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A Randomized Controlled Trial: Attachment-Based Family and Nondirective Supportive Treatments for Youth Who Are Suicidal
Open accessAbstract
Objective To evaluate the efficacy of attachment-based family therapy (ABFT) compared with a family-enhanced nondirective supportive therapy (FE-NST) for decreasing adolescents' suicide ideation and depressive symptoms.Method A randomized controlled trial of 129 adolescents who are suicidal ages 12- to 18-years-old (49% were African American) were randomized to ABFT (n = 66) or FE-NST (n = 63) for 16 weeks of treatment. Assessments occurred at baseline and 4, 8, 12, and 16 weeks. Trajectory of change and clinical recovery were calculated for suicidal ideation and depressive symptoms.Results There was no significant between-group difference in the rate of change in self-reported ideation (Suicidal Ideation Questionnaire-Jr; F 1,127 = 181, p = .18). Similar results were found for depressive symptoms. However, adolescents receiving ABFT showed a significant decrease in suicide ideation (t 127 = 12.61, p < .0001; effect size, d = 2.24). Adolescents receiving FE-NST showed a similar significant decrease (t 127 = 10.88, p < .0001; effect size, d = 1.93). Response rates (ie, ≥50% decrease in suicide ideation symptoms from baseline) at post-treatment were 69.1% for ABFT versus 62.3% for FE-NST.Conclusion Contrary to expectations, ABFT did not perform better than FE-NST. The 2 treatments produced substantial decreases in suicidal ideation and depressive symptoms that were comparable to or better than those reported in other more intensive, multicomponent treatments. The equivalent outcomes could be attributed to common treatment elements, different active mechanisms, or regression to the mean. Future studies will explore long-term follow up, secondary outcomes, and potential moderators and mediators.Clinical trial registration information Attachment-Based Family Therapy for Suicidal Adolescents; http://clinicaltrials.gov; NCT01537419.
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“Based on previous trials [21, 23], we estimate a 35% dropout rate.”
From The effectiveness and cost-effectiveness of attachment-based family therapy for young adults with high suicidal ideation: protocol of a randomized controlled trial (2024) · cites this paper as [23]
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“Several studies have demonstrated the effectiveness of ABFT for adolescents and young adults at risk for suicide [26–28].”
From Evaluating attachment-based family therapy in residential treatment in the United States: does adolescents' increased attachment security to caregivers lead to decreases in depressive symptoms? (2024) · cites this paper as [27]
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“However, effectiveness studies have shown mixed results on suicidal ideation [21, 23, 28, 29].”
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“For example, two randomized controlled clinical trials in the United States were conducted with samples in which a large percentage of teens (74% in the first trial and 49% in the second trial) identified as Black/African American (48, 62, 63), a group in the United States that has been historically marginalized and very likely to contend with race/ethnicity-related stress and trauma.”
From Combining attachment-based family therapy and cognitive behavioral therapy to improve outcomes for adolescents with anxiety (2023) · cites this paper as [48]
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“Including ABFT in the treatment of adolescent anxiety may be particularly beneficial for adolescents from historically marginalized communities, as ABFT was originally developed with these populations in mind (48–50).”
From Combining attachment-based family therapy and cognitive behavioral therapy to improve outcomes for adolescents with anxiety (2023) · cites this paper as [48]
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Cites
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“In a study of adolescents with major depressive disorder, cognitivebehavioral therapy (CBT) proved more effective than systemic behavior family therapy or NST in decreasing depressive symptoms.(5,11) However, Brent et al.”
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“Second, the 2 treatments were delivered in a highly regarded children’s hospital and university, which engenders the kind of institutional alliance that has often been associated with better outcomes.(43) Testing these treatments in real-world clinical settings might be needed to evaluate their true clinical value.”
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“This compares favorably to a meta-analysis that failed to find significant decreases in suicide attempts when active interventions were compared with TAU.33,34 In the Treatment Study of Adolescent Suicide Attempters (TASA),35 consisting of medication plus CBT plus family, 12% of participants made an attempt within 6 m…”
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“These criteria establish a common clinical presentation and increased risk for suicide attempts.(13,14) Seventh, this study incorporated a diverse racial and ethnic sample, providing a test of the generalizability of treatment effects across race and social class.”
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Evidence Base Update of Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth
Glenn, C. R., Esposito, E. C., Porter, A. C., & Robinson, D. J. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1591281 · Cited by 219
“RCT replication was less helpful for the status of Psychodynamic Therapy–Family-Based, “brand name” ABFT (Diamond et al., 2018, 2010), which is now rated as Level 4: Experimental for reducing SI and SA in youth.”
