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| ID | Type | Description | Link |
|---|---|---|---|
| 1R01MH097703-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute of Mental Health (NIMH) | NIH |
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This study will identify the effectiveness of an intensive treatment program for teens who are at high risk for harming themselves.
Suicidal ideation and behavior are the primary reasons for emergency psychiatric care and inpatient psychiatric hospitalization in this country. These expensive contacts with the health care system effectively address acute suicidality for many adolescents but there is a significant subset of suicidal patients that have continued suicidality. This study will target teens that are at risk for re-hospitalization based on continued suicidal ideation, their mood and another risk factor such as self-harm or substance use. These risk factors have been shown to increase risk for continued suicidal behavior and expensive contacts with the health care system. This protocol has been designed to determine whether Intensive Cognitive Behavioral Therapy (CBT), which was designed to treat adolescents with a mood disorder, suicidal ideation, and substance use, will result in better treatment outcomes compared to standard care in the community. The Intensive CBT condition will be delivered by a team of two licensed mental health therapists over the course of one year and will work with both the teen and parent. The standard care condition will receive treatment in the community. One hundred-and fifty adolescents (38 a year) will be recruited from several inpatient and partial hospital locations. Each adolescent will receive a thorough baseline assessment to determine whether they are appropriate for the study and will be assigned to either the Intensive CBT condition or treatment within the community. Both groups of teens will receive follow-up assessments at 6, 12, and 18 months to identify how they are doing over time.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intensive Outpatient CBT | Experimental | Intensive CBT for both parents and adolescents as well as family sessions to increase communication. |
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| Standard Care | Active Comparator | Standard Treatment in the Community |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intensive Outpatient CBT | Behavioral | Sessions will be delivered 1-2 times a week for the first 4-6 weeks, based on need, and then weekly until 6 months. Therapy can continue up until one year. |
| Measure | Description | Time Frame |
|---|---|---|
| Suicide attempts | Self-report by parents or teens of a suicide attempt occurring in the follow-up period | Measured at 18 months from Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Depressed mood as assessed by the Children's Depression Rating Scale - Revised | Depressed mood as determined by clinical interview | Measured at 18 months from Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Other self harm behaviors including Nonsuicidal self-injury (NSSI) substance abuse | Self report of behaviors considered self-harming including self-inflicted behaviors such as cutting with no suicidal intent or excessive substance use with negative consequences to the individual | Measures 18 months from Baseline |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anthony Spirito, PhD | Brown University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Brown University | Providence | Rhode Island | 02912 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31328281 | Derived | Esposito-Smythers C, Wolff JC, Liu RT, Hunt JI, Adams L, Kim K, Frazier EA, Yen S, Dickstein DP, Spirito A. Family-focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co-occurring risk factors: a randomized trial. J Child Psychol Psychiatry. 2019 Oct;60(10):1133-1141. doi: 10.1111/jcpp.13095. Epub 2019 Jul 21. |
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| ID | Term |
|---|---|
| D003863 | Depression |
| D013405 | Suicide |
| D013406 | Suicide, Attempted |
| D059020 | Suicidal Ideation |
| D019966 | Substance-Related Disorders |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D016728 | Self-Injurious Behavior |
| D064419 | Chemically-Induced Disorders |
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| ID | Term |
|---|---|
| D059039 | Standard of Care |
| D013812 | Therapeutics |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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| Standard Care | Behavioral | Treatment at step-down facilities |
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| D001523 |
| Mental Disorders |