Cognitive-Behavioral Family Treatment for Suicide Attempt Prevention: A Randomized Controlled Trial
Abstract
Objective Suicide is a leading cause of death. New data indicate alarming increases in suicide death rates, yet no treatments with replicated efficacy/effectiveness exist for youths with self-harm presentations, a high-risk group for fatal and nonfatal suicide attempts. We addressed this gap by evaluating Safe Alternatives for Teens and Youths (SAFETY), a cognitive-behavioral dialectical behavior therapy-informed family treatment designed to promote safety. Method Randomized controlled trial for adolescents (12–18) with recent (past 3 months) suicide attempts or other self-harm. Youth were randomized to SAFETY or treatment as usual enhanced by parent education and support accessing community treatment (E-TAU). Outcomes were evaluated at baseline, 3 months/end of treatment period, and followed through 6–12 months. The primary outcome was youth-reported incident suicide attempts through the 3-month follow-up. Results Survival analyses indicated a significantly higher probability of survival without a suicide attempt by the 3-month follow-up point among SAFETY youths (1.00, SE 0), compared to E-TAU youths ([0.67, SE 0.14], Z=2.45, p=.02, number needed to treat=3) and for the overall survival curves (Wilcoxon X2 [1]=5.81, p=.02). Sensitivity analyses using parent-report when youth-report was unavailable and conservative assumptions regarding missing data yielded similar results for 3-month outcomes. Conclusion Results support the efficacy of SAFETY for preventing suicide…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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