InfluentialSuicide and Suicide Risk in Adolescents
Hua, L. L., Lee, J., Rahmandar, M. H., Sigel, E. J., COMMITTEE ON ADOLESCENCE, & COUNCIL ON INJURY, V. (2024) · Pediatrics · doi:10.1542/peds.2023-064800 · Cited by 205
Kothgassner, O. D., Robinson, K., Goreis, A., Ougrin, D., & Plener, P. L. (2020) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-020-00123-9 · Cited by 163
Interventions for self-harm in children and adolescents
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Attachment-based family therapy: Theory, clinical model, outcomes, and process research
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Self-citationSuicide and Suicidal Behaviors Among Minoritized Youth
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Evidence-Based Interventions for Youth Suicide Risk
Busby, D. R., Hatkevich, C., McGuire, T. C., & King, C. A. (2020) · Current Psychiatry Reports · doi:10.1007/s11920-020-1129-6 · Cited by 59
Dysregulation and Suicide in Children and Adolescents
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Waraan, L., Siqveland, J., Hanssen‐Bauer, K., Czjakowski, N. O., Axelsdottir, B., Mehlum, L. I., & Aalberg, M. (2022) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045221125005 · Cited by 56
“The most frequently applied therapy method was Attachment Based Family Therapy (ABFT), a family systems approach that also incorporates elements of attachment theory (Diamond et al., 2010, 2019; Israel & Diamond, 2013; Waraan et al., 2020, 2021).”
BackgroundMethodResultInfluentialOon‐arom, A., Wongpakaran, T., Kuntawong, P., & Wongpakaran, N. (2020) · International Psychogeriatrics · doi:10.1017/s104161022000054x · Cited by 51
“Additionally, research revealed that identifying attachment style helpeddetermine appropriate intervention, such as attachmentbased psychotherapy or suicide narrative interview (Diamond et al., 2019; Zisk et al., 2017).”
BackgroundHe, H., Hong, L., Jin, W., Xu, Y., Kang, W., Liu, J., Song, J.-Y., Zheng, T., Chen, H., & Zhao, K. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04808-7 · Cited by 41
“Intervention implications for NSSI Several interventions appear to hold promise for reducing NSSI, including Dialectical Behavior Therapy for Adolescents (DBT-A) [106], family-centered therapies [107], Mentalization-Based Treatment for adolescents (MBT-A) [108], interpersonal therapy [109], and”
BackgroundParent–teen communication predicts treatment benefit for depressed and suicidal adolescents.
Zisk, A., Abbott, C. H., Bounoua, N., Diamond, G. S., & Kobak, R. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000457 · Cited by 41
“Note: Version of this consort diagram for primary outcome analyses previously published in Diamond et al. (2019).”
BackgroundMethodInfluentialSelf-citationDiamond, G. M., Boruchovitz‐Zamir, R., Nir‐Gotlieb, O., Gat, I., Bar‐Kalifa, E., Fitoussi, P., & Katz, S. (2022) · Family Process · doi:10.1111/famp.12770 · Cited by 36
Self-citationWongpakaran, N., DeMaranville, J., & Wongpakaran, T. (2021) · Healthcare · doi:10.3390/healthcare9091174 · Cited by 33
Itzhaky, L., Davaasambuu, S., Ellis, S. P., Cisneros-Trujillo, S., Hannett, K., Scolaro, K., Stanley, B. H., Mann, J. J., Wainberg, M. L., Oquendo, M. A., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.094 · Cited by 33
Review of family‐based treatments from 2010 to 2019 for suicidal ideation and behavior
Frey, L. M., Hunt, Q. A., Russon, J. M., & Diamond, G. (2022) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12568 · Cited by 32
Self-citationPsychological Treatments for Depression in Adolescents: More Than Three Decades Later
Méndez, X., Sánchez-Hernández, Ó., Garber, J., Espada, J. P., & Orgilés, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18094600 · Cited by 33
“[104] FT Attachment-Based ST Nondirective Indicated prevention: BDI-II > 20 41.”
BackgroundTreatments for Self-Injurious Thoughts and Behaviors in Youth: Progress and Challenges
Bettis, A. H., Liu, R. T., Walsh, B. W., & Klonsky, E. D. (2020) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2020.1806759 · Cited by 32
“…DBT-A, CBT, and ABFT approaches highlighted above, studies recruited relatively diverse samples, but did not report whether there were differences in treatment response by LGBTQ+ status or by racial/ethnic minority status (e.g., Asarnow et al., 2017; Diamond et al., 2019; McCauley et al., 2018).”
