Table 2.
Authors | Sample Size |
Sample Characteristics |
Setting | Inclusion (In) and Exclusion (Ex) Criteria |
Major Diagnoses |
Outcomes/ Measures |
Treatment Conditions, Dose, and Assessments |
Study Type |
Study Attrition Rate (and Treatment Completion) |
Main Results |
---|---|---|---|---|---|---|---|---|---|---|
Cognitive-Behavioral Therapy (CBT): | ||||||||||
CBT-Individual1 | ||||||||||
Donaldson, Spirito, & Esposito-Smythers (2005) | 39 | 12-17 year- olds; 82% female; 85% Caucasian, 10% Hispanic, 5% African American | Outpatient | In: Presented to ED or inpatient with SA; Ex: Psychosis, severe intellectual impairment |
CUD (45%), DBD (45%), MDD (29%), AUD (19%) | SA (structured follow-up interview; Spirito et al., 1992), SI (SIQ) | T: Skills-Based Treatment (n = 21), C: Supportive Relationship Treatment (n = 18), Dose: Six acute individual sessions and one adjunct family problem-solving session over 3 months + three monthly individual sessions; Assessments: Pre-treatment, F/u 3 and 6 months |
RCT | T: 29%; C: 11%; F/u Total sample: 20% Treatment completion: ≥ 6 sessions: 77%; full treatment: 60% |
Reduced SI for both groups over treatment, but NS between groups; NS for SA |
Taylor et al. (2011)2 | 25 | 12-18 year-olds; gender and ethnicity NR | Outpatient | In: ≥ 1 episode of DSH; Ex: ASD, psychosis, global learning disability, unwillingness to address DSH |
NR | DSH (SHI) | T: Individual Manualized CBT (MCBT) for DSH (n = 25), Dose: 8-12 individual sessions + optional 3-session parent psychoeducation group (M = 6 months); C: None; Assessments: Pre- and post-treatment, F/u 3 months |
Pilot | T: 36% Treatment completion: 64% |
Reduced DSH over treatment and maintained at F/u |
CBT-Individual + CBT-Family | ||||||||||
Brent et al. (2009) | 124 | 12-18 year-olds; 77% female; 67% Caucasian, 19% Hispanic, 13% African American | Outpatient | In: SA within past 90 days, UMD, moderate depressive symptoms; Ex: BP, PDD, SUD, psychosis |
UMD (100%) | SE (SSRS) | T1: CBT for Suicide Prevention (CBT-SP), Dose: acute 12-16 weekly individual sessions and up to 6 family sessions + continuation 6 individual sessions and up to 3 family sessions (n = 17); T2: Medication algorithm (n = 14); T3: Combined CBT-SP + medication (n = 93); Length for all Ts: 6 months; Assessments: Pre-treatment and at 6, 12, 18, and 24 weeks | Non-randomized controlled trial | Total sample Week 12: 23%, Week 18: 30%, Week 24: 33% Treatment completion: T1: 65%, T2: 57%, T3: 71% |
NS for SE |
Esposito-Smythers, Spirito, Uth, & LaChance (2006)2 | 6 | 14-16 year-olds; 83% female; 100% Caucasian | Outpatient | In: Inpatient hospitalization for SA or SI and comorbid AUD or CUD; Ex: SUD other than AUD or CUD, IQ < 70 | 100% AUD/CUD and MDD | SA (NR), SI (SIQ-Sn) | T: CBT for suicide and AUD/CUD (n = 6); Dose: weekly individual sessions for 6 months + biweekly individual sessions for 3 months + monthly individual sessions 3 months + conjoint family sessions as needed; C: None; Assessments: Pre-treatment, 6 and 12 months | Pilot | T: 17% Treatment completion: 83% |
Reduced SI; NS for SA |
CBT-Individual + CBT-Family + Parent Training | ||||||||||
Esposito-Smythers, Spirito, Kahler, Hunt, & Monti (2011)2 | 40 | 13-17 year-olds; 67% female; 89% Caucasian, 14% Hispanic | Outpatient | In: SA in past 3 months or significant SI (≥ 41 on SIQ) and AUD or CUD; Ex: BP, psychosis, current homicidal ideation, SUD other than AUD or CUD, IQ < 70 |
