THRIVE: A Recovery-Focused Suicide Prevention Intervention in Crisis Stabilization Centers

NCT07784634 | Not Yet Recruiting DMC

• 2 other identifiers: IRB-3000168661R01MH145192-01
• Study Type: interventional
• Target: 552
• Locations: 1 country
• Sites: 3

Brief Summary

Suicide is a major public health concern in the United States, with more than 1.4 million adults attempting suicide and nearly 50,000 adults dying by suicide each year. The launch of the national 3-digit 988 Suicide \& Crisis Lifeline in 2022 has strengthened the crisis care system by emphasizing the need for people in crisis to have someone to call, someone to respond, and somewhere to go. Community-based Crisis Stabilization Centers (CSCs) are an important part of the crisis care system, providing short-term crisis stabilization services and an alternative to Emergency Department care. However, suicide risk can remain high after discharge from CSCs, and no brief, effective, recovery-focused interventions are currently available for this setting. This study will evaluate the effectiveness of THRIVE (Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement) in CSCs. THRIVE is a recovery-focused intervention designed for adults receiving care for suicide risk . THRIVE includes one 60-minute psychotherapy group (focused on belonging, giving, meaningful living, and recovery) delivered during the CSC stay and up to six peer-led recovery coaching calls during the weeks following discharge. This multi-site Hybrid Type 1 randomized effectiveness-implementation trial will enroll 552 participants and compare care as usual (CAU) in CSCs to CAU plus THRIVE (CAU + THRIVE). The primary purpose of this study is to determine whether THRIVE reduces suicide risk events (SREs) following CSC discharge, including crisis care re-admissions, escalation to higher levels of care, suicide attempts, and suicide deaths. The study will also examine barriers and facilitators that may influence the adoption and implementation of THRIVE in community-based crisis settings.

Conditions

Behavioral: Care as Usual; Behavioral: Care as Usual + THRIVE

Keywords

THRIVE; Suicide Prevention; Suicide Recovery; Peer Support; Suicide; Suicide Attempts; Treatment Engagement; Treatment Initiatoin; Suicide Risk Events; Meaningful Living; Perceived Burdensomeness; Thwarted Belonging

Outcome Measures

Primary Outcomes (1)

• Total Suicide Risk Events (SREs) per Arm

  Suicide Risk Events (SREs) is the total aggregate number of crisis care contacts for suicide risk (e.g., crisis center re-admissions, care escalations to the emergency department or inpatient units, suicide attempts, suicide deaths) in the 12-months post-discharge. We will include SREs discovered through three sources: 1) Participant follow-up surveys, including the Columbia Suicide Severity Rating Scale; 2) Electronic Health Record data; 3) Claims data. We will apply a pre-set codebook with adjudication rules to determine whether post-discharge SREs are suicide-related or non-suicide related. Each participant will be ascribed one numeric value (e.g., "3"; "12") representing the total number of SREs occurring post-discharge based on all available data . To assess differences in the number of SREs according to arm, a generalized linear model (GLM) will be fit.

  12 Months

Study Arms (2)

Care as Usual + THRIVE

EXPERIMENTAL

Behavioral: THRIVE Toward Hope, Recovery, Interpersonal Growth, Values and Engagement (THRIVE), is a brief, suicide-specific, narrative, recovery-focused, 60 minute group psychotherapy intervention followed by up to 6 peer-led recovery coaching phone calls. THRIVE includes five components: 1) Creating a Safe Space for Disclosure; 2) Psychoeducation on Suicide Recovery; 3) Sharing the Suicide Narrative; 4) Completing the Meaningful Living Plan; 5) Taking Action on the Meaningful Living Plan in the Community. Behavioral: Usual Care Care as Usual in Crisis Stabilization Centers includes medication management, the safety planning Intervention, group psychoeducation, individual counseling, discharge planning, and community referral linkages

Behavioral: Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE); Behavioral: Center Care as Usual

Care as Usual

ACTIVE COMPARATOR

Care as Usual in the Crisis Stabilization Centers includes medication management, the safety planning Intervention, individual counseling, group psychoeducation, discharge planning, and community referral linkages.

Behavioral: Center Care as Usual

Interventions

Center Care as Usual BEHAVIORAL

Care as Usual in the Crisis Stabilization Centers includes medication management, the safety planning Intervention, individual counseling, group psychoeducation, discharge planning, and community referral linkages.

Care as Usual; Care as Usual + THRIVE

Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE) BEHAVIORAL

Toward Hope, Recovery, Interpersonal Growth, Values and Engagement (THRIVE), is a brief, suicide-specific, narrative, recovery-focused, 60 minute group psychotherapy intervention followed by up to 6 peer-led recovery coaching phone calls. THRIVE includes five components: 1) Creating a Safe Space for Disclosure; 2) Psychoeducation on Suicide Recovery; 3) Sharing the Suicide narrative; 4) Completing the Meaningful Living Plan; 5) Taking Action on the Meaningful Living Plan in the Community.

Care as Usual + THRIVE

Eligibility Criteria

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

You may qualify if:

• Admission to CSC with suicidal crisis, as defined by active suicide ideation ascertained by the Columbia Suicide-Severity Rating scale (C-SSRS), which the sites already routinely administer
• Ability and willingness to provide information and permission to contact at least one person in case of emergency or inability to reach the participant for follow-up.

You may not qualify if:

• Under age 18.
• Inability to communicate with the researcher in English.
• Acute psychiatric instability (e.g., psychotic symptoms) prohibiting participation in psychotherapy.

Sponsors & Collaborators

• University of Alabama at Birmingham: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (3)

Wellstone

Huntsville, Alabama, 35802, United States

Location

Connections Health Solutions

Phoenix, Arizona, 85007, United States

Location

Mental Health Cooperative

Nashville, Tennessee, 35756, United States

Location

MeSH Terms

Conditions

Suicide Prevention; Suicide; Suicide, Attempted

Interventions

Salvage Therapy; Nicotine

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Therapeutics; Solanaceous Alkaloids; Alkaloids; Heterocyclic Compounds; Pyridines; Heterocyclic Compounds, 1-Ring

Study Officials

• Jennifer D Lockman, PhD

  University of Alabama at Birmingham

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jennifer D. Lockman, PhD

CONTACT

205-934-7008; jdlockman@uabmc.edu

Fallan Lloyd, B.S.

CONTACT

615-593-6728; fclloyd@uabmc.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 14, 2026
• First Posted: August 25, 2026
• Study Start (Estimated): October 15, 2026
• Primary Completion (Estimated): October 1, 2030
• Study Completion (Estimated): October 1, 2031
• Last Updated: August 25, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP, ICF, ANALYTIC CODE
• Time Frame: De-identified data will be made available for sharing as soon as is possible, no later than at the time of an associated peer-reviewed publication or the end of the grant award period, whichever occurs first. Data will continue to be available following the end of the award period. Individuals may access it by applying.
• Access Criteria: Deidentified data will be deposited into the National Data Archive (NDA) and Open Science Framework (OSF) data repositories, which will restrict access to the data to qualified investigators who request access to the data. NDA and OSF will approve sharing requests at their discretion.

Locations

US (3)