Treatment for adolescents following a suicide attempt: results of a pilot trial
Abstract
Objective To compare the efficacy of a skills-based treatment protocol to a supportive relationship therapy for adolescents after a suicide attempt.Method Thirty-nine adolescents (12-17 years old) and parents who presented to a general pediatric emergency department or inpatient unit of a child psychiatric hospital after a suicide attempt were randomized to either a skills-based or a supportive relationship treatment condition. Follow-up assessments were conducted at intake and 3 and 6 months post-attempt.Results In contrast to the low rates of treatment received by adolescent suicide attempters in the community, approximately 60% of this sample completed the entire treatment protocol. Significant decreases in suicidal ideation and depressed mood at 3- and 6-month follow-ups were obtained, but there were no differences between treatment groups. There were six reattempts in the follow-up period.Conclusions When adolescents who attempt suicide are maintained in treatment, significant improvements in functioning can be realized for the majority of patients.
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In the seven trials that recorded treatment adherence, it was measured in various ways, including the proportion completing the full treatment course and the proportion attending the first appointment.
“In the seven trials that recorded information on treatment adherence, this was assessed using a variety of methods including: the proportion of participants that completed the full course of treatment (Donaldson 2005; Harrington 1998; Rossouw 2012a), the proportion attending their first appointment ( Ougrin 2011a)”
From Interventions for self-harm in children and adolescents (2021) · cites this paper as Donaldson 2005
In a single trial comparing brief psychological therapy (problem-solving and affect management) with supportive relationship therapy, no beneficial effects were found for repetition of self-harm, treatment adherence, depression, or suicidal ideation.
“In a single trial of brief psychological therapy consisting of problem-solving and affect management training skills compared with supportive relationship therapy (Donaldson 2005), no beneficial effects of the psychological therapy were found in terms of repetition of SH, treatment adherence, depression, and suicidal ideation.”
From Interventions for self-harm in children and adolescents (2021) · cites this paper as Donaldson 2005
Two trials had unclear risk of bias for allocation concealment because no details were provided.
“We rated two trials as having an unclear risk of bias for this item as no details on allocation concealment were provided (Donaldson 2005; Spirito 2002)”
From Interventions for self-harm in children and adolescents (2021) · cites this paper as Donaldson 2005
The other three trials were rated unclear risk for blinding of outcome assessors because no information was provided.
“We rated the remaining three trials, however, as having an unclear risk of bias for this item as no information on blinding of outcome assessors was provided (Cotgrove 1995;Donaldson 2005;Spirito 2002).”
From Interventions for self-harm in children and adolescents (2021) · cites this paper as Donaldson 2005
The remaining trial was rated unclear risk of bias for participant blinding because no information was given, though the treatments were similar enough that blinding remained possible (Donaldson 2005).
“We rated the remaining trial as having an unclear risk of bias for this item as, although no information on participant blinding was provided, both treatments were so similar it remains possible that participants may have been blind to treatment allocation (Donaldson 2005).”
From Interventions for self-harm in children and adolescents (2021) · cites this paper as Donaldson 2005
For four trials, the review classified intention-to-treat analyses as low risk of bias (36.4%), although the methods used were unclear.
“For four trials, the authors reported having conducted analyses on an intention-to-treat basis we therefore classified them as having a low risk of bias for this item (36.4%); although the methods used to conduct these analyses were not clear (Donaldson 2005;Harrington 1998;Mehlum 2014;Wood 2001a).”
From Interventions for self-harm in children and adolescents (2021) · cites this paper as Donaldson 2005
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- Authors
- Donaldson, D., Spirito, A., & Esposito-Smythers, C.
- Affiliations
- Brown University (US)
- Corresponding author
- Donaldson, Deidre
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2005-02
- Volume
- 44
- Issue
- 2
- Pages
- 113-120
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W1981377458
- Cited by
- 151
- References
- 30
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 8 · 2022: 5 · 2021: 10 · 2020: 2 · 2019: 8 · 2018: 8 · 2017: 2 · 2016: 6 · 2015: 12 · 2014: 16 · 2013: 11 · 2012: 6
- FWCI
- 10.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r03mh057349-02)
- National Institute of Mental Health (MH057349)
- 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 › Psychiatric care and mental health services
- Keywords
- adolescent suicide attempts, suicide attempters, suicidal ideation, depressive mood, repeated suicide attempts, treatment retention, post-acute care
- MeSH terms
- Adolescent, Child, Depressive Disorder, Emergency Services, Psychiatric, Female, Hospitalization, Humans, Male, Patient Admission, Pilot Projects, Problem Solving, Social Support, Suicide, Attempted, Cognitive Behavioral Therapy
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