UMD (94%), CUD (83%), AUD (64%), ANX (56%), DBD (50%) | SA (K-SADS-PL), SI (SIQ-Sn) | T: Integrated CBT for AUD/SUD and suicide (n = 20); Dose: Weekly individual and weekly-biweekly parent sessions for 6 months + biweekly individual and biweekly-monthly parent sessions for 3 months + monthly individual and parent monthly as needed for 3 months + conjoint family sessions as needed; C: Enhanced TAU – diagnostic evaluation + community-based TAU (n = 20); Dose: Varied for 12 months; Assessments: Pre-treatment, 3, 6, 12, and 18 months |
RCT | T: 25%, C: 15%; Total sample 3 months: 10%; 6 months: 15%; 12 months: 18%; 18 months: 20%; Treatment completion (24 sessions w/ adolescent and 12 sessions w/ parent): T: 74% adolescents, 74% families, and 90% parents, C: 44% adolescents, 19% families, and 25% parents |
Reduced SA in T compared to C over 18 months; NS for SI |
CBT skills-Group | ||||||||||
Rudd et al. (1996) | 264 | 15-24 year-olds; 18% female; 61% Caucasian, 26% African American, 11% Hispanic |
Partial outpatient | In: Presented with SA, UMD with SI, alcohol abuse with SI; Ex: SUD or chronic abuse, psychosis or thought disorder, severe PD |
MD (72%), AUD (44%) |
SA (measure NR), SI (MSSI) | T: Time-limited CBT group therapy (n = 143), Dose: 9 hours daily for 2 weeks; C: Inpatient and outpatient TAU (n = 121), Dose: Varied combination of individual and group therapy; Assessments: Pre-treatment, F/u 1, 6, 12, 18, and 24 months | RCT | F/u: 1 month: T: 16%, C: 25%, 6 months: T: 47%, C: 54%, 12 months: T: 68%, C: 79% Treatment completion: T: 79% |
Reduced SI for both groups, but NS between groups; not enough SAs to examine group differences |
Dialectical Behavior Therapy (DBT): | ||||||||||
DBT3 | ||||||||||
Fleischhaker et al. (2011)4 | 12 | 13-19 year-olds; 100% female; ethnicity NR | Outpatient | In: NSSI or SA past 4 months, and BPD or ≥ 3 BPD criteria; Ex: AN/BN, SUD, psychosis, severe mood episode requiring inpatient treatment, IQ < 70, illiteracy |
BPD (83%) | NSSI and SA (LPC) | T: DBT (n = 12), Dose: Weekly individual sessions + weekly multifamily skills group (+ regular phone contact as needed) for 16-24 weeks; C: None; Assessments: Pre-treatment, F/u 4 weeks and 1 year post-treatment |
Pilot | F/u T: 0% Treatment completion: 75% |
Reduced NSSI from pre-treatment to F/u 4 weeks post-treatment, F/u 1 year over half still engaging in NSSI; No SAs reported during trial |
James et al. (2008) | 16 | 15-18 year- olds; 100% female; ethnicity NR | Outpatient | In: DSH > 6 months; Ex: ASD, BP, SZ, moderate to severe mental impairment |
BPD (100%) | DSH (unspecified clinical interview) | T: DBT (n = 16), Dose: Weekly individual sessions + weekly skills group + telephone consultation for two 6-month blocks; C: None; Assessment: Pre- and post-treatment, F/u 8 months |
Pilot | T: 13% Treatment completion: (78% of sessions completed, on average) |
Reduced DSH from pre- to post-treatment and F/u |
James, et al. (2011) | 25 | 13-17 year- olds; 88% female; ethnicity NR | Outpatient | In: DSH > 6 months; Ex: ASD, BP, SZ, moderate to severe mental impairment |
BPD (100%) | DSH (unspecified clinical interview) | T: DBT (n = 25), Dose: Weekly individual sessions + weekly skills group + telephone consultation for two 6-month blocks; C: None; Assessments: Pre- and post-treatment |
Pilot | T: 28% Treatment completion: 72% |
Reduced DSH from pre- to post-treatment |
Katz et al. (2004) | 62 | 14-17 year- olds; 84% female; 73% Caucasian | Inpatient | In: Hospitalization for SA or SI; Ex: BP, mental disability, psychosis, severe learning difficulties |
NR |
DSH during treatment (incident reports from nursing staff), DSH at F/u (LPC), SI (SIQ) | T: DBT (n = 32), Dose: 10 daily skills group + twice weekly individual sessions + DBT milieu for 2 weeks; C: Psychodynamic psychotherapy (n = 30), Dose: Daily group sessions + weekly individual sessions + psychodynamic milieu; Assessments: Pre- and post-treatment, F/u 1 year |
