effective method. It reduces suicidal thoughts and attempts, and participants in these studies often go longer without self-harm. This suggests that CBT-SP is generally well-received and can help manage suicidal thoughts.

The Youth-Nominated Support Team (YST) intervention provides additional support. Research indicates it can lower the risk of death in suicidal teenagers. Most participants remain engaged with the program, demonstrating its acceptability and manageability for many.

Both treatments have shown promising results in reducing suicidal behaviors and improving safety for participants. Together, these approaches aim to offer comprehensive support and care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the CBT-SP treatment for suicide prevention because it combines Cognitive Behavioral Therapy with a Youth-Nominated Support Team. Unlike traditional options like medication or standard talk therapy, this approach specifically targets the thought patterns and behaviors associated with suicide risk. The integration of a support team adds a community-based element that can enhance engagement and provide real-world support, potentially leading to more effective and lasting outcomes. This dual approach aims to not only address the immediate mental health needs but also build a supportive environment for ongoing recovery.

What evidence suggests that CBT-SP and eYST could be effective for suicide prevention?

Research has shown that Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) can reduce self-harm and delay its recurrence. Studies have found it significantly lowers suicide attempts and offers short-term benefits in reducing suicidal thoughts. The Youth-Nominated Support Team (YST) intervention, designed to help suicidal teens by creating a support network, has been linked to lower death rates. In this trial, participants will receive a combination of CBT-SP and YST, aiming to provide both therapy and social support, potentially enhancing their effectiveness in preventing suicide among teens. The evidence supporting both treatments is promising and suggests they may work well together. ^{1 2 4 6 7}

Who Is on the Research Team?

Cynthia Ewell Foster, PhD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for Black adolescents who visit an urban emergency department with suicidal thoughts or behaviors. They will receive a combination of Cognitive Behavioral Therapy and support from nominated adults in their lives, aiming to improve mental health outcomes.

Inclusion Criteria

Patients that are able to provide at least one verifiable contact for emergency or tracking purposes

Eligible for care at MiSide

Present to the ED with suicide risk (per protocol)

Exclusion Criteria

Actively engaged in specialty mental health treatment

Do not have a parent/legal guardian available to provide consent

Do not understand written and spoken English

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) and engage with the Youth-Nominated Support Team (eYST) over 12 sessions

12 weeks

12 sessions (in-person)

Follow-up

Participants are monitored for feasibility and acceptability of the intervention

2 weeks

Assessments at 6 weeks and 14 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP)
• Youth-Nominated Support Team

Trial Overview

The study tests the integration of Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) with a computer-assisted Youth-Nominated Support Team (eYST). Participants undergo 12 therapy sessions and nominate up to four adults as support persons, who are educated on how to assist.

How Is the Trial Designed?

Group I: CBT for Suicide Prevention and the Youth-Nominated Support Team Experimental Treatment 2 Interventions

Participation will be 3 months.

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Children's Hospital of Michigan

Collaborator

Trials

26

Recruited

4,200+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

MiSide

Collaborator

Published Research Related to This Trial

A manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) was developed and tested on 110 adolescents aged 13 to 19 who recently attempted suicide, focusing on risk reduction and relapse prevention.

The therapy was well-received, with 72.4% of participants completing 12 or more sessions, indicating its feasibility for preventing recurrence of suicidal behavior in this high-risk group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability. Stanley, B., Brown, G., Brent, DA., et al.[2022]

The study involved 147 patients who had previously attempted suicide, and after a 6-session cognitive-based psychotherapy intervention over four months, there was a notable reduction in the odds of further suicide attempts and an increase in outpatient visits, although these results were not statistically significant.

While the intervention did not significantly lower the risk of subsequent suicide attempts or clinical severity at the 12-month mark, it did improve treatment adherence among patients who had made multiple attempts, suggesting that targeted approaches may be beneficial for specific subgroups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief Cognitive-based Psychosocial Intervention and Case Management for Suicide Attempters Discharged from the Emergency Department in Taipei, Taiwan: A Randomized Controlled Study. Lin, YC., Liu, SI., Chen, SC., et al.[2021]

Cognitive behavior therapy (CBT) and problem-solving therapy (PST) both led to significant improvements in various measures related to hopelessness and suicidal ideation among suicide attempters, indicating their efficacy as treatment options.

Participants receiving CBT and PST reported higher satisfaction levels compared to those receiving treatment as usual (TAU), highlighting the potential benefits of these brief therapies in managing suicidal thoughts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing cognitive behavior therapy, problem solving therapy, and treatment as usual in a high risk population. Stewart, CD., Quinn, A., Plever, S., et al.[2018]

In a study involving 418 adults with suicidal ideation, the internet-based cognitive behavioral therapy (CBT) intervention 'Living with Deadly Thoughts' showed a lower rate of reliable deterioration (7%) compared to an attention control group (14%), indicating it is a safer option for suicide prevention.

The analysis found that initial severity of suicidal thinking was linked to lower odds of deterioration, while other psychological and demographic factors did not significantly affect deterioration rates, reinforcing the safety of internet-based CBT interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rates and Predictors of Deterioration in a Trial of Internet-Delivered Cognitive Behavioral Therapy for Reducing Suicidal Thoughts. Batterham, PJ., Christensen, H., Calear, AL., 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]

Brief cognitive behavioral therapy (BCBT) is projected to prevent 23 to 25 more suicide attempts and 1 to 3 more suicide deaths per 100 patients compared to standard treatment for suicidal US Army soldiers, indicating its efficacy in reducing suicide risk.

BCBT is estimated to save the Department of Defense between $15,000 to $16,630 per patient compared to usual treatment, suggesting it may be a cost-effective intervention for addressing suicide risk among active-duty soldiers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Economic Evaluation of Brief Cognitive Behavioral Therapy vs Treatment as Usual for Suicidal US Army Soldiers. Bernecker, SL., Zuromski, KL., Curry, JC., et al.[2022]

In a study of 108 active duty US Army personnel with PTSD, both group cognitive processing therapy-cognitive only version (CPT-C) and group present-centered therapy (PCT) significantly reduced rates of suicide ideation, with improvements maintained for up to 12 months post-treatment.

There were no reported suicide attempts during or after treatment in either group, and exacerbation of preexisting suicide ideation was uncommon, suggesting that group CPT-C is safe and does not increase suicide risk among participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

EVALUATING POTENTIAL IATROGENIC SUICIDE RISK IN TRAUMA-FOCUSED GROUP COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF PTSD IN ACTIVE DUTY MILITARY PERSONNEL. Bryan, CJ., Clemans, TA., Hernandez, AM., et al.[2019]

Cognitive-behavioral therapies (CBTs) significantly reduce suicide behavior, as shown in a systematic review of 28 studies, indicating their efficacy in addressing this serious clinical issue.

The effectiveness of CBT was particularly notable in adult populations and individual treatment formats, but not in adolescents or group settings, suggesting that treatment approaches may need to be tailored for different age groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral interventions to reduce suicide behavior: a systematic review and meta-analysis. Tarrier, N., Taylor, K., Gooding, P.[2022]

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