Online Learning Module for Parents of Suicidal Youth

(SAFETY-P Trial)

Overseen By Anastasia Berg, M.Ed.

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Jennifer Hughes

Disqualifiers: Acute psychiatric, Medical condition, others

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

Compensation: Varies

Number of Visits: 6

65 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Safe Alternatives for Teens and Youth - Parent (SAFETY-P)?

The SAFETY Program, which is similar to SAFETY-P, showed significant improvements in reducing suicidal behavior, hopelessness, and depression in both youths and parents, as well as better social adjustment for youths. This suggests that SAFETY-P may also be effective in helping suicidal youth and their families. ^{1 2 3 4 5}

Is the Online Learning Module for Parents of Suicidal Youth safe for participants?

The research on similar programs, like SAFETY and online gatekeeper training, suggests they are generally safe and not distressing for participants. Most parents found the training acceptable and beneficial, with no significant reports of distress. ^{6 7 8 9 10}

How does the online learning module for parents of suicidal youth differ from other treatments?

This online learning module is unique because it focuses on educating parents about reducing access to lethal means, which is a crucial but often overlooked aspect of suicide prevention. It provides a user-friendly, web-based decision aid to support parents in making informed decisions about safety planning and lethal means counseling, which is not typically addressed in standard treatments. ^{6 9 11 12 13}

What is the purpose of this trial?

This project aims to adapt the parent component of Safe Alternatives for Teens and Youth (SAFETY) outpatient intervention to SAFETY-Parent (SAFETY-P), a self-paced interactive learning module for parents, to be implemented as an augmentation for youth being seen for suicidal ideation, suicidal behavior, or recent suicide attempts across multiple settings at Nationwide Children's Hospital (NCH, Columbus, Ohio).

Research Team

Jennifer L Hughes, PhD, MPH

Principal Investigator

Nationwide Children's Hospital

Eligibility Criteria

This trial is for parents of young individuals who are dealing with suicidal thoughts, behaviors, or have recently attempted suicide. It's specifically designed to support these parents as they navigate their child's challenges.

Inclusion Criteria

I am under 25 and have thought about or attempted suicide, or I am a parent or provider of a child who has.

Exclusion Criteria

For Phase 2 and Phase 3 participants: The youth or parent has an acute psychiatric or medical condition that would interfere with their ability to participate in study procedures; Lack of access to a digital device (smartphone, iPad, tablet computer, desktop, laptop PC)

Timeline

Intervention Adaptation for Online Delivery

Participants are screened for eligibility to participate in the trial

4 weeks

4 stakeholder focus groups

Case Series Iterative Adaptation

Pilot testing of SAFETY-P with a nonrandomized case series of 5 clinicians and 10 families

1 month

Participants use SAFETY-P for up to one month

Pilot RCT of SAFETY-P

Conduct a pilot RCT with N=30 youth and parents, randomized to SAFETY-P + TAU or TAU alone

3 months

Measures at baseline, 1 month, and 3 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Follow-up measures at 1 and 3 months

Treatment Details

Interventions

• Safe Alternatives for Teens and Youth - Parent (SAFETY-P)

Trial Overview The SAFETY-Parent (SAFETY-P) program, an online learning module for parents, is being tested. It aims to augment existing treatments for suicidal youth by providing additional support and resources to their parents.

Participant Groups

Group I: Treatment As Usual (TAU) Experimental Treatment 1 Intervention

Phase 3 will include an RCT with N = 30 youth and parents, with half randomized treatment as usual (TAU). Participants will complete measures at baseline, 1 month, and 3 months.

Group II: Safe Alternatives for Teens and Youth - Parent (SAFETY-P) + Treatment as Usual (TAU) Experimental Treatment 2 Interventions

Phase 2 will include pilot testing of the SAFETY-P asynchronous parent intervention module with a nonrandomized case series of 10 families receiving services in CATC. Participants will be provided with the SAFETY-P modules and complete follow-up measures after one month. Phase 3 will include an RCT with N = 30 youth and parents, with half randomized to SAFETY-P + treatment as usual (TAU). Participants will complete measures at baseline, 1 month, and 3 months.

Who Is Running the Clinical Trial?

Jennifer Hughes

Lead Sponsor

Trials

2

Recruited

250+

American Foundation for Suicide Prevention

Collaborator

Trials

36

Recruited

10,500+

Findings from Research

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]

The LINC to LIFE Safety Planning (L2L SP) training program, which lasts 150 minutes, significantly improved mental health providers' knowledge, perceived behavioral control (PBC), and intentions regarding safety planning for suicidal clients immediately after the training.