Non-randomized controlled trial (treatment assigned by unit) | F/u T: 17%, C: 10% Treatment completion: 100% |
Fewer behavioral incidents (e.g., violence toward self or others-DSH not specified) in T group; Reduced DSH and SI in both groups at F/u, NS differences between groups |
Rathus, & Miller (2002)4 | 111 | 16.1 years old ± 1.2 (T), 15.0 years old ± 1.7 (C); 93% female (T), 73% female (C); 68% Hispanic, 17% African American, 8% Caucasian | Outpatient | In: SA in past 16 weeks or current SI, and BPD or ≥ 3 BPD features; Ex: NR |
UMD (T: 92%, C: 73%), BPD (T: 88%, C: 16%), ANX (T: 40%, C: 21%), SUD (T: 48%, C: 5%) | SA (patient self-report to therapist), SI (HASS and SSI) | T: DBT (n = 29), Dose: Twice weekly individual sessions + multifamily skills group for 12 weeks; C: Psychodynamic or supportive therapy (n = 82), Dose: Twice weekly individual + family sessions for 12 weeks; Assessments: Pre- and post-treatment |
Non-randomized controlled trial (more severe patients assigned to DBT) | Varies for analyses (e.g., 90% T and 50% C completed baseline SSI; 34% T completed pre- and post-treatment measures) Treatment completion (12 weeks): T: 62%, C: 40% |
Reduced SI in T group pre- to post-treatment (not measured in C group; therefore not able to compare between groups); NS for SA |
DBT-Group only | ||||||||||
Perepletchikova et al. (2011) | 11 | 8-11 year- olds; 55% female; 73% Caucasian | School | In: 2nd-6th graders; Ex: NR |
MDD symptoms (55%), ANX symptoms (45%) | SI (MFQ) |
T: DBT group skills (n = 11), Dose: Twice weekly for 6 weeks; C: None; Assessments: Pre- and post-treatment |
Pilot | NR |
Reduced SI from pre- to post- treatment |
Family-Based Therapy (FBT): | ||||||||||
FBT-Attachment | ||||||||||
Diamond et al. (2010) | 66 | 12-17 year-olds; 83% female; 74% African American | Outpatient | In: SI (> 31 on SIQ-Jr) and moderate depression; Ex: Needed psychiatric hospitalization, recent discharge from psychiatric hospital, psychosis, mental retardation or borderline intellectual functioning |
ANX – not specified (67%), ADHD or DBD (58%), MDD (39%) | SI (SIQ-Jr and SSI) | T: Attachment-Based Family Therapy (n = 35), Dose: Weekly sessions for 3 months; C: Enhanced TAU (n = 31); Dose: Varied outpatient treatment with clinical monitoring; Assessments: Pre-treatment, 6 weeks, 12 weeks (post-treatment), and 24 weeks |
RCT | 6 weeks T: 6%, C: 13%; 12 weeks (post-treatment) T: 11%, C: 6%; 24 weeks T: 11%, C: 16%; Treatment completion: ≥ 1 session: T: 91%, C: 68%; ≥ 6 sessions: T: 69%, C: 19%; ≥ 10 sessions: T: 63%, C: 6% |
Reduced SI in T compared to C and maintained at F/u |
FBT-Ecological | ||||||||||
Huey et al. (2004) | 160 | 10-17 year-olds; 35% female; 65% African American, 33% Caucasian | Home (T); Inpatient (C) | In: Hospitalization for SA, SI or SP, homicidal ideation or behavior, psychosis, threat to harm self or others; Medicaid-funded or without health insurance, residing in non-institutional environment; Ex: ASD |
NR | DSH or SA (CBCL); SA (YRBS); SI (BSI and YRBS) | T: Multisystemic Therapy (n = 80), Dose: Daily contact if needed for 3-6 months; C: Inpatient hospitalization (n = 80), Dose: Daily behaviorally-based milieu program; Assessments: Pre-treatment, 4 months, F/u 1 year post-treatment |
RCT | Total sample: 2% Treatment completion: T: 94%; C: 100% |
Reduced SAs from pre- to post-treatment in T compared to C (YRBS only); NS for SI |
FBT-Emergency | ||||||||||
Asarnow et al. (2011) | 181 | 10-18 year-olds; 69% female; 45% Hispanic, 33% Caucasian, 13% African American | ED | In: Presented to ED with SA and/or SI; Ex: Psychosis; symptoms or other factors that interfered with ability to consent |
