Table 1 (a) Psychological therapies for suicidal behaviors: dialectical behavior therapy; (b) psychological therapies for suicidal behaviors: cognitive-behavioral therapy and psychodynamic therapy; (c) psychological therapies for suicidal behaviors: family therapy; (d) psychological therapies for suicidal behaviors: brief skills training, motivational interviewing-based intervention, intensive community care service, integrative therapy, combination therapy.
From: Psychological interventions for suicidal behavior in adolescents: a comprehensive systematic review
a | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Study | Design | N (IG/IC) | In/Outpatient | Age [mean(sd)] | Sex [female, n (%)] | Type SB | Duration intervention | Outcomes/ assessment | Psychological interventions | Pharmacotherapy (yes/no/AN//NS) | Results | p value | OXFORD study quality |
Dialectical behavior therapy | |||||||||||||
Hiller and Hughes. [22] | Pre/post | IG = 91 CG = NA | Outpatient | IG = 15.2 (1.5) | IG = 76 (84%) | SA, NSSI, SI | IG: 19 weeks of weekly individual therapy, family sessions as needed, weekly multi-family skills groups, phone contacts, DBT consultation team. | -SA, NSSI: L-SASI | IG: DBT-A | NS | Significantly decrease in frequency of SA and NSSI during cycle 1 and the total duration of treatment. | SA: p = 0.02 at the end of cycle 1. SA: p = 0.05 NSSI: p = 0.009 post-treatment. | 4 |
Tabbett-Mock et al. [21] | CCT | IG-1 = 425 IG-2 = 393 CG = 367 | Inpatient | IG-1 = 15.6 (1.4) IG-2 = 15.7 (1.4) CG = 15.59 (1.54) | IG-1 = 282 (66.4%) IG-2 = 247 (62.8%) CG = 236 (62.8%) | SA, NSSI, SI | IG: 8 months of DBT milieu treatment: DBT training, token economy, 9 DBT skill groups weekly, daily therapeutic and leisure groups, intensive psychotherapy. CG: token economy system, CBT skill groups weekly, activity groups weekly, intensive psychotherapy. | -SA, NSSI: medical record -SI: observation hours for SI | IG-1: DBT Group 1 IG-2: DBT Group 2 CG: TAU | NS | Significantly fewer SA for IG-1 compared to IG-2 and TAU. Significantly fewer NSSI for IG-1 compared to TAU and compared to IG-2 at post-treatment. No differences between groups in observation hours for self-injury. | SA: p = 0.037 NSSI: p < 0.001 Self-injury (observation hours): p = 0.901 post-treatment. | 2 |
Tabbett-Mock et al. [20] | CCT | IG = 425 CG = 367 | Inpatient | IG = 15.6 (1.4) CG = 15.5 (1.5) | IG = 282 (66.3%) CG = 236 (62.7%) | SA, NSSI, SI | IG: 8 months of DBT milieu treatment: DBT training, token economy, 9 DBT skill groups weekly, daily therapeutic and leisure groups, intensive psychotherapy. CG: token economy system, CBT skill groups weekly, activity groups weekly, intensive psychotherapy. | -SA, NSSI: medical record. -SI: observation hours for SI | IG: DBT CG: TAU | NS | Significantly fewer SA and NSSI for IG compared to CG. No differences between groups in SI at post-treatment. | SA: p = 0.01. NSSI: p < 0.05. SI: p = 0.11 post-treatment | 2 |
Santamarina-Pérez et al. [8] | RCT | IG = 18 CG = 17 | Outpatient | IG = 15.3 (1.2) CG = 15.2 (1.5) | IG = 16 (88.9%) CG = 15 (88.2%) | SA, NSSI, SI | IG:16 weeks of biweekly individual session, weekly of group skills training sessions, weekly consultation team meeting, telephone consultations CG: 16 weeks of biweekly individual session. GS were added by adolescents and parents separately. | -NSSI, SA: C-SSRS -SI: SIQ-JR | IG: DBT-A CG: TAU + GS | Yes | Significantly fewer NSSI for IG compared to CG at post-treatment. No differences between groups in SA, SI at post-treatment. | NSSI: p = 0.045. SA: NA. SI: p = 0.515 post-treatment | 2 |
