Safety Planning + Interpersonal Therapy for Suicide Prevention

Recruiting at 6 trial locations

Overseen By Taylor Ryan, MA

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Cognitive delays, Altered mental status, others

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

Compensation: Varies

Number of Visits: 3

Duration: 12 weeks

1000 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores two treatments to help prevent suicide in adolescents. The Stanley Brown Safety Planning Intervention and Follow-up Contacts (SPI+) involves creating a personalized safety plan to manage suicidal thoughts and crises. Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention (IPT-A SCI) is a therapy that aims to improve relationships and reduce depression. The trial seeks to determine which method works better for young people visiting emergency departments due to suicidal thoughts or actions. It is suitable for English or Spanish-speaking teens aged 12-19 who have recently visited the hospital for suicide-related issues and have a phone for follow-up. As an unphased trial, this study offers participants a unique opportunity to contribute to important research that could enhance mental health interventions for adolescents.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these interventions are safe for suicidal adolescents?

Research has shown that both treatments under study are generally safe for teenagers. Previous studies have found the Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention (IPT-A SCI) to be safe, practical, and acceptable. Early results with small groups of teens have been promising, encouraging further research.

The Stanley Brown Safety Planning Intervention (SPI+) is also considered safe. It offers a brief, evidence-based method to lower suicide risk, with structured follow-up to help keep individuals safe. This approach is designed for people who have faced suicidal crises and involves creating personalized safety plans.

Both treatments aim to reduce the risk of suicide and help young people handle crises. While data on negative effects is limited, existing research suggests that both interventions are generally well-tolerated. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments because they offer innovative approaches to suicide prevention in adolescents. Unlike traditional therapies, which often require extended periods to see results, the Ultra-Short Crisis Intervention (IPT-A SCI) is designed to be scalable and flexible, providing quicker support to reduce depressive symptoms and improve interpersonal relationships. The Safety Planning Intervention (SPI+) stands out by empowering at-risk youths with personalized, step-by-step plans to manage suicidal thoughts, including follow-up contacts for ongoing support. These treatments aim to directly address interpersonal issues and crisis management, which are key factors in suicidal behavior among young people.

What evidence suggests that this trial's treatments could be effective for suicide prevention in adolescents?

Research has shown that the Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention (IPT-A SCI), one of the treatments in this trial, is as effective as standard treatments in reducing suicidal thoughts, depression, and anxiety in children and teens. Early study results have been promising in lowering suicidal thoughts and depression in young people.

The Stanley Brown Safety Planning Intervention and Follow-up Contacts (SPI+), another treatment option in this trial, nearly halved the chances of suicidal behavior over six months. It offers a simple, personalized plan with steps to follow during a suicidal crisis, helping to manage and reduce risk. Both treatments provide practical, evidence-based support for at-risk youth. ^{1 2 4 6 7}

Who Is on the Research Team?

Holly C Wilcox, PhD

Principal Investigator

Johns Hopkins Bloomberg School of Public Health

Are You a Good Fit for This Trial?

This trial is for diverse high-risk youth aged 12-19 who have visited acute care for suicide-related concerns or screened positive for suicidal thoughts or attempts in the past month. Participants must have a cell phone and be able to communicate in English or Spanish.

Inclusion Criteria

I've had a recent acute care visit for suicide concerns or scored high on a suicide risk test.

I've had thoughts of suicide or attempted it in the last four weeks.

I have a cell phone that can make calls and receive texts for the next year.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the Stanley Brown Safety Planning Intervention and Follow-up Contacts (SPI+) or Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention (IPT-A SCI) to prevent suicidal crises.

12 weeks

Weekly sessions

Follow-up

Participants are monitored for changes in suicidal behavior, quality of life, anxiety, and depression.

12 months

Assessments at baseline, 3 months, 6 months, and 12 months

What Are the Treatments Tested in This Trial?

Interventions

• Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention (IPT-A SCI)
• Stanley Brown Safety Planning Intervention and Follow-up Contacts (SPI+)

Trial Overview

The study compares two interventions: SPI+, which helps prevent escalation of suicidal crises, and IPT-A SCI, a psychotherapy that teaches skills to avoid such crises and tackles interpersonal issues leading to them. It aims to set future care standards for at-risk youth.

How Is the Trial Designed?

