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Cited by 13Psychotherapy Techniques and ApplicationsCounseling, Therapy, and Family DynamicsSuicide and Self-Harm Studies

Attachment-Based Family Therapy for Adolescents and Young Adults With Suicide Ideation and Depression: An Open Trial

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van der Spek, Nadia, Dekker, Willemieke, Peen, Jaap, Santens, Tara, Cuijpers, Pim, Bosmans, Guy, Dekker, Jack·2024·Crisis
DOI 10.1027/0227-5910/a000916
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Abstract

Abstract: Background: Suicide ideation among adolescents is difficult to treat. Attachment-based family therapy (ABFT) is a promising evidence-based family intervention developed to decrease depressive symptoms and suicide ideation among adolescents. Aims: This open trial assessed the feasibility of ABFT for adolescents (12–23 years) with suicide ideation and depression in an outpatient community mental health center in the Netherlands, by monitoring treatment compliance and satisfaction, treatment dose, and symptom reduction. Methods: Eligible patients were referred by the multidisciplinary treatment team at the facility. Treatment dose was monitored by the therapist. Depression (CDI-2), family functioning (SRFF), and strengths and difficulties (SDQ) were assessed online before the intervention and at 3, 6, and 9 months after baseline. Suicide ideation (SIQ-JR) was assessed at each therapy session, and a satisfaction questionnaire was administered postintervention. A total of 25 families signed informed consent, received ABFT treatment, and were included in the analyses. The therapists were at beginners’ level of ABFT, working under supervision during the trial. Results: The treatment dose was acceptable, though impacted by COVID-related lockdowns, and treatment compliance was 89%. Patients received on average 22 ABFT sessions, and about half of the patients received additional psychotherapy. On average, patients were satisfied with ABFT. There was a significant decrease in suicide ideation postintervention ( d = 0.69) and significant effects on the CDI-2, SRFF, and SDQ at follow-up with medium-to-large effect sizes ( d = 0.53–0.94). Limitations: These results should be interpreted with considerable caution, as there was no control group to establish the effectiveness of ABFT, and the sample was small. Conclusion: ABFT appears to be a feasible therapy for youth with depression and suicide ideation in an outpatient community mental health setting.

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  • Multiple studies have shown high acceptability and feasibility of ABFT for both adolescents and emerging adults.

    “Multiple studies have shown high acceptability and feasibility of ABFT for both adolescents and emerging adults [20, 24–27].”

    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 [25]

    The Discussion (p. 6) describes ABFT as feasible and reports that families were satisfied on average. The Participants section (p. 4) gives an age range of 13–22, which includes adolescents and some emerging adults. This paper reports one open trial, however, and does not establish high acceptability and feasibility separately for both age groups or show that multiple studies found both outcomes. (LLM, conf=0.86)

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  • ABFT has been disseminated in mental health care settings in various Western countries to treat adolescents with suicidality and has been increasingly used in emerging adults.

    “ABFT has been disseminated in mental health care settings in various Western countries, to treat adolescents with suicidality, and has been increasingly used in emerging adults too [24, 25, 76].”

    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 [25]

    The introduction (p. 2) says ABFT has been feasible in different settings and countries for depressed and suicidal adolescents, and Participant Recruitment (p. 2) includes patients aged 12–23, covering some emerging adults. The paper does not establish that its use among emerging adults has been increasing or document dissemination across Western mental health care settings. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Several studies have demonstrated the effectiveness of ABFT for adolescents and young adults at risk for suicide.

    “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 [28]

    The introduction (p. 2) reports that two randomized trials found reductions in suicide ideation with ABFT compared with waitlist or treatment as usual. But it also reports trials with no significant additional effect and says more research is needed to firmly confirm effectiveness. This paper’s open trial lacked a control group (p. 1), so the unqualified statement that several studies have demonstrated effectiveness overstates the evidence it presents. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Pilot studies indicated the acceptability and feasibility of ABFT in the Netherlands and Belgium and also for the young adult population.

    “Our pilot studies indicated the acceptability and feasibility of ABFT in the Netherlands and Belgium [20, 25, 27] and also for the young adult population.”

    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 [25]

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Research works printed but not linked: 1

  1. Diamond, G. M., Boruchovitz-Zamir, R., Nir-Gotlieb, O., Gat, I., BarKalifa, E., Fitoussi, P. Y., & Katz, S. (2022). Attachment-based family therapy for sexual and gender minority young adults and their nonaccepting parents. Family Process , 61 (2), 530 -548.

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Authors
van der Spek, N., Dekker, W., Peen, J., Santens, T., Cuijpers, P., Bosmans, G., & Dekker, J.
Affiliations
  • Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
  • Arkin (NL)
  • KU Leuven (BE)
  • Babeș-Bolyai University (RO)
ORCID
Venue
Crisis
Publisher
Hogrefe Publishing Group
Published
2024-01
Volume
45
Issue
1
Pages
48-56
ISSN
  • 0227-5910 (ISSN-L)
  • 2151-2396
DOI
10.1027/0227-5910/a000916
OpenAlex
W4386271289
Cited by
13
References
24
Citations by year
2026: 2 · 2025: 4 · 2024: 6 · 2021: 1
FWCI
3.48
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Crisis (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Lirias (submittedVersion, other-oa)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Keywords
attachment-based family therapy, suicidal ideation, adolescent depression, young adults, feasibility, family intervention, medication adherence, patient satisfaction, family functioning, COVID-19 lockdown
MeSH terms
Adolescent, Child, Depression, Family Therapy, Humans, Object Attachment, Surveys and Questionnaires, Young Adult, Suicidal Ideation

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