BackgroundResultInfluentialPredicting Patterns of Treatment Response and Outcome for Adolescents Who Are Suicidal and Depressed
Abbott, C. H., Zisk, A., Bounoua, N., Diamond, G. S., & Kobak, R. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.12.013 · Cited by 34
Self-citationSaving Lives: Recognizing and Intervening with Youth at Risk for Suicide
Arango, A., Gipson, P. Y., Votta, J. G., & King, C. A. (2021) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-081219-103740 · Cited by 28
Evidence-Base Update of Psychosocial and Combination Treatments for Child and Adolescent Depression
Weersing, V. R., Goger, P., Schwartz, K. T. G., Baca, S. A., Angulo, F., & Kado-Walton, M. (2024) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2024.2384022 · Cited by 24
Lengvenytė, A., Olié, É., Strumila, R., Navickas, A., González-Pinto, A. M., & Courtet, P. (2021) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2021.1907712 · Cited by 26
“Only six studies justified their sample size by performing power calculations to detect meaningful differences in SI (Yovell et al. 2016; Grunebaum et al. 2018; Diamond et al. 2019; McCall et al. 2019; Fu et al. 2020; Ionescu et al. 2020), and one study performed power calculations to detect differences in SA within s…”
BackgroundInfluentialTreatment Recommendations and Barriers to Care for Suicidal LGBTQ Youth: A Quality Improvement Study
Zullo, L., van Dyk, I. S., Ollen, E. W., Ramos, N., Asarnow, J. R., & Miranda, J. M. (2021) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2021.1950079 · Cited by 32
“ABFT has previously been studied with a general population of youth and has shown promise for reducing suicidal ideation (Diamond et al., 2019, 2010).”
BackgroundAttachment‐based family therapy in the age of telehealth and COVID‐19
Levy, S. A., Mason, S., Russon, J., & Diamond, G. S. (2021) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12509 · Cited by 27
Self-citationWittenborn, A. K., Woods, S., Priest, J. B., Morgan, P. C., Tseng, C., Huerta, P. L., & Edwards, C. (2021) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12569 · Cited by 24
Waraan, L., Rognli, E. W., Czajkowski, N. O., Aalberg, M., & Mehlum, L. I. (2021) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-021-00361-x · Cited by 23
Psychotherapie nach einem Suizidversuch – Evidenzlage und Bewertung
Teismann, T., & Gysin-Maillart, A. (2021) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-021-03466-y · Cited by 31
Overall goal of Cognitive-Behavioral Therapy in Major Psychiatric Disorders and Suicidality
Serafini, G., Costanza, A., Aguglia, A., Amerio, A., Placenti, V., Magnani, L., Escelsior, A., Sher, L., & Amore, M. (2022) · Medical Clinics of North America · doi:10.1016/j.mcna.2022.05.006 · Cited by 30
Establishment and validation of a nomogram for suicidality in Chinese secondary school students
Yan, J., Liu, Y., Yu, J., Liao, L., & Wang, H. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.02.062 · Cited by 22
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“Furthermore, family therapy has been considered a recommended approach for decreasing suicide, especially among children and adolescents (48, 49).”
BackgroundImplementing Evidence-Based Suicide Prevention Strategies for Greatest Impact
Melhem, N., Moutier, C. Y., & Brent, D. A. (2023) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20220078 · Cited by 23
Goodman, M., Sullivan, S. R., Spears, A. P., Crasta, D., Mitchell, E. L., Stanley, B., Dixon, L., Hazlett, E. A., & Glynn, S. (2022) · Couple and Family Psychology Research and Practice · doi:10.1037/cfp0000206 · Cited by 20
Waraan, L., Rognli, E. W., Czajkowski, N. O., Mehlum, L., & Aalberg, M. (2021) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104520980776 · Cited by 19
“The lack of differences between ABFT and TAU is consistent with findings by Diamond et al. (2018).”