At a six-month follow-up, improvements in attitudes, PBC, and emotional responses were noted, suggesting that the training has lasting benefits, although declines in knowledge indicate a need for refresher sessions to maintain effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

LINC to Life: Evaluation of a Safety Planning Training Program with Clinicians and Mental Health Staff. Bender, AM., Schuck, A., Peterson, AL., et al.[2022]

The pilot study involving 66 adolescents showed that the ASAP intervention, which includes a smartphone app for emotion regulation, did not significantly reduce suicide attempts post-discharge, but indicated a trend towards fewer attempts (16% vs. 31%).

Participants with a history of previous suicide attempts may benefit more from the ASAP intervention, suggesting that this program could be tailored for those at higher risk, and overall, the intervention and app were well-received by users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents. Kennard, BD., Goldstein, T., Foxwell, AA., et al.[2023]

A 1-hour virtual training significantly improved clinicians' knowledge and self-efficacy in using electronic safety plans for suicide prevention, with lasting effects observed at a 6-month follow-up.

Among clinicians working with suicidal youth, 81% attempted to use the electronic safety plan template, and 63% completed it, indicating that this training can enhance the implementation of safety planning in community settings despite some challenges like technology issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a Virtual Suicide Safety Planning Training on Clinician Knowledge, Self-Efficacy, and Use of Safety Plans in Community Mental Health Clinics. Whitmyre, ED., Esposito-Smythers, C., Goldberg, DG., et al.[2023]

The SAFETY-A intervention significantly improved treatment linkage rates for racial-ethnic minority youths after emergency department treatment for suicidal episodes, compared to those receiving enhanced usual care.

This study involved 105 participants and suggests that SAFETY-A is an effective approach to promote mental health equity and continuity of care for at-risk youths.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Care Linkage for Racial-Ethnic Minority Youths Receiving Emergency Department Treatment for Suicidality: SAFETY-A. Kodish, T., Lau, AS., Belin, TR., et al.[2023]

The SAFETY program, a cognitive-behavioral and family-focused treatment, significantly reduced the likelihood of suicide attempts in adolescents aged 12-18 who had recently engaged in self-harm, with a 100% survival rate without attempts in the SAFETY group compared to 67% in the control group at the 3-month follow-up.

This study, involving a randomized controlled trial, is the second to show that combining cognitive-behavioral therapy with family involvement can effectively protect high-risk youths from suicide attempts, highlighting the importance of family support in treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-Behavioral Family Treatment for Suicide Attempt Prevention: A Randomized Controlled Trial. Asarnow, JR., Hughes, JL., Babeva, KN., et al.[2023]

Safety planning, including lethal means safety (LMS) counseling, is crucial for reducing suicide and violence risk by helping at-risk patients make safer firearm storage decisions.

The article provides a framework and evidence for effectively delivering LMS counseling, emphasizing the importance of individualized safety recommendations and proper documentation of these discussions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Therapeutic Risk Management and Firearm-related Lethal Means Safety. Simonetti, JA., Wortzel, HS., Matarazzo, BB.[2023]

References

1. United States 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. [2023]

2. England pubmed.ncbi.nlm.nih.gov

LINC to Life: Evaluation of a Safety Planning Training Program with Clinicians and Mental Health Staff. [2022]

3. England pubmed.ncbi.nlm.nih.gov

The SAFETY Program: a treatment-development trial of a cognitive-behavioral family treatment for adolescent suicide attempters. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Impact of a Virtual Suicide Safety Planning Training on Clinician Knowledge, Self-Efficacy, and Use of Safety Plans in Community Mental Health Clinics. [2023]

6. Switzerland pubmed.ncbi.nlm.nih.gov

"Lock and Protect": Development of a Digital Decision Aid to Support Lethal Means Counseling in Parents of Suicidal Youth. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Improving Care Linkage for Racial-Ethnic Minority Youths Receiving Emergency Department Treatment for Suicidality: SAFETY-A. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Cognitive-Behavioral Family Treatment for Suicide Attempt Prevention: A Randomized Controlled Trial. [2023]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Parent Education for Responding to and Supporting Youth with Suicidal Thoughts (PERSYST): An Evaluation of an Online Gatekeeper Training Program with Australian Parents. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Clinician Experience and Attitudes Toward Safety Planning with Adolescents at Risk for Suicide. [2022]

11. Canada pubmed.ncbi.nlm.nih.gov

An Interactive Web-Based Lethal Means Safety Decision Aid for Suicidal Adults (Lock to Live): Pilot Randomized Controlled Trial. [2023]

12. United States pubmed.ncbi.nlm.nih.gov

Helping Parents Cope with Suicide Threats: An Approach Based on Nonviolent Resistance. [2022]

13. United States pubmed.ncbi.nlm.nih.gov

Therapeutic Risk Management and Firearm-related Lethal Means Safety. [2023]