Berk et al. [16] | Pre/post | IG = 24 CG = NA | Outpatient | IG = 15.2 (1.3) | IG = 22 (92%) | SA, NSSI, SI | IG: 6 months of weekly individual sessions, weekly family group skills training, telephone counselling, consultation among professional staff | -SA, NSSI: clinical interview -SI: SIQ-JR | IG: DBT CG: NA | NS | Significant pre/post-treatment decreases in SA, NSSI, SI. | SA: p = 0.046 NSSI: p = 0.001 SI: p < 0.001 | 4 |
Hancock-Johnson et al. [17] | Pre/post | IG = 22 CG = NA | Inpatient | IG = 15.5 (NS) | IG = 18 (81.8%) | SH | IG: 6 months of weekly individual session, regular group sessions, emergency skills coaching, as needed. | -SH: electronic care records, HoNOSCA | IG: DBT. | NS | Significant pre/post-treatment decreases in total SH, specifically in head-banging. No differences in other self-injurious behaviors. | SH: p = 0.015 Head-banging: p = 0.028. | 4 |
Flynn et al. [18] | Pre/post | IG = 84 CG = NA | Outpatient | IG = 15.7 (1.1) | IG = 71 (85%) | SH, SI | IG: pretreatment phase of 4–6 weekly individual sessions plus 16 weeks of treatment of weekly individual therapy, group skills training, phone coaching and team consultation. | -SI: QSI -SH: clinical file | IG: 16-week DBT-A | NS | Significant improvements on presence and frequency of SH and SI pre/post-treatment and at 16-week F/U. | SH (presence and frequency): p < 0.001; p < 0.001 SI: p < 0.001 post-treatment. SH (presence and frequency): p = 0.003; p = 0.03) SI: p < 0.001 at 16-weeks F/U. | 4 |
Gillespie et al. [19] | Pre/post | IG-1 = 84 IG-2 = 68 CG = NA | Outpatient | IG-1 = 15.7 (1.1) IG-2 = 15.6 (1.2) | IG-1 = 71 (85%) IG-2 = 58 (85%) | SH, SI | IG-1: 16 weeks of weekly individual therapy, group skills training, phone coaching, and team consultation. IG-2: additional 8 weeks of the intervention. | -SI: QSI -SH: clinical file | IG-1: 16-week DBT-A IG-2: 24-week DBT-A | NS | Significant improvements on presence and frequency of SH and SI pre/post-treatment in both groups. Significantly greater decrease in SI for 24-week DBT-A compared to 16-week DBT-A pre/post-treatment. | SH (presence and frequency): p = NS SI: p < 0.001 at post-treatment. SI: p = 0.03 post-treatment. | 4 |
McCauley et al. [15] | RCT | IG = 86 CG = 87 | Outpatient | IG = 14.8 (1.4) CG = 15.0 (1.4) | IG = 82 (95.3%) CG = 81 (94.1%) | SA, NSSI, SI | IG: 6 months of weekly individual and group sessions; weekly therapist-team consultation. CG: 6 months of weekly individual and group sessions; weekly therapist-team consultation | -SA, NSSI: SASII, -SI: SIQ-JR | IG: DBT CG: IGST | AN | Significantly greater decrease in SA, NSSI, SH, SI for IG compared to CG at post-treatment. No differences between groups in SA, NSSI, SI at 12-month F/U. | SA: p < 0.05 NSSI: p < 0.05 SH: p < 0.05 SI: p = 0.03 post-treatment. SA: p > 0.05 NSSI: p > 0.05 SI: p = 0.46 at 12-month F/U. | 2 |