BackgroundResultChildhood maltreatment and suicide ideation: A possible mediation of social support
Donald, A. R., Chang, W., Ran, H., Fang, D., Che, Y., Deng, W.-H., Wang, S., Peng, J., Chen, L., & Xiao, Y. (2022) · World Journal of Psychiatry · doi:10.5498/wjp.v12.i3.483 · Cited by 23
Gaynor, K., Dwan-O'Reilly, M., Redmond, D., Nealon, C., Twomey, C. D., & Hennessy, E. (2023) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2023.152374 · Cited by 22
Hunt, Q. A., Weiler, L. M., McGuire, J. K., Mendenhall, T. J., Kobak, R., & Diamond, G. S. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12594 · Cited by 20
Self-citationRusson, J., Morrissey, J., Dellinger, J., Jin, B., & Diamond, G. (2022) · Crisis · doi:10.1027/0227-5910/a000821 · Cited by 18
Self-citationHunt, Q. A., Ewing, E. S. K., Weiler, L. M., Ogbaselase, F. A., Mendenhall, T. J., McGuire, J. K., Monet, M., Kobak, R., & Diamond, G. S. (2021) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12549 · Cited by 22
Self-citationChen, X., Dong, Y., Ye, M., Wang, X., Yan, J., Yao, Y., Zhou, Q., Qian, C., & Liu, Z. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06735-1 · Cited by 17
S3-Leitlinie Depressive Störungen im Kindes- und Jugendalter: Wo geht es hin?
Schulte‐Körne, G., Klingele, C., Zsigo, C., & Kloek, M. (2023) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-023-03721-4 · Cited by 16
Tsvieli, N., Nir‐Gottlieb, O., Lifshitz, C. C., Diamond, G. S., Kobak, R., & Diamond, G. M. (2019) · Family Process · doi:10.1111/famp.12445 · Cited by 18
Self-citationCourtney, D., Watson, P., Chan, B. W. C., BENNETT, K. J., Krause, K. R., Offringa, M., Butcher, N. J., Monga, S., Neprily, K., Zentner, T., et al. (2021) · Depression and Anxiety · doi:10.1002/da.23200 · Cited by 17
“R, Hamilton depression rating scale‐revised; IPT, interpersonal therapy; KSADS, Kiddie schedule for affective disorders and schizophrenia; MADRS, Montgomery Asberg depression rating scale; MINI, mini international neuropsychiatric interview; OMI, outcome measurement instrument; PHQ‐9, patient health questionnaire–9 it…”
BackgroundInfluentialAdrian, M. C., Blossom, J. B., Chu, P. V., Jobes, D. A., & McCauley, E. (2021) · Practice Innovations · doi:10.1037/pri0000156 · Cited by 16
van Aswegen, T., Samartzi, E., Morris, L. D., van der Spek, N., de Vries, R., Seedat, S., & van Straten, A. (2023) · International Journal of Psychology · doi:10.1002/ijop.12926 · Cited by 24
“Individual studies compared family therapy to CBT and nondirective supportive treatment (Brent et al., 1997); family therapy to family enhanced nondirective supportive therapy (FE-NST) (Diamond et al., 2019); family therapy to individual psychody-namic therapy (Trowell et al., 2007); family therapy to child-centred th…”
BackgroundMethodInfluentialCourtney, D., Iseyas, N., Monga, S., Butcher, N. J., Krause, K. R., Besa, R., & Szatmári, P. (2023) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2023.10.013 · Cited by 17
Schulte-Frankenfeld, P. M., Breedvelt, J., Brouwer, M. E., van der Spek, N., Bosmans, G., & Bockting, C. (2024) · Clinical Psychology in Europe · doi:10.32872/cpe.13717 · Cited by 18
“Out of 370 records identified, seven articles met the inclusion criteria ( n = 332), of which four were included in the meta-analysis ( n = 287) (G. M. Diamond et al., 2012; G. S. Diamond et al., 2002, 2010, 2019; Russon et al., 2022; van der Spek et al., 2024; Waraan et al., 2021).”
InfluentialSuicide among LGBTQIA+ youth: A review of the treatment literature
Russon, J., Washington, R., Machado, A., Smithee, L. C., & Dellinger, J. (2021) · Aggression and Violent Behavior · doi:10.1016/j.avb.2021.101578 · Cited by 21
Self-citationCorrective attachment episodes in attachment-based family therapy: the power of enactment
Tsvieli, N., Lifshitz, C. C., & Diamond, G. M. (2021) · Psychotherapy Research · doi:10.1080/10503307.2021.1913295 · Cited by 15
“ABFT has been shown to be efficacious in three clinical trials for depressed and suicidal adolescents (G.S. Diamond et al., 2002, 2010, 2019).”