Group I: Ultra-Brief Crisis IPT-A Active Control 1 Intervention

Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention (IPT-A SCI) is a scalable, flexible, and extensively examined mental health treatment developed to reduce depressive symptoms and improve interpersonal functioning, and has been adapted for use in adolescents (IPT-A SCI) and shown to be effective in treating depression and reducing associated suicide risk. Interpersonal problems are often at the core of suicidal thinking and behavior in youths including minority youths.

Group II: Safety Planning Intervention Active Control 1 Intervention

The SPI is a brief, evidence- based intervention that provides people with an individualized set of steps that can be used progressively to both reduce risk and maintain safety when suicide ideation (SI) emerges. Safety plans are developed collaboratively between providers, at risk youth, and family members when possible. Core SPI components include recognizing warning signs of an imminent suicidal crisis (e.g., changes in mood, thoughts or behaviors); using internal coping skills to reduce distress; using people or places in the individual's support network as a means of distraction from SI; reaching out to family or friends to help manage the crisis; contacting health professionals or emergency services; and reducing access to lethal means. SPI+ includes a brief follow-up component post- discharge that includes contacting the patient for a mood and risk check-in; reviewing and revising the safety plan; and facilitating connection with community mental health services.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

Patient-Centered Outcomes Research Institute

Collaborator

Trials

592

Recruited

27,110,000+

Johns Hopkins All Children's Hospital

Collaborator

Trials

47

Recruited

5,009,000+

Children's Hospital of Philadelphia

Collaborator

Trials

749

Recruited

11,400,000+

Columbia University

Collaborator

Trials

1,529

Recruited

2,832,000+

Research Foundation for Mental Hygiene, Inc.

Collaborator

Trials

68

Recruited

21,100+

Reichman University, Israel

Collaborator

Trials

1

Recruited

1,000+

Johns Hopkins All Childrens Hospital

Collaborator

Trials

1

Recruited

1,000+

Childrens Hospital of Philadelphia

Collaborator

Trials

1

Recruited

1,000+

Reichman University

Collaborator

Published Research Related to This Trial

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]

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]

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]

A systematic review of 22 studies found that suicide safety planning (SSP) is effective in reducing suicidal behavior and ideation, highlighting its importance as a suicide prevention strategy.

SSP can be delivered in various formats, including standard, enhanced, and electronically, but more research is needed to explore its impact on mental illness symptoms and resilience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Suicide Safety Planning Interventions: A Systematic Review Informing Occupational Therapy. Marshall, CA., Crowley, P., Carmichael, D., et al.[2023]

Interpersonal psychotherapy (IPT) was successfully integrated into a psychiatry residency program over a 5-year period, highlighting its effectiveness as a brief, evidence-based treatment for acute major depression.

The implementation process not only enhanced the training of residents in evidence-based treatment approaches but also helped convey essential psychotherapy concepts, indicating its value in medical education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing interpersonal psychotherapy in a psychiatry residency training program. Lichtmacher, J., Eisendrath, SJ., Haller, E.[2006]

An ultra-brief acute crisis intervention based on Interpersonal Psychotherapy (IPT) was developed for children and adolescents at risk of suicide, consisting of five weekly sessions and monthly follow-ups over three months.

Preliminary results from a pilot study with 26 adolescents showed promising trends in reducing suicidal ideation, indicating that the intervention is safe, feasible, and acceptable, although further research is needed due to the small sample size.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultra-Brief Crisis IPT-A Based Intervention for Suicidal Children and Adolescents (IPT-A-SCI) Pilot Study Results. Haruvi Catalan, L., Levis Frenk, M., Adini Spigelman, E., et al.[2020]

Over 90% of adolescents recently hospitalized for suicide risk reported having access to their safety plans after discharge, indicating high retention and potential for use during critical periods.

While safety plan use and suicidal ideation both declined over time, the relationship between them varied by sex: girls showed a correlation in changes, while boys' safety plan use decreased regardless of their suicidal ideation changes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety plan use in the daily lives of adolescents after psychiatric hospitalization. May, AM., Al-Dajani, N., Ballard, ED., et al.[2023]

Citations

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A comparative effectiveness trial of a brief suicide crisis intervention based on Interpersonal Psychotherapy for Adolescents (IPT-A-SCI) ...