RCT | IG = 39 CG = 38 | Outpatient | IG = 15.9 (1.4) CG = 15.3 (1.6) | IG = 34 (87.2%) CG = 34 (89.5%) | SA, NSSI, SI | IG: 19 weeks of weekly individual sessions and multi-family skills training. CG: 19 weeks of weekly individual sessions. | -SA, NSSI: LPC interview. -SI: SIQ-Jr | IG: DBT-A CG: E-TAU | AN | Significantly fewer SH and significantly greater decrease in SI for IG compared to CG at post-treatment. Significantly fewer SH (SA, NSSI) in IG compared to CG at 1–3-year F/U. No differences between groups in SI at 1–3-year F/U. | SH: p = 0.021 SI: p = 0.010 post-treatment. SH: p < 0.05 at 1-year F/U; p < 0.001 at 3-year F/U. SI: p = 0.110 at 1-year F/U; p = 0.111 at 3-year F/U. | 2 | |
b | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Cognitive-behavioral therapy (CBT) | |||||||||||||
Duarte-Velez et al. [28] | RCT | IG = 24 CG = 22 | Outpatient | IG = 15.8 (1.2) CG = 15.1 (1.4) | IG = 20 (83%) CG = 37 (80%) | SA, SI | IG: 6 to 14 weeks of weekly sessions, support by collateral case management as needed. CG: procedures and intensity of treatment was the same as the IG. | -SA: C-SSRS -SI: SIQ-JR | IG: SCBT-SB CG: TAU | AN | Significantly fewer SA for IG compared to CG from 6 to 12-month F/U. No differences between groups in SA from BL to 6 or 12-month F/U. No differences between groups in SI at 3–6–12 month F/U. | SA: Cohen´s h = 0.8 from 6–12-month F/U. SA: Cohen´s h < 0.1 from BL-6-month F/U; Cohen´s h = 0.4 from BL-12-month F/U. SI: Cohen´s d = 0.1 at 3-month F/U; Cohen´s d = 0.2 at 6-month F/U; Cohen´s d < 0.05 at 12-month F/U. | 2 |
Goldston et al. [27] | RCT | IG = 7 CG = 6 | Outpatient | IG = 16.43 (NS) CG = 16.56 (NS) | IG = 3 (42%) CG = 5 (83%) | SA, SI | IG: 20 weeks, initially weekly with possibility for more frequent sessions, proactive support through phone calls and objective monitoring to enhance treatment effectiveness. CG: monthly reviews with adolescents/ families to identify treatment needs. | -SA: C-SSRS -SI: SIQ | IG: CBT-RP + E-TAU CG: E-TAU | Yes | No differences between groups in SA and SI at post-treatment and 3-month F/U. | NS | 2 |
Esposito-Smythers et al. [25] | RCT | IG = 74 CG = 73 | Outpatient | IG = 15.1 (1.4) CG = 14.7 (1.5) | IG = 57 (77%) CG = 55 (75.3%) | SA, NSSI, SI | IG: 12 months of weekly individual and bi-weekly parent sessions (0–6 months), bi-weekly individual sessions and monthly parent sessions (6–9 months), monthly individual and parent sessions (9–12 months). CG: variable frequency and type of care provided. | -SA: C-SSRS -NSSI: SITBI -SI: SIQ-Jr | IG: F-CBT CG: E-TAU | AN | No differences between groups in SA, NSSI, SI from pretreatment to 6–12–18- month F/U. | SA: p = 0.95 NSSI: p = 0.33 SI: p = 0.49 at 6-month F/U. SA: p = 0.44 NSSI: p = 0.18 SI: p = 0.95 at 12-month F/U. SA: p = 0.29 NSSI: p = 0.58 SI: p = 0.38 at 18-month F/U. | 2 |
Högberg and Hällström. [24] | RCT | IG = 15 CG = 12 | Outpatient | IG = 14.2 (1.1) CG = 15.2 (0.9) | Total sample: 19 (70.3%) | SA, SI | IG: 12 sessions over 8 months. CG: 20 sessions over 8.5 months. | -SA, SI: C-SSRS | IG: MR-CBT CG: TAU | AN | No differences between groups in SA or SI at post-treatment. | SA, SI: p = 0.07 post-treatment. | 2 |
Esposito-Smythers et al. [26] | RCT | IG = 41 CG = 40 | Outpatient | IG = 15.4 (1.4) CG = 15.4 (1.4) | IG = 23 (56%) CG = 24 (60%) | SH (SA, NSSI) SI | IG: 2 weekends of joining parent-adolescent sessions and individualized booster session post-intervention CG: NS | -SH (SA, NSSI) -SI: SITBI 2.0-SF | IG: ASH-P CG: AO-C | AN | Significantly greater reductions in SH for IG compared to CG at 12-month F/U. No differences between groups in SH at 6-month F/U. No differences between groups in SI at 6–12-month F/U. | SH: p ≤ 0.01 at 12-month F/U. SH: p > 0.05 at 6-month F/U. SI: p > 0.05 at 6–12-month F/U. | 2 |