BackgroundSelf-citationChang, C. J., Ohannessian, C. M., Ewing, E. S. K., Kobak, R., Diamond, G. S., & Herres, J. L. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01566-7 · Cited by 16
Self-citationvan der Spek, N., Dekker, W., Peen, J., Santens, T., Cuijpers, P., Bosmans, G., & Dekker, J. (2024) · Crisis · doi:10.1027/0227-5910/a000916 · Cited by 13
Cloutier, P., Gray, C., Sheridan, N., Silverman, A. J., Cappelli, M., Zemek, R. L., Jabbour, M., Reid, S. M., & Kennedy, A. (2021) · Child and Adolescent Mental Health · doi:10.1111/camh.12506 · Cited by 14
Interventions for youth suicide and suicide-related behaviour: An update to a systematic review
Bailey, E., Robinson, J., & Witt, K. (2023) · Australasian Psychiatry · doi:10.1177/10398562231187972 · Cited by 14
“Of these, two examined family therapy interventions but did not find compelling evidence in favour of the treatment.(19,20,31) Three trials evaluated CBT and/or DBT interventions, with all trials identifying some positive effects at post-treatment; however, in the two trials which included a follow-up assessment (eith…”
BackgroundAn Update on the Latest Treatment Approaches with Suicidal Adolescents
Spirito, A., Webb, M. A., Cheek, S. M., Wolff, J. C., & Esposito-Smythers, C. L. (2021) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-021-00239-x · Cited by 13
“these findings were not replicated in the second, larger study [26].”
MethodResultEmotional processing in attachment-based family therapy for suicidal adolescents
Lifshitz, C. C., Tsvieli, N., Bar‐Kalifa, E., Abbott, C. H., Diamond, G. S., Kobak, R., & Diamond, G. M. (2020) · Psychotherapy Research · doi:10.1080/10503307.2020.1745315 · Cited by 13
“Participants were 39 suicidal and depressed adolescents who had received 16 weeks of attachment-based family in the context of a randomized clinical trial comparing ABFT to family enhanced non-directive supportive therapy (Diamond et al., 2019).”
BackgroundMethodSelf-citationFamily Treatments for Individuals at Risk for Suicide
Sullivan, S. R., Spears, A. P., Mitchell, E. L., Walsh, S., Love, C., & Goodman, M. S. (2021) · Crisis · doi:10.1027/0227-5910/a000828 · Cited by 16
Near-Fatal Self-Harm Among Canadian Adolescents
Mitchell, R. H., Ani, C., Cyr, C., Irvine, J., Joffe, A. R., Skinner, R., Wong, S., Stang, A. S., Laffin, M., & Korczak, D. J. (2022) · The Canadian Journal of Psychiatry · doi:10.1177/07067437211058602 · Cited by 12
Russon, J., Abbott, C. H., Jin, B., Rivers, A. S., Winston‐Lindeboom, P., Kobak, R., & Diamond, G. S. (2023) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12995 · Cited by 16
Self-citationWright-Hughes, A. M., Farrin, A. J., Fonagy, P., Ougrin, D., Stahl, D. R., Wright, J. M., Irving, D., Mughal, F., Truscott, A., Diggins, E., et al. (2025) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2025.01.017 · Cited by 15
Self-citationModerators of Treatment for Adolescent Depression
Meyer, A. E., & Curry, J. F. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2020.1796683 · Cited by 12
Psychological interventions for suicidal behavior in adolescents: a comprehensive systematic review
García-Fernández, A., Bobes-Bascarán, T., Martínez-Cao, C., González-Blanco, L., Fernández, J. F., Madera, P. Z., Zazo, E. S., Jiménez-Treviño, L., García‐Portilla, M. P., Bobes, J., et al. (2024) · Translational Psychiatry · doi:10.1038/s41398-024-03132-2 · Cited by 12
“Based on prior positive results [35], Diamond et al. [36] conducted a second RCT to compare the ef fi cacy of attachment-based family therapy (ABFT) to family-enhanced nondirective supportive therapy (FE-NST) during 16 weeks.”
BackgroundPeer Deviance, Social Networks, and Suicide Ideation Intensity in a Clinical Sample of Adolescents
Abbott, C., Zisk, A., Bounoua, N., Diamond, G., & Kobak, R. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-018-01320-5 · Cited by 14
Self-citationSuicide Interventions for Youths
Sim, L. A., Murad, M. H., Croarkin, P. E., McKean, A. J. S., Mohammed, K. S., Rajjo, T. I., Firwana, M., Simha, S., Fleti, F., Hegazi, M., et al. (2025) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2025.3485 · Cited by 11
The Safety Planning Intervention for Children (C-SPI): Rationale and Case Illustration
Itzhaky, L., & Stanley, B. (2022) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2022.10.001 · Cited by 11
Waraan, L., Mehlum, L. I., Rognli, E. W., Czajkowski, N. O., & Aalberg, M. (2021) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.21307/sjcapp-2021-006 · Cited by 13
Exploring the relations between interpersonal risk and adolescent suicidality during treatment.
