Randomized Suicide Prevention Trial Using ASSIP and ACT in Suicide Attempters

NCT07132099 | Recruiting

• 1 other identifier: IR.ARDAKAN.REC.1404.002
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This is a randomized controlled trial that aims to compare the effectiveness of two psychological treatment approaches: the Attempted Suicide Short Intervention Program (ASSIP) and Acceptance and Commitment Therapy (ACT). The study seeks to determine which of these two methods is more effective in reducing suicidal ideation and mental pain in individuals who have recently attempted suicide. In this study, 60 participants with a history of suicide attempts will be randomly assigned to three groups. One group will receive ASSIP in addition to treatment as usual (TAU), the second group will receive ACT alongside TAU, and the third group will be a control group receiving TAU only. The results will be assessed using the Beck Scale for Suicide Ideation (BSSI) and the Orbach \& Mikulincer Mental Pain Scale (OMMP) at three stages: pre-test, post-test, and follow-up. The ultimate goal of this research is to provide valuable insights into the comparative effectiveness of ASSIP and ACT interventions for suicide attempters and to contribute to evidence-based suicide prevention strategies. The findings are expected to inform clinical practice and guide future research in this field.

Conditions

Suicide; Suicide Ideation

Keywords

Attempted Suicide Short Intervention Program; Acceptance and Commitment Therapy; Suicidal Ideation; Mental Pain; Suicide attempt; ASSIP; ACT

Outcome Measures

Primary Outcomes (2)

• Mental Pain

  This measure assesses the intensity of mental pain using the 44-item Orbach \& Mikulincer Mental Pain Scale (OMMP). The scale has nine subscales to measure various aspects of mental pain, including inevitability, lack of control, narcissism/worthlessness, emotional turmoil, numbness, alienation, confusion, social withdrawal, and emptiness (meaninglessness).

  pre-intervention, immediately following the intervention, and at 1-month follow-up

• Suicidal Ideation

  This measure assesses suicidal thoughts, attitudes, and behaviors using the 19-item self-report Beck Scale for Suicide Ideation (BSSI). Each item is rated on a Likert scale from 0 to 2, with a total score ranging from 0 to 38. A score of 0-5 indicates no suicidal ideation, 6-19 suggests the presence of suicidal thoughts, and 20-38 signifies a high level of suicide ideation and planning.

  pre-intervention, immediately following the intervention, and at 1-month follow-up

Study Arms (3)

ASSIP + TAU

EXPERIMENTAL

Participants in this group receive the Attempted Suicide Short Intervention Program (ASSIP) in addition to treatment as usual (TAU).

Behavioral: Attempted Suicide Short Intervention Program (ASSIP); Other: Treatment as Usual (TAU)

ACT + TAU

EXPERIMENTAL

Participants in this group receive Acceptance and Commitment Therapy (ACT) alongside treatment as usual (TAU).

Behavioral: Acceptance and Commitment Therapy (ACT); Other: Treatment as Usual (TAU)

Control Group (TAU only)

OTHER

This control group receives only treatment as usual (TAU).

Other: Treatment as Usual (TAU)

Interventions

Attempted Suicide Short Intervention Program (ASSIP) BEHAVIORAL

This is a brief, structured, patient-centered therapy consisting of three to four face-to-face sessions. Each session typically lasts between 60 to 90 minutes. A fourth session may be added if clinically necessary.

ASSIP + TAU

Acceptance and Commitment Therapy (ACT) BEHAVIORAL

This intervention uses the "ACT for Life" protocol, which is designed to maximize recovery after suicidal crises. It consists of three components delivered over three to six individual sessions. The average number of sessions is four to five, with each session lasting approximately 60 minutes.

ACT + TAU

Treatment as Usual (TAU) OTHER

Treatment as usual (TAU) is not a structured intervention within this study. It may include standard outpatient or inpatient services, pharmacotherapy, or no structured treatment, depending on individual circumstances.

