Spirito 2002.

Study characteristics
Methods	Allocation: randomisation using a random numbers table. Follow‐up period: 3 months. N lost to follow up: 13/76 (17%) for repetition of SH data.
Participants	Inclusion criteria: i) aged 12‐18 years; ii) receiving medical care in either the emergency department or paediatric ward of a children's hospital following a suicide attempt. Exclusion criteria: none stated. Numbers: Of the 76 participants, 36 were allocated to the experimental arm and 40 to the control arm. Profile: 63 (90%) were female. Source of participants: patients presenting to hospital following a suicide attempt. Location: Northeast USA, possibly Providence, RI.
Interventions	Experimental: compliance enhancement intervention plus standard disposition planning involving a single, one‐hour session that reviewed expectations for outpatient treatment as well as addressing the factors likely to impede attendance and treatment misconceptions, and encouraged both the adolescent and parent to make a verbal contract to attend all treatment sessions. Participants were also contacted by telephone at 1, 2, 4, and 8 weeks post‐discharge to review their compliance with treatment. Control: standard disposition planning involving treatment based on judgment of psychiatric clinician who conducted the evaluation. Some participants in both the experimental and control arms had a brief inpatient psychiatric stay prior to receiving outpatient care. The remainder received outpatient care at local mental health centre. Therapist: 3 post‐doctoral fellows in psychology. Type of therapy offered: compliance enhancement. Length of treatment: 8 weeks.
Outcomes	Included: i) repetition of SH according to self‐ and parent‐report, however, only data from self‐report was used; ii) suicide; iii) compliance. Excluded: i) problems concerning therapy sessions.
Notes	Source of funding: "This investigation was supported by NIMH grant MH52411 and by a grant from the van Amerigen Foundation" (p.435). Declaration of author interests: not stated. Other: In two cases a parent reported repetition of SH but the adolescent denied this.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: “Randomly assigned” (p.436) Comment: Correspondence with study authors clarified that the method used was a "random numbers table." Use of a random numbers table is likely to have minimised the role of bias in the generation of the randomisation sequence.
Allocation concealment (selection bias)	Unclear risk	Comment: no details on allocation concealment were provided.
Blinding (performance bias and detection bias) Of participants	High risk	Comment: The nature of this study means that participants could have known to which group they had been allocated.
Blinding (performance bias and detection bias) Of personnel	High risk	Comment: The nature of the study means personnel are likely to have known which participant was receiving which treatment.
Blinding (performance bias and detection bias) Of outcome assessors	Unclear risk	Comment: No details on outcome assessor blinding were provided.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Quote: “Adolescents who refused to participate in the project (n = 6) were compared on age and gender to those who were enrolled. No significant differences were found. In addition, adolescents who were lost to follow‐up (n = 13) were compared to those who remained in the project. There were no significant differences noted on age, gender, race, [socioeconomic status], or any of the baseline psychological measures” (p.437) Comment: Although there was no indication that intention‐to‐treat analyses had been conducted, efforts were clearly made to establish whether results could be affected by attrition bias.
Selective reporting (reporting bias)	Unclear risk	Comment: Data on suicides had to be requested from study authors, suggesting that selective reporting bias may have been present.
Other bias	Low risk	Comment: No apparent other sources of bias.