Abbott, C. H., Zisk, A., Herres, J. L., Diamond, G. S., Ewing, E. S. K., & Kobak, R. (2021) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000656 · Cited by 9
Self-citationStrengthening Attachment-Based Therapies: A Case for Cognitive Bias Modification?
Verhees, M. W. F. T., Ceulemans, E., & Bosmans, G. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2019.01.022 · Cited by 9
A unique model of care for youth in crisis: A pilot open trial.
Adrian, M. C., Twohy, E., Babeva, K. N., Jenness, J. L., Gurtovenko, K., Blossom, J. B., King, S., McCartney, L., & McCauley, E. (2023) · Psychological Services · doi:10.1037/ser0000778 · Cited by 11
Pediatric suicide: Review of a preventable tragedy
Greydanus, D. E., Nazeer, A., Qayyum, Z., Patel, D. R., Rausch, R., Hoang, L.-N., Miller, C., Chahin, S. S., Apple, R. W., Saha, G. K., et al. (2024) · Disease-a-Month · doi:10.1016/j.disamonth.2024.101725 · Cited by 10
Ibrahim, M., Levy, S. A., Gallop, B., Ewing, E. S. K., Hogue, A., Chou, J. L., & Diamond, G. S. (2021) · Family Process · doi:10.1111/famp.12660 · Cited by 8
Self-citationPsychotherapy for Suicide Prevention
Calati, R., Mansi, W., Rignanese, M., Pierro, R. D., López‐Castromán, J., Madeddu, F., & Courtet, P. (2022) · Springer eBooks · doi:10.1007/978-3-030-42003-1_70 · Cited by 9
Herres, J., Krauthamer Ewing, E. S., Levy, S., Creed, T. A., & Diamond, G. S. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1096291 · Cited by 11
“For example, two randomized controlled clinical trials in the United States were conducted with samples in which a large percentage of teens (74% in the first trial and 49% in the second trial) identified as Black/African American (48, 62, 63), a group in the United States that has been historically marginalized and v…”
BackgroundSelf-citationKinder und Jugendliche mit suizidalem Erleben und Verhalten
In‐Albon, T., Schlau, S., & Friedrich, S. (2025) · Die Psychotherapie · doi:10.1007/s00278-025-00771-8 · Cited by 7
“…et al. 2021), zur Risikoabschätzung (Czyz et al. 2021; Mehlum et al. 2014), zur Psychoedukati-on zu suizidalem Erleben und Verhalten (Asarnow et al. 2017;Diamond et al. 2019), zum Einbezug der Eltern (Czyz et al. 2021; Asarnow et al. 2017) und zum Emotions-regulationstraining (Mehlum et al. 2014).”
Ghazal, L., Cui, N., Fenglin, C., Froelicher, E. S., & Shimbrer, M. S. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1356816 · Cited by 7
Mughal, F., Young, P. J., Stahl, D. R., Asarnow, J. R., & Ougrin, D. (2025) · JCPP Advances · doi:10.1002/jcv2.12302 · Cited by 8
“16 RCTs included a family treatment component within interventions (Asarnow et al., 2011, 2017; Bjure-berg et al., 2023; Cottrell et al., 2020; Diamond et al., 2010, 2019; Esposito ‐ Smythers et al., 2011, 2019; Kennard et al., 2018; King et al., 2006, 2019;”
InfluentialDimidjian, S., Kaufman, J., Coleman, N., Lévy, J. J., Beck, A. L., Gallop, R., & Segal, Z. V. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.051 · Cited by 7
Self-citationPsychosocial Treatments for Ethnoculturally Diverse Youth with Suicidal Thoughts and Behaviors
Duarté‐Vélez, Y., Vélez‐Grau, C., & Álvarez, K. (2021) · Springer eBooks · doi:10.1007/978-3-030-82465-5_19 · Cited by 8
Systemic therapy for children and adolescents with depression: a systematic review and meta-analysis
Huang, Y., Li, Y., Haun, M. W., Xie, R., Yang, L. J., Retzlaff, R., & Qian, Y. (2023) · Current Psychology · doi:10.1007/s12144-023-04558-5 · Cited by 7
“And high self-reported parent-child conflict was reported to be one of the most important predictors of persistent depression (Brent et al., 1997; Diamond et al., 2019; Diamond et al., 2002; Diamond et al., 2010; Israel & Dia-mond, 2013; Poole et al., 2018).”
