Cognitive–behavioural suicide prevention for male prisoners: a pilot randomized controlled trial

Pratt, D.; Tarrier, N.; Dunn, G.; Awenat, Y.; Shaw, J.; Ulph, F.; Gooding, P.

doi:10.1017/s0033291715001348

Cited by 76Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologyPsychological Treatments and Assessments

Cognitive–behavioural suicide prevention for male prisoners: a pilot randomized controlled trial

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Pratt, D., Tarrier, N., Dunn, G., Awenat, Y., Shaw, J., Ulph, F., Gooding, P.·2015·Psychological Medicine

DOI 10.1017/s0033291715001348PMC PMC4682193

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Abstract

Background.: Prisoners have an exceptional risk of suicide. Cognitive–behavioural therapy for suicidal behaviour has been shown to offer considerable potential, but has yet to be formally evaluated within prisons. This study investigated the feasibility of delivering and evaluating a novel, manualized cognitive–behavioural suicide prevention (CBSP) therapy for suicidal male prisoners. Method.: A pilot randomized controlled trial of CBSP in addition to treatment as usual (CBSP; n = 31) compared with treatment as usual (TAU; n = 31) alone was conducted in a male prison in England. The primary outcome was self-injurious behaviour occurring within the past 6 months. Secondary outcomes were dimensions of suicidal ideation, psychiatric symptomatology, personality dysfunction and psychological determinants of suicide, including depression and hopelessness. The trial was prospectively registered (number ISRCTN59909209). Results.: Relative to TAU, participants receiving CBSP therapy achieved a significantly greater reduction in suicidal behaviours with a moderate treatment effect [Cohen's d = −0.72, 95% confidence interval −1.71 to 0.09; baseline mean TAU: 1.39 (s.d. = 3.28) v. CBSP: 1.06 (s.d. = 2.10), 6 months mean TAU: 1.48 (s.d. = 3.23) v. CBSP: 0.58 (s.d. = 1.52)]. Significant improvements were achieved on measures of psychiatric symptomatology and personality dysfunction. Improvements on psychological determinants of suicide were non-significant. More than half of the participants in the CBSP group achieved a clinically significant recovery by the end of therapy, compared with a quarter of the TAU group. Conclusions.: The delivery and evaluation of CBSP therapy within a prison is feasible. CBSP therapy offers significant promise in the prevention of prison suicide and an adequately powered randomized controlled trial is warranted.

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The first phase of imprisonment, the early phase of long-term sentences, history of psychiatric illness, suicidal behavior, intoxication, and isolation are considered risk factors for suicide in prisons.
“The first phase of imprisonment, the early phase of long-term sentences, history of psychiatric illness, suicidal behavior, intoxication, and isolation have been considered risk factors for suicide in prisons. 43”
From Psychosocial Interventions for Prisoners with Mental and Substance Use Disorders: A Systematic Review (2022) · cites this paper as [43]
The Methods and Results (pages unavailable) describe prisoners identified as at risk of suicidal behaviour and report frequent previous suicide attempts; the Discussion also describes this sample as at elevated risk. The paper does not identify early imprisonment, the early phase of long sentences, psychiatric-illness history, intoxication, or isolation as prison-suicide risk factors. (LLM, conf=0.78)
Experimental — accuracy not yet measured
CBT (n = 2) and ACT (n = 1) showed a moderate effect on outcome variables.
“Other interventions that showed a moderate effect on the outcome variables include CBT (n = 2) and ACT (n = 1).35, 43”
From Psychosocial Interventions for Prisoners with Mental and Substance Use Disorders: A Systematic Review (2022) · cites this paper as [43]
Only one intervention was directly related to suicide prevention.
“Only one intervention was directly related to suicide prevention, 43 though prevalence studies have reported high rates of suicide among prisoners.”
From Psychosocial Interventions for Prisoners with Mental and Substance Use Disorders: A Systematic Review (2022) · cites this paper as [43]

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Authors: Pratt, D., Tarrier, N., Dunn, G., Awenat, Y., Shaw, J., Ulph, F., & Gooding, P.
Affiliations: University of Manchester (GB)
King's College London (GB)
Corresponding author: Pratt, D.
ORCID: Pratt, D.
Dunn, G.
Awenat, Y.
Shaw, J.
Ulph, F.
Gooding, P.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2015-07-13
Volume: 45
Issue: 16
Pages: 3441-3451
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291715001348
PMC: PMC4682193
OpenAlex: W2137692853
Cited by: 76
References: 45
Citations by year: 2026: 4 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 11 · 2021: 8 · 2020: 6 · 2019: 7 · 2018: 3 · 2017: 3 · 2016: 7 · 2015: 3
FWCI: 6.61
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Research Explorer (The University of Manchester) (acceptedVersion, other-oa)
Research Portal (King's College London) (submittedVersion)
Funders: National Institute for Health and Care Research (PB-PG-0609-19126)
National Institutes of Health
National Institute of Mental Health
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords: suicide prevention, cognitive behavioral therapy, incarcerated men, prison suicide, suicidal ideation, self-harm, psychiatric symptoms, personality dysfunction, depression, hopelessness, feasibility
MeSH terms: Suicide Prevention, Adult, Affect, Attention, Cognition, Depression, England, Humans, Male, Middle Aged, Patient Compliance, Pilot Projects, Prisoners, Problem Solving, Psychiatric Status Rating Scales, Self Concept, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Self Report

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Cognitive–behavioural suicide prevention for male prisoners: a pilot randomized controlled trial

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