UMD (40%) | SA (DISC-IV and HASS), SI (HASS) | T: Family Intervention for Suicide Prevention (n = 89), Dose: One family-based CBT session in ED + phone contact 48 hours post-charge and several other times over 1 month; C: Enhanced ED TAU (n = 92), Dose: ED usual care + specialized staff training; Assessments: Pre-treatment, F/u 2 months |
RCT | F/u T: 15%; C: 9% Treatment completion: 100% |
NS between groups for all SITBs outcomes |
Ougrin, Boege, Stahl, Banarsee, & Taylor. (2013)2 | 70 | 12-18 year-olds; 80% female; 53% Caucasian, 20% African American, 11% Asian | ED | In: Recent DSH or DSP but not currently receiving psychiatric services; Ex: gross reality distortion, severe intellectual disability; imminent violence or suicide risk | EMD (60%); DBD (13%) | DSH (Accident and Emergency department reports and patient records) | T: Therapeutic Assessment (n = 35); Dose: 30-minute session using cognitive analytic therapy paradigm with family + assessment as usual (AAU); C: AAU (n = 35); Dose Psychosocial history and risk assessment over 1 hour; Assessments: F/u 2 years | RCT | F/u T: 6%, C: 9% Treatment completion: 100% |
NS between groups for DSH over F/u |
Rotheram-Borus et al. (1996; 2000) | 140 | 12-18 year-olds; 100% female; 88% Hispanic | ED | In: Presented to ED with SA, female gender; Ex: > 1 week psychiatric hospitalization |
UMD (44%), ANX (38%), DBD (24%) | SA (ED records), SI (HASS) | T: Specialized ED Care, Dose: Psychoeducation + family session + staff training (n = 65); C: Standard ED Care (n = 75); Dose: ED evaluation and referral to outpatient therapy; Assessments: Pre- and post-treatment, F/u 3, 6, 12, and 18 months |
Non-randomized controlled trial | F/u Total sample: 8% Treatment completion: 100% |
Greater reduction in SI in T compared to C post-intervention; however, NS between groups for all SITBs outcomes at F/u |
FBT-Parent training only | ||||||||||
Pineda & Dadds (2013) | 48 | 12-17 year-olds; female: 73% (T); 78% (C); Caucasian: 64% (T), 50% (C); Mixed ethnicity: 27% (T) 44% (C) | Outpatient | In: ≥ 1 SITBs past two months; primary ANX or MDD; Ex: PDD or psychosis |
MDD (100%); ANX (38%) | SITBs (combines all DSH and SRB) (ASQ-R) | T: Resourceful Adolescent Parent Program (RAP-P) (n = 24); Dose: Four 2-hour sessions, weekly or biweekly + crisis management and safety planning; C: Routine care (n = 24); Dose: Varied outpatient treatment; Assessments: Pre- and post-treatment, F/u 6 months |
RCT | F/u T: 8%, C: 25% Treatment completion (all four sessions): T and C: 100% |
Reduced SITBs in T compared to C from pre- to post-treatment; reductions maintained at F/u |
FBT-Problem-Focused | ||||||||||
Harrington et al. (1998) | 162 | 10-16 year-olds; 90% female; ethnicity NR | Home (T); Outpatient (C) | In: DSP; Ex: DSH (other than DSP), inability to engage in family intervention, psychiatrist decided participation was contraindicated (e.g., psychosis) |
MDD (67%), CD (10%) | SI (SIQ) | T: Family-based problem solving (n = 85), Dose: Five home sessions + TAU; C: TAU (n = 77), Dose: Varied outpatient treatment; Assessments: Pre-treatment, 2 and 6 months | RCT | Total sample F/u 2 months: 4%, F/u 6 months: 8% Treatment completion: 74% of T intervention sessions attended |
Reduced SI in T compared to C in subset of adolescents without MDD |
Interpersonal Psychotherapy (IPT): | ||||||||||
IPT-Individual | ||||||||||