Kaswan, Z. A. M., Bowers, C. A., Teplyakov, I., Sibtain, A., Munoz-Martin, J., Ahmed, S., Kaffman, L., Giuliano, L., Dietrich, M. O., & Kaffman, A. (2025) · eNeuro · doi:10.1523/eneuro.0249-25.2025 · Cited by 6
“Attachment-based randomized controlled trials have been shown to increase rates of secure attachment and to improve psychiatric comorbidities in high-risk populations (Wright and Edginton, 2016; Diamond et al., 2019; Gregory et al., 2020; Hepworth et al., 2020).”
Fang, D., Lü, J., Ran, H., He, Y., Zheng, G., Liu, S., Xiang, Y., Wang, X., Liu, X., Xiao, Y., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119946 · Cited by 6
Repairing attachment in families with depressed adolescents: A task analysis
Stern, R. S., King, A. A., & Diamond, G. S. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23399 · Cited by 6
Self-citationPredictors of outcome after a time-limited psychosocial intervention for adolescent depression
Parhiala, P., MARTTUNEN, M. J., Gergov, V., Torppa, M., & Ranta, K. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.955261 · Cited by 8
“, 2006), and family therapy (Brent et al., 1998; Diamond et al., 2019) among depressed adolescents suggest that younger adolescents may have stronger response to psychotherapy than older adolescents.”
BackgroundInfluentialQuantifying the Representation of Black Adolescents in Suicide Intervention Research
Sumlin, E. D., Hill, R., Asim, N., Busby, D. R., Brown, J. L., & Sharp, C. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01113-5 · Cited by 7
“Utilizing the search criteria outlined by Robinson and colleagues, six additional studies were identified for analysis (i.e., Aalsma et al., 2020; Diamond et al., 2019; Goldman-Mellor et al., 2020; Hill et al., 2020; Rengasamy & Sparks, 2019; Zisk et al., 2019).”
Musculação para um aluno com síndrome de down e o aumento da resistência muscular localizada
da Silva, C. A., Tonello, M. G. M., Gorla, J. I., & Calegari, D. R. (2007) · Lecturas: Educación física y deportes · Cited by 6
Diamond, G., Rivers, A. S., Winston-Lindeboom, P., Russon, J., & Roeske, M. (2024) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-024-00833-w · Cited by 5
Self-citationKennedy, A., Gray, C., Sheridan, N., Dunn, L. C., Stewart, J., Drouin, S., Elliott, H., Adeponle, A. B., Barrowman, N. J., Sucha, E., et al. (2025) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-025-00941-1 · Cited by 5
“…Nondirective Support-ive Therapy which focused primarily on individual sessions with the adolescent in reducing SI and the authors concluded that ABFT could be fortified by integrating cognitive and emotional skills such as parent or adolescent psychoeducation, CBT, or DBT techniques [13].”
Braus, N., Flückiger, C., Wichmann, J., Frankman, C., Gräfenkämper, R., Zemp, M., & Hunger‐Schoppe, C. (2025) · Psychotherapy Research · doi:10.1080/10503307.2025.2565236 · Cited by 5
Ibrahim, M., King, A. A., Levy, S. A., Russon, J., & Diamond, G. S. (2022) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-022-09539-6 · Cited by 5
“Attachment-based family therapy (ABFT) is one promising treatment approach for adolescent depression and suicide (Diamond et al., 2010; 2019where specific treatment mechanisms have begun to be examined.”
BackgroundMethodInfluentialSelf-citationAdrian, M. C., McCauley, E., Gallop, R., Stevens, J. H., Jobes, D. A., Crumlish, J. A., Stanley, B., Brown, G. K., Green, K. L., Hughes, J. L., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-074116 · Cited by 5
Self-citationBrown, T. R., Lee, S. S., Schiff, S. J., Jansen, M. O., Bath, E. P. J., & Meza, J. I. (2024) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2024.08.007 · Cited by 9
Trajectories of parent criticism across treatment for youth self‐harm
Aitken, M., Perquier, F., Park, B., Carvalho, D., Wright-Hughes, A. M., Cottrell, D. J., & Szatmári, P. (2025) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14144 · Cited by 8
“…among adolescents (Brent et al., 2009; Wilkinson, Kelvin, Roberts, Dubicka, & Goodyer, 2011), leading to increasing interest in the effectiveness of family interventions for youth self-harm in recent years (Asarnow, Hughes, Babeva, & Sugar, 2017; Diamond et al., 2019; Korczak et al., 2020).”