Hetrick et al. [23] | RCT | IG = 26 CG = 24 | Secondary school | IG = 14.8 (1.6) CG = 14.5 (1.3) | IG = 21 (80.7%) CG = 20 (83.3%) | SA, SI | IG: 8 modules of CBT delivered over 10 weeks. CG: contact with school wellbeing staff and any outside mental health service provision normally available. | -SA: 2-item questionnaire -SI: SIQ | IG: Reframe-IT + TAU CG: TAU | AN | No differences between groups in SA or SI from BL to post-treatment or BL to 22-week F/U. | SA: p > 0.05 SI: p > 0.05 post-treatment. SA: p > 0.05 SI: p = 0.593 at 22-week F/U. | 2 |
Psychodynamic therapy | |||||||||||||
Mentalization-based therapy (MBT) | |||||||||||||
Jørgensen et al. [33] | RCT | IG = 55 CG = 56 | Outpatient | IG = 15.7 (1.1) CG = 15.9 (1.0) | IG = 55 (100%) CG = 55 (98%) | SH | IG: 1 year of 3 introductory sessions, 37 weekly group sessions, 5 individual case formulation sessions, and 6 parent sessions. CG: 12 individual supportive sessions, one per month. | -SH: RTSHI-A | IG: MBT-G CG: TAU | Yes | No differences between groups in SH from BL to post-treatment and 3-12-month F/U. | SH: p = 0.17 post-treatment SH: p = 0.75 at 3-month F/U. SG: p = 0.67 at 12-month F/U. | 2 |
Beck et al. [32] | RCT | IG = 55 CG = 56 | Outpatient | IG = 15.7 (1.1) CG = 15.9 (1.0) | IG = 55 (100%) CG = 55 (98%) | SH | IG: 1 year of 3 introductory sessions, 37 weekly group sessions, 5 individual case formulation sessions, and 6 parent sessions. CG: 12 individual supportive sessions, one per month. | -SH: RTSHI-A | IG: MBT-G CG: TAU | AN | No differences between groups in SH at post-treatment. | SH: p = 0.61 post-treatment | 2 |
Griffiths et al. [30] | RCT | IG = 22 CG = 26 | Outpatient | IG = 15.4 (1.3) CG = 15.7 (1.4) | IG = 17 (77.3%) CG = 21 (80.8%) | SH | IG: 12 weeks of weekly sessions in group format (10 adolescents per group). CG: variable. | -SH: RTSHI-A -SH related hospital: electronic records | IG: MBT-Ai +TAU CG: TAU | NS | No differences between groups in SH from BL to post-treatment and 12–24-month F/U. | SH: p > 0.05 post-treatment and 12–24-weeks F/U. | 2 |
Bo et al. [34] | Pre/post | IG = 25 CG = NA | Outpatient | IG = 16.4 (0.9) | IG = 25 (100%) | SH | IG: 1 year of 2 individual case formulation sessions, 6 group introductory sessions, 34 group therapy sessions, 7 parent sessions. | -SH: RTSHI-A | IG: MBT-G | NS | Significant pre/post-treatment decreases in SH. | SH: p = 0.005 post-treatment. | 4 |
Psychodynamic family-based therapy | |||||||||||||
Diamond et al. [36] | RCT | IG = 66 CG = 63 | Outpatient | IG = 14.3 (7.5) CG = 12.6 (5.7) | IG = 55 (83.3%) CG = 52 (82.5%) | SA, NSSI, SI | IG: 16 weeks (1 or 2 weekly sessions) of individual adolescent and parent sessions, joint parent-adolescent sessions. CG: 16 weeks of weekly individual sessions, one joint adolescent-parent session, four parent education sessions. | -SA, NSSI: C-SSRS -SI: SIQ-JR, | IG: ABFT CG: NST-FE | NS | No differences between groups in SA over treatment period. Significantly fewer percentage of NSSI for IG compared to CG. No differences between groups in in rate of change of SI, SI remission rate (SIQ-Jr<12), and SI response rate ( ≥ 50% decrease from BL SIQ-Jr) at post-treatment. | SA: p = 0.37 NSSI: p < 0.05 SI (rate of change): p = 0.18. | 2 |
c | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Family therapy | |||||||||||||
Systemic family therapy | |||||||||||||
RCT | IG = 415 CG = 417 | Child and adolescent mental health services | IG = 14.3 (1.4) CG = 14.3 (1.4) | IG = 368 (89%) CG = 369 (88%) | SA, NSSI, SI | IG: 6–8 sessions over 6 months. CG: variable | -SA, NSSI: SASII -SI: BSS | IG: SHIFT CG: TAU | NS | No differences between groups in the repetition of SA and NSSI at 12–18-36-month F/U. Significantly greater decrease in SI for IG as compared to CG at 12-month F/U. No differences between groups in SI at 18-month F/U. | SA, NSSI: p = 0.33 at 12–18-month F/U. SA, NSSI: p = 0.78 at 36-month F/U. SI: p = 0.024 at 12-month F/U; p = 0.20 at 18-month F/U. | 2 | |
Integrated family therapy | |||||||||||||
Ayer et al. [41] | Pre/post | IG-1 = 2399 IG-2 = 494 CG = NA | Outpatient | IG-1 = 16.0 (NS) CG = 15.6 (NS) | IG-1 = 99 (20%) IG-2 = 624 (26%) | SA, NSS, ISI | IG-1: 10 sessions over firstly 3 months followed by 2–3 sessions of ACC over 4 to 6 months. IG-2: FBT included MST (4–6 months, average of 40 direct contact hours) or FSN (3 months of 14 individual sessions, 6 parent group sessions, 4 therapeutic home visits, referrals to support groups). | -SA, NSSI, SI: binary indicators. | IG-1: A-CRA IG-2: FBT | NS | No differences between groups in SA, NSSI or SI from BL to 12-month F/U. | SA: Effect size = 0.14 NSSI: Effect size = −0-06 SI: Effect size = 0.15 from BL to 12-month F/U. | 4 |
Wijana et al. [40] | Pre/post | IG = 49 CG = NA | Outpatient | IG = 14.6 (1.3) | IG = 42 (85.7%) | SA, SH | IG: 3 months of bi-weekly meetings, more frequently as needed. | -SA, SH: DSHI-9r | IG: ICT | AN | Significant pre/post-treatment decreases in the frequency of SA and SH. No differences in SA at 6–12-month F/U. Significant post-treatment to 6–12-month F/U in the frequency of SH. | SA: p < 0.0001 SH: p = 0.001 at post-treatment. SA: p = 0.001 SH: p = 0.22 at 6–12-month F/U. | 4 |
Asarnow et al. [39] | RCT | IG = 20 CG = 22 | Outpatient | IG = 14.3 (1.8) CG = 14.8 (1.8) | IG = 18 (90%) CG = 19 (86.4%) | SA/ SH, NSSI | IG: 12 sessions over 3 months. Adolescent and parent individual sessions plus joint parent/adolescent sessions, CBT, DBT skills, and homework. CG: in-clinic parent session and 3 telephone calls ensuring adherence to treatment. | -SA/SH, NSSI: C-SSRS | IG: SAFETY CG: E-TAU | NS | Significantly longer time to first SA for IG as compared to CG at 3-month F/U. No differences between groups in NSSI at 3-month F/U. | SA: p = 0.01 at 3-month F/U. NSSI: p = 0.524 at 3-month F/U. | 2 |
Brief family-based therapy | |||||||||||||
Wharff et al. [42] | RCT | IG = 68 CG = 71 | Hospital, emergency department. | IG = 15.4 (1.3) CG = 15.6 (1.5) | IG = 50 (74%) CG = 50 (70%) | SB | IG: one emergency crisis intervention (based on CBT), duration 60–90 min. CG: standard psychiatric evaluation and clinical/discharge recommendations. | -SB: RFL-A | IG: FBCI + TAU CG: TAU | NS | No differences between groups in SB post-treatment and 1-month F/U. | SB: p = 0.24 | 2 |
Support-based therapy | |||||||||||||
