Family Therapy as Hospital Aftercare for Adolescent Suicide Attempters

NCT01195740 | Completed Phase 2

• 1 other identifier: 08-006296
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Few empirically-based treatment models exist for adolescent suicide attempters post psychiatric hospitalization, despite the fact that managed care has limited the role of hospitalization to stabilization, rather than remission. This study will test the efficacy and initial outcomes of Attachment Based Family Therapy (ABFT) as an aftercare model to further gains made in inpatient treatment and reduce risk factors for future suicide attempts.

Conditions

Suicide Ideation; Depression; Family Conflict

Keywords

Suicide Ideation; Depression; Family Conflict

Outcome Measures

Primary Outcomes (2)

• Client Satisfaction Questionnaire (CSQ)

  The CSQ is a 31 item questionnaire with responses on a 4-point scale. There are no subscales, and a total score is computed by summing scores across items. Higher scores indicate higher levels of satisfaction. In a variety of studies, the CSQ has demonstrated good internal consistency and predictive validity and has been reviewed favorably by several independent sources (Attkisson \& Greenfield, 1994; Ogles et al., 2002). The CSQ has 8 items, and takes approximately 5 minutes to complete

  14 weeks

• Cornell Services Index (CSI)

  The CSI is a self-report measure of medical and psychological services received (treatment utilization). We will complete information on type of provider, site of service, time to first session, and frequency of service, psychiatric assessments, pharmacotherapy, and individual and family therapy. The Cornell Services Index has been found to have good test-retest and interrater reliability. The Cornell has 32 items, and takes approximately 10 minutes to complete.

  baseline, 14 weeks

Secondary Outcomes (7)

• Beck Depression Inventory (BDI)

  baseline, weekly, 14 weeks

• Relatedness Scale (RS)

  baseline, 14 weeks

• Relationship Structures Questionnaire (RSQ)

  Baseline, 14 weeks

• Suicide Ideation Questionnaire (SIQ-JR)

  baseline, weekly, 14 weeks

• Columbia Suicide-Severity Scale (C-SSRS)

  baseline, 14 weeks (if attempt made during treatment)

Study Arms (2)

Attachment Based Family Therapy

EXPERIMENTAL

Behavioral: Attachment Based Family Therapy

Enhanced Usual Care

ACTIVE COMPARATOR

Behavioral: Enhanced Usual Care

Interventions

Attachment Based Family Therapy BEHAVIORAL

ABFT has three phases. In phase one, treatment focuses on helping the adolescent identify past and present family conflicts that have strained the attachment bond and damaged trust. Adolescents and parents are taught new communication and affect regulation skills in preparation for reparative conversations in phase two. This phase of treatment involves adolescents and parents discussing these past and present conflicts using their new communication skills. The final phase of treatment focuses on promoting adolescent autonomy (i.e., improving school productivity, finding a job, etc.). For the suicidal/depressed adolescent, this can decrease isolation and increase exposure to positive experiences. To accomplish these goals, there are five ABFT treatment tasks. Each task may take one or several sessions. Youth randomized to this condition will receive approximately 14 weeks of ABFT. One orientation meeting will occur, whenever possible, on the inpatient unit prior to discharge.

Also known as: Attached Based Family Therapy, ABFT

Attachment Based Family Therapy

Enhanced Usual Care BEHAVIORAL

Belmont offers the Therapeutic Bridge Program, funded by the Pew Charitable Trusts, which helps adolescents make the transition from the hospital back to home, school and community behavioral health services. The program serves as a "bridge" between inpatient and outpatient care during the first 90 days after discharge, linking them to supportive services. Aftercare begins at the point of intake. Several discharge planning meetings are held with the adolescent and parents during the inpatient stay. The range of services are based on the patient and families' need, and may include meeting with school personnel , conducting home visits or making referrals to other community services agencies. The main objective is to secure outpatient mental health services for the patient. These services will be enhanced by the weekly research tracking, assessment and 24-hour crisis phone line which will call into a cell phone rotated among the licensed mental health professionals on the research team.

Enhanced Usual Care

Eligibility Criteria

• Age: 12 Years - 17 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• in inpatient mental health treatment
• report a suicide attempt in the past month
• have a primary caretaker willing to participate in aftercare
• are able to travel to CHOP
• have no history of psychosis or low intellectual capacity
• speak adequate English.

You may not qualify if:

• being discharged to a residential placement

Sponsors & Collaborators

• Children's Hospital of Philadelphia: lead
• American Foundation for Suicide Prevention: collaborator

Study Sites (1)

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (2)

• Diamond GS, Levy S. Bindungsorientierte Familientherapie als ambulante Nachsoge fur Jugendliche nach Suizidversuch. Psychotherapie im Dialog 13: 41-45, 2012.

  RESULT

• Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, Hawton K. Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev. 2021 Mar 7;3(3):CD013667. doi: 10.1002/14651858.CD013667.pub2.

  PMID: 33677832 DERIVED

MeSH Terms

Conditions

Depression

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior

Study Officials

• Guy S. Diamond, PhD

  Children's Hospital of Philadelphia

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 3, 2010
• First Posted: September 6, 2010
• Study Start: July 1, 2008
• Primary Completion: November 1, 2011
• Study Completion: November 1, 2011
• Last Updated: December 17, 2012

Record last verified: 2012-12

Locations

US (1)