Tang, Jou, Ko, Huang, & Yen (2009)5 | 73 | 12-18 year-olds; 66% female; ethnicity NR (study conducted in Taiwan) | School | In: Moderate to severe depression, SI, or previous SA, moderate to severe anxiety, or significant hopelessness in the past 2 weeks; Ex: Psychosis, drug abuse, serious medication condition, or severe (e.g., high-lethality) suicidal behaviors |
MDD (100%) | SI (BSS) | T: Intensive Interpersonal Psychotherapy for depressed adolescents with suicide risk (IPT-A-IN) (n = 35), Dose: Two sessions weekly + 30 min. phone follow-up for 6 weeks; C: Psychoeducation + supportive counseling (parent included if needed) (n = 38), Dose: One to two sessions weekly for 6 weeks; Assessments: Pre- and post-treatment | RCT | T: 0%, C: 8% Treatment completion (full 6-week program): T: 100%; C: 92% |
Reduced SI in T compared to C |
Psychodynamic Therapy: | ||||||||||
Psychodynamic therapy-Individual + Family | ||||||||||
Rossouw, & Fonagy (2012) |
80 | 12-17 years old; 85% female; 75% Caucasian, 10% Asian, 7.5% mixed race, 5% African American | Outpatient | In: ≥ 1 DSH episode past month; Ex: AN or BN, PDD, psychosis, severe learning disability (IQ < 65), chemical dependence |
Depressive symptoms (97%), BPD (73%) | DSH (CI-BPD and RTSHI) | T: Mentalization-Based Treatment (MBT-A) for self-harm (n = 40), Dose: Weekly individual + monthly family therapy for 1 year; C: Community-based TAU-varied (n = 40), Dose: 1 year; Assessments: Pre-treatment, 3, 6, and 9 months after randomization, and post-treatment |
RCT | 3 months T: 13%, C: 8%; 6 months T: 3%, C: 10%; 9 months T: 13%, C: 15%; 12 months T: 10%, C: 13% Treatment completion: T: 50%, C: 43% |
Reduced DSH in T compared to C post-treatment (12-month) assessment only |
Combined Skills Group Intervention: | ||||||||||
CBT skills + DBT skills + Psychodynamic therapy skills-Group | ||||||||||
Green et al. (2011) | 366 | 12-17 year-olds; 89% female; 94% Caucasian | Outpatient | In: ≥ 2 DSH episodes past year; Ex: AN, acute psychosis, substantial learning difficulties |
Depressive disorder symptoms (62%), behavioral problems (33%) | DSH (interview validated in Harrington et al., 1998), SI (SIQ) | T: Developmental group psychotherapy (n = 183), Dose: (see Wood et al.) + routine care; C: Routine care only (n = 183), Dose: Varied, but no group therapy; Assessments: Pre-treatment, F/u 6 months and 1 year | RCT | F/u T: 2%, C 2% Treatment completion (≥ 4 sessions): T: 79%, C: 63% |
DSH and SI improvement for both groups, NS differences between groups |
Hazell et al. (2009) | 72 | 12-16 year-olds; 90% female; ethnicity NR | Outpatient | In: ≥ 2 DSH episodes past year, ≥ 1 DSH episode past 3 months; Ex: More intensive treatment required, inability to attend groups, acute psychosis, or intellectual disability |
MDD (57%), DBD (7%), alcohol problems (4%) | DSH (PHI), SI (SIQ) | T: Developmental group psychotherapy (n = 35), Dose: (see Wood et al.) for up to 1 year; C: Routine care (n = 37), Dose: Varied for 1 year; Assessments: Pre-treatment, 8 weeks, 6 months, and 1 year |
RCT | T: 3%, C: 8% Treatment completion (≥ 4 sessions): T: 71%, C: 62% |
Increased DSH in T compared to C at 6 months and 1 year (however, group differences were nonsignificant after controlling for history of medication overdose); NS for SI |
Wood, Trainor, Rothwell, Moore, & Harrington (2001) | 63 | 12-16 year-olds; 78% female; ethnicity NR | Outpatient | In: ≥ 1 DSH episode past year; Ex: Suicide risk too severe for ambulatory care, inability to attend groups, psychosis, significant learning problems |
MDD (84%), DBD (69%) | DSH (interview—see Kerfoot, 1984), SI (SIQ) | T: Developmental group psychotherapy (DGT) + Routine care (n = 32), Dose: Six acute sessions + weekly long-term group as needed for 6 months (Mdn = 8 sessions, Range 0-19) + Routine care as needed; C: Routine care (n = 31), Dose: Family sessions + non-specific counseling as needed (Mdn = 4 sessions, Range 0-30); Assessments: Pre-treatment, 6 weeks, and 7 months |