ACT + TAU; ASSIP + TAU; Control Group (TAU only)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Being 18 years of age or older
• Having the ability to read and write
• Providing informed consent to participate in the study
• Having at least one suicide attempt in the past 4 months

You may not qualify if:

• Having a severe psychiatric or physical illness that interferes with the treatment process
• Receiving concurrent structured psychological interventions (other than TAU) that may interfere with the study's treatment process.
• Lack of informed consent to participate in the study
• Substance abuse based on DSM-5 criteria

Sponsors & Collaborators

• Ardakan University: lead

Study Sites (1)

The Imam Hossein District Health Center

Eslamshahr, Tehran Province, Iran

RECRUITING

Related Publications (20)

• Olfson M, Wall M, Wang S, Crystal S, Liu SM, Gerhard T, Blanco C. Short-term Suicide Risk After Psychiatric Hospital Discharge. JAMA Psychiatry. 2016 Nov 1;73(11):1119-1126. doi: 10.1001/jamapsychiatry.2016.2035.

  PMID: 27654151 BACKGROUND

• World Health Organization. (2025). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide

  BACKGROUND

• Shneidman ES. The psychological pain assessment scale. Suicide Life Threat Behav. 1999 Winter;29(4):287-94. No abstract available.

  PMID: 10636323 BACKGROUND

• Shirani Isfahani, N., Mohammadpanah Ardakan, A., & Rezapoor Mirsaaleh, M. (2023). Lived emotional experiences of women who attempt suicide. Journal of Health System Research, 19(4), 325-335. (in Persian)

  BACKGROUND

• Pompili M. On mental pain and suicide risk in modern psychiatry. Ann Gen Psychiatry. 2024 Jan 16;23(1):6. doi: 10.1186/s12991-024-00490-5.

  PMID: 38229110 BACKGROUND

• Mojahedi M, Esmaeili A, Mahdizadeh K, Nakhaei MH, Salehiniya H, Sahranavard S. Trends of suicide attempts and factors related to completed suicide during the years 2014-2019 in South Khorasan province, Iran. Asian J Psychiatr. 2021 Nov;65:102825. doi: 10.1016/j.ajp.2021.102825. Epub 2021 Sep 2.

  PMID: 34562752 BACKGROUND

• Karami, J., Begian Kuleh Marz, M. J., Momeni, Kh., & Elahi, A. (2018). Measurement of psychological pain: Psychometric properties and confirmatory factor analysis of the One-Dimensional Multidimensional Pain Questionnaire (OMMP). Health Psychology, 7(25), 146-172. (in Persian)

  BACKGROUND

• Hosseini, A., Jamshidi, T., Sedghi, S., Jalali, M., & Shamsi, F. (2019). Effectiveness of a suicide prevention training program based on SOS in reducing suicidal ideation and depression in girls. Journal of Nursing and Midwifery, 17(3), 192-203. (in Persian)

  BACKGROUND

• Rizvi A, Harmer B, Saadabadi A. Suicidal Ideation. 2024 Apr 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK565877/

  PMID: 33351435 BACKGROUND

• Gysin-Maillart A, Schwab S, Soravia L, Megert M, Michel K. A Novel Brief Therapy for Patients Who Attempt Suicide: A 24-months Follow-Up Randomized Controlled Study of the Attempted Suicide Short Intervention Program (ASSIP). PLoS Med. 2016 Mar 1;13(3):e1001968. doi: 10.1371/journal.pmed.1001968. eCollection 2016 Mar.

  PMID: 26930055 BACKGROUND

• Feyzollahi S, Narimany M, Mosazadeh T. (2021). Effectiveness of Acceptance and Commitment Therapy on Suicidal Thoughts, Self-concealment and Cognitive Emotion Regulation in Women with Suicidal Thoughts. Rooyesh. 10(2), 69-80. (in Persian)

  BACKGROUND

• Favril L, Yu R, Geddes JR, Fazel S. Individual-level risk factors for suicide mortality in the general population: an umbrella review. Lancet Public Health. 2023 Nov;8(11):e868-e877. doi: 10.1016/S2468-2667(23)00207-4.