King et al. [43] | RCT | IG = 223 CG = 225 | Inpatient | IG = 15.6 (1.2) CG = 15.6 (1.4) | IG = 159 (71.3%) CG = 160 (71.1%) | SA, SI | IG: 3 months of psychoeducation for support, weekly contact between supports and adolescents. CG: 3 months | -SA: DISC-IV, -SI: SIQ-JR | IG: YST-II + TAU CG: TAU | AN | Significantly greater risk of death for CG compared to IG at 11-14- year F/U. | SA: p < 0.01 at 11–14-year F/U. | 2 |
d | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Brief skills training | |||||||||||||
Gryglewicz et al. [50] | Pre/post | IG = 460 CG = NA | Outpatient | IG = 14.6 (1.8) | CG = 334 (75.2%) | SA, AA, IA, SI | IG: for 3 months, caring contacts were made within 24–72 h post-discharge, followed by weekly sessions for 1 month and monthly sessions for 2 months. | -SA, AA, IA, SI: C-SSRS. | IG: LINC | NS | Significant reductions in SA and SI over the course of treatment. | SA: p < 0.001 SI: p < 0.001 over treatment | 4 |
Yen et al. [48] | RCT | IG = 25 CG = 25 | Inpatient | IG = 15.9 (1.2) CG = 15. 5 (1.4) | IG = 21 (84%) CG = 19 (76%) | SA, AA, IA, NSSI, SI | IG: 3 sessions in the inpatient unit (two individual and one among adolescent and parents), and phone contacts over 6-month post-hospitalization. CG: enhanced monitoring of suicidality and risk factors. | -SA, AA, IA, NSSI, SI: C-SSRS | IG: CLASP-A CG: E-TAU | NS | No differences between groups in SA from BL to 6-month F/U. | SA: p = NS. | 2 |
Rengasamy and Sparks. [49] | Pre/post | IG-1 = 72 IG-2 = 70 CG = NA | Outpatient | IG-1 = 15 (1.6) IG-2 = 15.1 (1.6) | IG-1 = 48 (67%) IG-2 = 51 (73%) | SA | IG-1: 6 phone contacts with adolescent and guardian post-discharge. IG-2: single call intervention. | -SA: C-SSRS. | IG-1: MCI IG-2: SCI | NS | Significantly lower rates of SA for IG-1 compared to IG-2 at 3-month F/U. | SA: p = 0.037 at 3-month F/U. | 4 |
Kennard et al. [46] | RCT | IG = 34 CG = 32 | Inpatient | IG = 14.9 (1.6) CG = 15.3 (1.4) | IG = 30 (88.2%) CG = 29 (90.6%) | SA, NSSI, SI | IG: 3-h ASAP intervention plus BRITE App through daily text messages. CG: Variable. | -SA, NSSI: C-SSRS -SI: SIQ-JR | IG: ASAP + TAU CG: TAU | Yes | No differences between groups for all SITBs at 4–12–24-weeks post-hospitalization. | SA: p = 0.17 NSSI: p = 0.98 SI: p = 0.49 at 4–12–24-weeks post-hospitalization. | 2 |
Motivational interviewing-based intervention | |||||||||||||
Czyz et al. [53] | SMART | Phase 1: IG-1 = 40 IG-2 = 40 Phase 2: IG-1 = 36 IG-2 = 44 | Inpatient/ Outpatient | Phase 1: IG-1 = 15.1 (1.4) IG-2 = 15.2 (1.3) Phase 2: IG-1 = 15.3 (1.3) IG-2 = 15.0 (1.4) | Phase 1: IG-1 = 27 (67.5%) IG-2 = 27 (67.5%) Phase 2: IG-1 = 27 (67.5%) IG-2 = 27 (67.5%) | SA, IA, AA, SI, NSSI | MI-SP: adolescent individual session (60 min) family session (30 minutes) during hospitalization. Texts: two daily for 4 weeks. Booster calls: one call with the adolescent and, separately, one call with the parent. | -SA, IA, AA, SI: C-SSRS. -NSSI: SITBs Interview. -SI: daily surveys. | Phase 1: IG-1: MI-SP + TAU IG-2: MI-SP + text + TAU Phase 2: IG-1: add booster calls IG-2: no booster calls | NS | Phase 1: Significantly lower intensity of SI for IG-1 compared to IG-2. No differences between groups in SI severity at 1–3-month F/U. No differences between groups in SA and SB at 1–3-month F/U. Phase 2: No differences between groups in SI severity at 1–3-month F/U. No differences between groups in SA and SB at 1–3-month F/U. | Phase1: SI (intensity): p = 0.018 SI (severity): p = 0.511; p = 0.714 at 1–3-month F/U. SA: p = 0.139 SB: p = 0.135 Phase 2: SI (severity): p = 0.067; p = 0.151 at 1–3-month F/U. SA: p = 0.654; SB: p = 0.685 at 1–3-month F/U. | 2 |
