Individuals with alcohol or drug use problems who are hospitalized for suicide attempt are at high risk for reattempt. This treatment development study adapts a promising outpatient intervention to prevent suicide reattempt in order to administer it during hospitalization to individuals with alcohol and drug use problems, and to test the adapted intervention in a pilot randomized controlled trial.

Inclusion Criteria:

• suicide attempt within one week of hospitalization with acknowledgment of some intent to die using a standard item
• problematic alcohol or drug use as determined by score >8 on Alcohol Use Disorders Identification Test, AUDIT or >3 on the 10-item version of the Drug Abuse Screening Test, DAST-10
• admission to hospital
• residence within 40 miles of Strong Memorial Hospital

Exclusion Criteria:

• under age 18
• treated in ED, CPEP, or observation unit only
• unable to communicate with the researcher in English
• unable to comprehend the nature of the study
• participation untenable from a medical (e.g., intubated), psychiatric (e.g., florid psychosis), or behavioral (e.g., refusing to speak with staff) standpoint
• short hospital length of stay, ruling out administering three sessions of the therapy prior to discharge