Preventing Youth Suicide in Primary Care: A Family Model
- Conditions
- Suicide
- Interventions
- Behavioral: Enhanced Usual CareBehavioral: Attachment-Based Family Therapy
- Registration Number
- NCT00604097
- Lead Sponsor
- Children's Hospital of Philadelphia
- Brief Summary
The purpose of the study is to test the efficacy of a brief family therapy (Attachment-Based Family Therapy) for youth presenting in primary care with suicidal ideation and depressed mood.
- Detailed Description
Youth suicide is a serious public health problem and clinical challenge for medical and behavioral health providers, yet few preventive interventions have been tested for this population. This project addresses this deficit by testing the efficacy of a brief family therapy for adolescents presenting with serious risk for suicide in a primary care setting. Several innovations characterize the study. First, patients will be identified and treated directly in the primary care setting. Integrating behavioral health services into primary care may a) reduce burden on physicians by promoting parents as safety monitors, b) increase behavioral health treatment adherence, and c) address many underlying family problems associated with suicide. Second, to identify seriously at risk adolescents, we will assess for severe and persistent suicidal ideation and co-occurring depression. Patients will need to score above clinical cutoffs on both ideation (SIQ-JR \> 31) and depression (BDI-II \>20) at two consecutive appointments (generally within 3 days of each other). Third, treatment will target two of the most critical suicide risk factors: depression and family conflict. Depression is the most consistently associated risk factor for suicide and family conflict is the most common precipitant of completed suicide (20%) and non-fatal suicidal episodes (50%). Fourth, we will use Attachment Based Family Therapy (ABFT; Diamond et al., 2002) as the intervention approach, an efficacious and manualized family therapy model specifically designed for adolescent depression. ABFT has been successful in reducing suicidal ideation, hopelessness, depression, anxiety, and family conflict. Participants will be recruited from the primary care centers at The Children's Hospital of Philadelphia. Eighty-seven percent of patients are African American and 60% are girls. One hundred adolescents will be randomized to 6 to 10 weeks of either ABFT or Enhanced Usual Care (EUC). Patients will be evaluated at baseline 6, 12, 24, and 52 weeks.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 66
- Suicidal ideation (SIQ-JR > 30)
- Moderate depressed mood (BDI-II > 19)
- At least one parent/caregiver willing to participate
- Psychosis
- Mental retardation or other significant cognitive impairment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description 2 Enhanced Usual Care Enhanced Usual Care 1 Attachment-Based Family Therapy Attachment-Based Family Therapy
- Primary Outcome Measures
Name Time Method Suicidal Ideation Questionnaire - JR (SIQ-JR) Baseline, 6 weeks, 12 weels, 24 weeks Beck Depression Inventory - II (BDI-II) Baseline, 6 weeks, 12 weeks, 24 weeks Scale for Suicidal Ideation (SSI) baseline, 6 weeks, 12 weeks, 24 weeks
- Secondary Outcome Measures
Name Time Method Treatment retention 12 weeks Number of treatment sessions attended.
Trial Locations
- Locations (4)
CHOP Adolescent Care Center
🇺🇸Philadelphia, Pennsylvania, United States
CHOP Primary Care Center at Cobb's Creek
🇺🇸Philadelphia, Pennsylvania, United States
CHOP Primary Care Center in South Philadelphia
🇺🇸Philadelphia, Pennsylvania, United States
CHOP University City Primary Care
🇺🇸Philadelphia, Pennsylvania, United States