Czyz et al. [52] | RCT | IG = 18 CG = 18 | Inpatient | Total sample = 15.4 (1.3) | Total Sample = 28 (78.8%) | SA, SI | IG: adolescent individual session (60 minutes), family session (30 min), separate booster phone calls for adolescents and parents. CG: one or more individual sessions of varying duration. | -SA, SI: C-SSRS | IG: MI-SafeCope + TAU CG: TAU | NS | Significantly higher self-efficacy to refrain from SA for IG compared to CG at 1–3-month F/U. Significantly greater reliance on self to cope with SI, and significantly higher likelihood of safety plan uses to manage SI for IG compared to CG at 2-week, 1–3-month F/U. No differences between groups in SA or SI (frequency and duration) at 1–3-month F/U. | SA (self-efficacy): p = 0.030 at 1–3-month F/U. SI (coping relying on self): p = 0.042 SI (safety plan use): p = 0.004 at 2-week, 1–3-month F/U. SA: p = NS. SI (frequency; duration): p = 0.76; p = 0.575 at 1–3-month F/U. | 2 |
Grupp-Phelan et al. [51] | RCT | IG = 79 CG = 80 | Emergency department. | IG = 15.2 (1.6) CG = 14.9 (1.5) | IG = 63 (78.8%) CG = 63 (79.7%) | SA, SI | IG: one brief Motivational Interview session and 1 or 2 F/U case management phone calls. CG: brief mental health care consultation and referral | -SA: C-SSRS -SI: SIQ-JR | IG: STAT-ED CG: E-TAU | NS | No differences between groups in SA at 6-month F/U. No differences between groups in SI at 2–6-month F/U. | SA: p = 0.62 at 6-month F/U. SI: p = 0.72 at 2–6-month F/U. | 2 |
Intensive community care service | |||||||||||||
RCT | IG = 53 CG = 53 | Outpatient. | IG = 16.2 (1.5) CG = 16.3 (1.7) | IG = 36 (68%) CG = 33 (62%) | SH | IG: approximately 4 months of intensity of care flexible, with a maximum of daily contacts. CG: approximately 2 months. | -SH: SHQ | IG: SDS CG: TAU | NS | Significantly greater reductions in multiples episodes of SH for IG compared to CG at 6-month F/U. No differences between groups in any or serious SH. | SH (5 > ): p = 0.008 at 6-month F/U. SH (any/serious): p = 0.560 at 6-month F/U. | 2 | |
Integrative therapy. | |||||||||||||
English et al. [56] | Pre/post | IG = 21 CG = NA | Child and adolescent mental health services | IG = 15.7 (NS) | IG = 17 (81%) | SH | IG: START consisting of TA followed by one of the following modules: SFBT (4–6 sessions), CBT (8–16 sessions) or MBT-A (16–24 sessions). | -SH: SHQ | IG: START (SFBT + CBT + MBT-A) | Yes | START significantly reduced the number of SH pre/post-treatment. CBT alone significantly reduced SH. Insufficient data to prove the efficacy of SFBT or MBT-A alone. | SH: p < 0.02 at post-treatment (START) SH: p = 0.027 at post-treatment (CBT) | 4 |
Combination therapy. | |||||||||||||
Joyce et al. [57] | Trajectory study | Total Sample=84909 | Inpatient/outpatient | Total Sample=15.0 (2.6) | Total Sample=49995 (59%) | SA | NS | NS | Group 1: Antidepressant Monotherapy Grupo 2: Psychotherapy Monotherapy Group 3: Dual Therapy Group 4: No treatment | Yes | Psychotherapy monotherapy lowest incidence of SA; Dual therapy highest incidence of SA | NS | 4 |