RCT | F/u 7 months: T: 3%, C: 0% Treatment completion (≥ 4 sessions): T: 72%, C: 61% |
Fewer DSH repeaters (i.e., multiple DSH episodes) in T compared to C and longer time to repeat DSH in T compared to C; NS for SI |
Other intervention techniques: | ||||||||||
Resource interventions-Individual | ||||||||||
Cotgrove, Zirinsky, Black, & Weston (1995) | 105 | 12-16 year-olds; 85% female; ethnicity NR | ED | In: Admitted for DSH, DSP, or SA; Ex: NR |
NR | SA (unspecified psychiatrist questionnaire) | T: Green card for re-admission to the hospital (n = 47); C: Clinic or child psychiatry department TAU (n = 58); Assessments: Pre-treatment and F/u 1 year |
RCT | Total sample: 0% Treatment completion: T: 11% used green card |
NS between group differences in SA |
Deykin, Hsieh, Joshi, & McNamarra (1986)6 | 319 | 13-17 year-olds; female: 68% (Boston), 55% (Brockton); Caucasian: 28% (Boston), 68% (Brockton), African American: 57% (Boston), 4% (Brockton) | Community | In: ED presentation with DSH, SA, or SI; Ex: NR | NR | DSH, SI, SA (physicians' reports and medical chart review) | T: Direct service (advocacy, financial needs, social support) + educational training for providers (n = 172), Dose: NR; C: Hospital TAU (n = 147), Dose: NR; Assessments: Pre-treatment, Continuous F/u 2 years | Non-randomized controlled trial | N/A (incidence of ED visits examined; specific adolescents were not followed over time) | NS for all SITBs outcomes |
Robinson et al. (2012) | 164 | 15-24 year-olds, 65% female; ethnicity NR | Community | In: History DSH or SRB; Ex: Known organic cause for DSH/SRB, intellectual disability |
ANX (63%), MD (67%) |
DSH (SBQ-14), SI (BSS) | T: Post cards promoting well-being and evidence-based skills use + Community-based TAU (n = 81), Dose: Monthly for 12 months; C: Community-based TAU only (n = 83), Dose: 12 months; Assessments: Pre-treatment, F/u 12 and 18 months |
RCT | F/u: 12 months: T: 26% C: 37%; 18 months: T: 38%, C: 55% |
Reduced DSH and SI in both groups, but NS between groups |
Support-based interventions | ||||||||||
King et al. (2006) | 289 | 12-17 year- olds; 68% female; 82% Caucasian | Community | In: Recent psychiatric hospitalization, SI or SA past month, and score of 20 or 30 on CAFAS self-harm subscale; Ex: Psychosis, severe mental disability |
NR | SA (SSBS), SI (SIQ-Jr and SSBS) |
T: Youth-nominated Support Team-I + TAU-varied (n = 151), Dose: Psychoeducation for supports + weekly contact between supports and adolescents + supports contacted by intervention specialists for 6 months; C: TAU-varied (n = 138), Dose: 6 months; Assessments: Pre- and post-treatment |
RCT | T: 24%, C: 13% Treatment completion: T: 76%, C: 87% |
Reduced SI in T compared to C in females only; NS for SA |
King et al. (2009) | 448 | 13-17 year- olds; 71% female; 84% Caucasian | Community | In: Recent psychiatric hospitalization, SI or SA past month; Ex: Severe cognitive impairment, psychosis, medical instability, residential placement, no legal guardian available |
UMD (88%); DBD (42%); ANX (29%); PTSD or acute stress disorder (25%); AUD or SUD (21%) |
SA (DISC-IV), SI (SIQ-Jr) | T: Youth-nominated Support Team-II + TAU-varied (n = 223), Dose: Psychoeducation for supports + weekly contact between supports and adolescents for 3 months; C: TAU-varied (n = 225); Dose: 3 months; Assessments: Pre-treatment, 6 weeks, 3, 6, and 12 months |
RCT | F/u: 6 weeks: 25%, 3 months: 24%, 6 months: 30%, 12 months: 23% Treatment completion (full intervention-two support people for 12 weeks): T: 74% |
