A Text-Based Expressive Writing Program for Adolescents at Risk of Suicide

NCT07479823 | Not Yet Recruiting

• 1 other identifier: HSHH-2026-EW-RCT
• Study Type: interventional
• Target: 160
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to learn if a structured expressive writing program can help reduce suicidal thoughts in adolescents and young adults who have experienced suicidal thoughts, suicide attempts, or self-harm. The study will include participants aged 13 to 24 years who are receiving mental health care or have recently been identified as being at risk for suicide. The main questions the study aims to answer are:

• Does a structured expressive writing program lower suicidal thoughts compared with usual care alone?
• Does the program improve depression, impulsivity, and self-esteem? Researchers will compare participants who receive the expressive writing program together with treatment as usual to participants who receive treatment as usual alone. Participants will:
• Be randomly assigned to one of two groups: a writing program group or a usual care group
• Complete questionnaires about mood, suicidal thoughts, and well-being at the start of the study, after 4 weeks, and after 8 weeks
• If assigned to the writing program group, complete guided writing activities several times per week for 4 weeks. Each writing session will take about 15 to 20 minutes and will focus on understanding emotions, personal experiences, relationships, and meaning in difficult experiences. Researchers will study whether this writing program is a helpful and practical way to support young people who are experiencing suicidal thoughts or emotional distress.

Conditions

Suicidal Ideation; Suicide Risk; Self-Injurious Behavior; Adolescent Mental Health

Keywords

Expressive Writing; Suicide Prevention; Adolescent Suicide; Self-Harm; Youth Mental Health

Outcome Measures

Primary Outcomes (1)

• Change in Suicidal Ideation

  Suicidal ideation will be measured using the Beck Scale for Suicide Ideation (BSSI). The outcome measure is the change in BSSI score between baseline and follow-up assessments.

  Baseline, 4 weeks, and 8 weeks

Secondary Outcomes (5)

• Change in Depressive Symptoms

  Baseline, 4 weeks, and 8 weeks

• Change in Impulsivity

  Baseline, 4 weeks, and 8 weeks

• Change in Self-Esteem

  Baseline, 4 weeks, and 8 weeks

• Change in Alexithymia

  Baseline, 4 weeks, and 8 weeks

• Program Acceptability

  4 weeks

Study Arms (2)

Expressive Writing Intervention plus Treatment as Usual

EXPERIMENTAL

Participants in this group receive a structured expressive writing intervention in addition to treatment as usual.

Behavioral: Structured Expressive Writing Intervention

Treatment as Usual

ACTIVE COMPARATOR

Participants receive treatment as usual, which may include standard mental health care or counseling services.

Behavioral: Treatment as Usual (TAU)

Interventions

Structured Expressive Writing Intervention BEHAVIORAL

A structured expressive writing program in which participants complete guided writing sessions several times per week for four weeks. Each session lasts approximately 15 to 20 minutes and focuses on emotional awareness and personal reflection.

Expressive Writing Intervention plus Treatment as Usual

Treatment as Usual (TAU) BEHAVIORAL

Participants receive the standard mental health care or support services that are normally available during the study period.

Treatment as Usual

Eligibility Criteria

• Age: 13 Years - 24 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Adolescents or young adults aged 13 to 24 years.
• Individuals with a history of suicidal ideation, suicide attempts, or non-suicidal self-injury.
• Individuals currently receiving mental health services or who have been evaluated as having suicide risk within the past 6 months.
• Ability to read and write in Korean.
• For participants under 19 years of age, both participant assent and parental consent are required.

You may not qualify if:

• Individuals requiring immediate psychiatric hospitalization.
• Severe intellectual disability or neurodevelopmental disorder that prevents participation in writing activities.
• Acute psychosis or manic episode that would interfere with participation in the study.
• Participation in another suicide prevention clinical trial during the study period.

Sponsors & Collaborators

• Hallym University Medical Center: lead

MeSH Terms

Conditions

Suicidal Ideation; Self-Injurious Behavior; Suicide Prevention

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Suicide; Behavioral Symptoms; Behavior

Central Study Contacts

Hyun Ju Hong, MD, PhD

CONTACT

82+031-380-1500; honghj88@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Masking is not used in this study because the intervention involves a behavioral expressive writing program. Participants and researchers will be aware of the group assignments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomly assigned in a 1:1 ratio to one of two groups: (1) a structured expressive writing intervention plus treatment as usual (TAU), or (2) treatment as usual (TAU) alone. The intervention group will complete guided expressive writing sessions for 4 weeks, while the control group will receive usual care during the study period.

Study Record Dates

• First Submitted: March 13, 2026
• First Posted: March 18, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): March 1, 2028
• Last Updated: March 18, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share