Diamond 2014.

Study name	Family Therapy as Hospital Aftercare for Adolescent Suicide Attempters. Trial Registration Number: NCT01195740.
Methods	Allocation: randomised. Design: single‐centre (mental health inpatient unit). Setting: community. Follow‐up period: 16 weeks. Location: Philadelphia, USA.
Participants	Male and female adolescents between 12 and 17 years of age, who made at least one suicide attempt in the previous month were included in this trial. Preliminary results suggest 80% of participants were female, 65% were of African‐American ethnicity.
Interventions	Participants randomised to the experimental group received attachment based family therapy alongside enhanced usual care. Enhanced usual care is a facilitated referral process with ongoing clinical monitoring. Each adolescent's treating therapist was ultimately responsible for engaging and retaining the adolescent and their family with treatment.
Outcomes	Primary outcome: scores on the Client Satisfaction Questionnaire and the Cornell Services Index measured at 16 weeks post‐treatment. Secondary Outcomes: scores on various measures of attachment with parents (e.g., the Relatedness Scale and the Relationship Structures Questionnaire), and scores on the Lethality of Suicide Attempt Rating Scale at 16 weeks post‐treatment. Information on future suicide attempts and scores on the Beck Depression Inventory, the Suicide Ideation Questionnaire, the Columbia Suicide‐Severity Scale, and the Suicide Intent Scale were also collected.
Starting date	April, 2009. End date: May, 2011.
Contact information	Name: Dr. Guy S. Diamond (PI). Affiliation: Drexel University. email:gd342@drexel.edu
Notes	Dr. Suzanne Levy and Dr. Guy Diamond very kindly provided unpublished information relating to this trial. Additionally, Dr. Levy provided the following notes pertaining to the findings of this study: "In 2011, we completed a pilot study testing the feasibility, acceptability and outcomes of Attachment‐Based Family Therapy (ABFT; Diamond et. al, 2002) as an aftercare model. We aimed to build on the gains made during inpatient treatment and reduce risk factors for future suicide attempt. Additionally, we sought to strengthen our partnership with an adolescent inpatient unit, creating an infrastructure for long‐term collaboration in suicide research. Twenty adolescents (80% female, 65% identified as African American), with mean age of 14.9 years, and a parent/caregiver were recruited from inpatient care following a suicide attempt. Of the parents, 8 (40%) had an income under $30,000, 14 (70%) were single or separated/divorced, and 7 (35%) had no more than a high school education. Families were randomised to 16 weeks of either ABFT or Enhanced Usual Care (EUC). As a result of variety of means to build a relationship with a local psychiatric hospital (meeting with hospital staff, holding case conferences, quick response time to referrals [intake within 48 hours of discharge], follow‐up post referral, and hosting free educational presentations) we were able to successfully join with the hospital and create a lasting research infrastructure to support future research projects. ABFT was a welcomed option by all of the social workers, nurses, and psychiatrists on the inpatient unit. In terms of feasibility, we met our recruitment goals, the majority of families were interested in receiving family therapy (74% of those referred) and those that got ABFT attended sessions regularly (mean = 11.2 sessions). Additionally, we were able to collect weekly data from participants the majority of the time and collect post treatment data from 90% of the participants. Participants receiving ABFT indicated they were marginally statistically significantly more satisfied with treatment than those receiving EUC (t(12)=2.02, p=0.07). Related to effectiveness, results show that compared to EUC, ABFT was marginally significantly more effective at preventing future suicide attempts (0% ABFT, 16.7% EUC Chi(1)=3.60, p=0.058; Fisher’s exact p=0.206), reducing attachment related avoidance for mothers (F(1,9)=3.85, p=0.08), and ABFT participants received treatment faster than EUC participants (t(6)=‐2.09, p=.08). Additionally, ABFT compared to EUC, was statistically more effective at reducing attachment related anxiety for fathers (F(1,3)=12.33, p=0.04). Overall, the results of this study demonstrate that ABFT is both a feasible and acceptable treatment as aftercare for youth with a suicide attempt after discharge from inpatient care."