  PMID: 37898519 BACKGROUND

• Chung DT, Ryan CJ, Hadzi-Pavlovic D, Singh SP, Stanton C, Large MM. Suicide Rates After Discharge From Psychiatric Facilities: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2017 Jul 1;74(7):694-702. doi: 10.1001/jamapsychiatry.2017.1044.

  PMID: 28564699 BACKGROUND

• Chun HS, Michel K, Lee KU. A Case of Suicide Attempt Treated With Attempted Suicide Short Intervention Program. Psychiatry Investig. 2024 Feb;21(2):216-217. doi: 10.30773/pi.2023.0279. Epub 2024 Jan 24. No abstract available.

  PMID: 38258293 BACKGROUND

• Charvet C, Boutron I, Morvan Y, Le Berre C, Touboul S, Gaillard R, Fried E, Chevance A. How to measure mental pain: a systematic review assessing measures of mental pain. Evid Based Ment Health. 2022 Nov;25(4):e4. doi: 10.1136/ebmental-2021-300350. Epub 2022 Jul 28.

  PMID: 35902215 BACKGROUND

• Cassell EJ. Diagnosing suffering: a perspective. Ann Intern Med. 1999 Oct 5;131(7):531-4. doi: 10.7326/0003-4819-131-7-199910050-00009.

  PMID: 10507963 BACKGROUND

• Barnes, S. M., Smith, G. P., Monteith, L. L., Gerber, H. R., & Bahraini, N. H. (2017). ACT for Life: Using Acceptance and Commitment Therapy to Understand and Prevent Suicide. In U. Kumar (Ed.), Handbook of Suicidal Behaviour, 485-504.

  BACKGROUND

• Barnes, S. M., Borges, L. M., Smith, G. P., Walser, R. D., Forster, J. E., & Bahraini, N. H. (2021). Acceptance and commitment therapy to promote recovery from suicidal crises: A randomized controlled acceptability and feasibility trial of ACT for life. Journal of Contextual Behavioral Science, 20, 35-45.

  BACKGROUND

• Alamdarian, H., Ibrahimi, M., Hadad, A., & Ghasemi, A. (2023). Predicting suicidal tendencies based on self-compassion and psychological flexibility in married women with multiple sclerosis. Journal of Sabzevar University of Medical Sciences, 30(3), 311-301. (in Persian)

  BACKGROUND

• ASSIP. (n.d.). Attempted Suicide Short Intervention Program. http://www.assip.ch/

  BACKGROUND

Related Links

• Official website of the Attempted Suicide Short Intervention Program (ASSIP). This website provides general information and background on the ASSIP protocol used in this study.
• Official website of the World Health Organization (WHO) with information and facts about suicide. This resource provides background statistics and data on suicide, which are referenced in the study's protocol.

MeSH Terms

Conditions

Suicide; Suicidal Ideation; Suicide, Attempted

Interventions

Acceptance and Commitment Therapy; Therapeutics

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Cognitive Behavioral Therapy; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Azadeh Choobforoushzadeh, PhD

  Ardakan University

  STUDY DIRECTOR

• Marjan Fathi, Postdoctoral

  Iran University of Medical Sciences

  STUDY DIRECTOR

Central Study Contacts

Hadiseh Yaghoobi, MA Student

CONTACT

+98 9913338890; yaghoobih98@gmail.com

Azadeh Choobforoushzadeh, PhD

CONTACT

+98 9127025535; azadechoobforoush@ardakan.ac.ir

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Only participants will be unaware of their group assignment.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Researcher, Master of General Psychology Student

Model Details: This study is a randomized controlled trial with three parallel groups. Participants will be randomly assigned to one of these three groups. The first group will receive ASSIP alongside treatment as usual (TAU) , the second group will receive ACT alongside TAU , and the third group (the control group) will receive only TAU. All groups will receive their interventions simultaneously and in parallel for the duration of the study.

Study Record Dates

• First Submitted: August 11, 2025
• First Posted: August 20, 2025
• Study Start: August 1, 2025
• Primary Completion: September 21, 2025
• Study Completion: October 1, 2025
• Last Updated: August 20, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

IR (1)