Reduced SI in T compared to C in multiple attempters only and at 6-week f/u only; NS for SA |
ED = emergency department; NR = not reported; NS = non-significant; RCT = randomized controlled trial
Major Diagnoses: ADHD = attention deficit disorder; AN = anorexia nervosa; ANX = anxiety disorder–type not specified; ASD = autism spectrum disorder; AUD = alcohol use disorder; BN = bulimia nervosa; BP = bipolar disorder; BPD = borderline personality disorder; CD = conduct disorder; CUD = cannabis use disorder; DBD = disruptive behavior disorder; EMD = emotional disorder; MD = mood disorder (bipolar or unipolar); MDD = major depressive disorder; PD = personality disorder; PDD = pervasive developmental disorder; PTSD = post-traumatic stress disorder; SUD = substance use disorder; SZ = schizophrenia; UMD = unipolar mood disorder
Measures: ASQ-R = Adolescent Suicide Questionnaire Revised; BSI = Brief Symptom Inventory; BSS = Beck Scale for Suicide Ideation; CAFAS = Child and Adolescent Functional Assessment Scale; CBCL = Children Behavior Checklist; CI-BPD= Child Interview for DSM-IV Personality Disorder; DISC-IV = Diagnostic Interview Schedule for Children Version IV; HASS = Harkavy-Asnis Suicide Scale; K-SADS-PL = Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version; LPC = Lifetime Parasuicide Count; MFQ = Mood and Feeling Questionnaire; MSSI = Modified Scale for Suicide Ideation; PHI = Parasuicide History Interview; RTSHI = Risk Taking and Self Harm Inventory; SBQ-14 = Suicide Behavior Questionnaire; SHI = Self Harm Inventory; SIQ (Jr or Sn) = Suicide Ideation Questionnaire (for junior high and senior high school students); SSBS = Spectrum of Suicide Behavior Scale; SSI = Scale for Suicidal Ideation; SSRS = Suicide Severity Rating Scale; YRBS = Youth Risk Behavior Survey
Outcomes: DSH = deliberate self-harm; DSP = deliberate self-poisoning; NSSI = nonsuicidal self-injury; SA = suicide attempt; SE = suicide event (defined by Columbia Classification Algorithm of Suicide Assessment as one or more of the following: completed suicide, attempted suicide, preparatory acts towards imminent suicidal behavior, suicidal behavior, or suicidal ideation); SI = suicide ideation; SITB = self-injurious thought or behavior (suicidal and nonsuicidal); SP = suicide planning or preparation; SRB = suicide-related behavior (suicide thoughts, plans, attempts)
Treatment Conditions: C = control or comparison group; CBT = Cognitive-Behavioral Therapy; DBT = Dialectic Behavior Therapy; F/u = follow-up; T = experimental treatment group; TAU = treatment as usual
The CBT-Individual interventions included optional family components (see each study for the specific dose of optional family therapy offered). However, the authors report these components were infrequently utilized during treatment.
Motivational interviewing (MI) or motivational enhancement techniques incorporated in treatment package.
Although motivational enhancement techniques were not explicitly discussed in these DBT studies, increasing motivation to change is a core component of the DBT package.
DBT group skills delivered in a multifamily group format.
IPT-A-IN was primarily an individual-based intervention. However, one parent of a participant in the IPT group received three family therapy sessions. In addition, parents were included in the TAU supportive counseling sessions if needed.
Deykin et al. (1986) assessed incidence of ED visits over two years at the two sites where the intervention (Boston) and control (Brockton) treatments were employed; that is, specific participants were not followed over time.