Attachment quality in adolescents with non-suicidal self-injury
Снегирева, Т. В., & Воликова, С. В. (2020) · Journal of Modern Foreign Psychology · doi:10.17759/jmfp.2020090406 · Cited by 5
“Один из подходов, показавший свою эффективность в лечении подростков с депрессивными состояниями и суицидальными проявлениями, — это семейная терапия, основанная на привязанности (ABFT, attachment-based family therapy ) [3; 13].”
InfluentialSuicide and Suicide Attempts During Adolescence
Esposito-Smythers, C. L., Whitmyre, E. D., Defayette, A. B., López, R., Maultsby, K. D., & Spirito, A. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00059-5 · Cited by 5
Rognli, E. W., Waraan, L., Czajkowski, N. O., & Aalberg, M. (2020) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.21307/sjcapp-2020-011 · Cited by 7
“Still, in the largest randomised controlled trial conducted to date, ABFT was not found to be superior to family-enhanced non-directive supportive therapy for reducing adolescent suicidal ideation (19).”
InfluentialKweon, K. (2026) · Journal of korean Academy of Child and Adolescent Psychiatry · doi:10.5765/jkacap.250050 · Cited by 5
“ABFT has established strong evidence for reducing suicidal ideation and depressive symptoms in adolescents [51,52].”
Treatment Approaches with Suicidal Adolescents
Spirito, A., Webb, M. A., Wolff, J. C., & Esposito-Smythers, C. L. (2022) · Springer eBooks · doi:10.1007/978-3-030-42003-1_21 · Cited by 4
Aitken, M., Sagar, A., Courtney, D., & Szatmári, P. (2023) · JCPP Advances · doi:10.1002/jcv2.12168 · Cited by 4
“Family therapy is also resource ‐ intensive (Goorden et al., 2016), and is less effective than other treatments for adolescent depression (Brent et al., 1997), with effects on adolescent depression and self ‐ harm comparable to usual care (Cottrell et al., 2018; Diamond et al., 2019).”
BackgroundSimes, D., Shochet, I. M., Murray, K. E., & Sands, I. G. (2024) · Psychotherapy Research · doi:10.1080/10503307.2024.2415991 · Cited by 5
“…empirical research that found both ABFT and family-enhanced non-directive supportive therapy (parallel youth and parent therapy provided by the same therapist) to be Psychotherapy Research 1409 effective for relationship improvement and reduced suicidality (Diamond et al., 2019; Zisk et al., 2019).”
Figueira, J. A. V., Andrade, M. A. E. D. L. M., Santiesteban, R. V., Ramírez, A., Parra, I. D. C., Martín-Delgado, J., Martínez-Suárez, P. C., Vargas, L. P. B., Hidalgo, M. E. A., & Rodas, J. A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0320381 · Cited by 6
“This is illustrated by a study of 75 adolescents who had attempted suicide, where 74.7% had no prior history of suicidal behaviour, 18.7% had attempted it once, and 6.7% had made two or more attempts [13,14].”
Influential
Metadata
- Authors
- Diamond, G. S., Kobak, R. R., Krauthamer Ewing, E. S., Levy, S. A., Herres, J. L., Russon, J. M., & Gallop, R. J.
- Affiliations
- Drexel University (US)
- University of Delaware (US)
- The College of New Jersey (US)
- Virginia Tech (US)
- West Chester University (US)
- Corresponding author
- Diamond, Guy S.
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 58
- Issue
- 7
- Pages
- 721-731
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC6491252
- OpenAlex
- W2898714608
- Cited by
- 147
- References
- 45
- Citations by year
- 2026: 13 · 2025: 19 · 2024: 13 · 2023: 24 · 2022: 15 · 2021: 41 · 2020: 9 · 2019: 11
- FWCI
- 17.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- VTechWorks (Virginia Tech) (submittedVersion, public-domain)
- Funders
- National Institute of Mental Health (5R01MH091059-03)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- attachment-based family therapy, suicidal adolescents, suicidal ideation, depressive symptoms, family therapy, treatment efficacy, regression to the mean, African American adolescents
- MeSH terms
- Adolescent, Child, Depression, Family Therapy, Female, Humans, Male, Object Attachment, Pennsylvania, Suicide, Attempted, Reactive Attachment Disorder, Self Report, Suicidal Ideation
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