Implementing an IPTS Treatment Approach to Improve Outcomes in Suicidal Youth
Condition: Suicidal Ideation; Depression
MeSH terms: Suicidal Ideation
Study type: Interventional

Summary: 
      The purpose of this project is to evaluate a set of interventions derived from a theory of
      suicide that supplements a clinical program and compare their effects on outcomes to the
      outcomes of the unsupplemented program. This study proposes to evaluate the effect of these
      interventions on reducing specific negative cognitions associated with depression and suicide
      ideation in an intensive outpatient program for suicidal youth (Suicide Prevention and
      Resilience at Children's, SPARC).
    

Detailed description: 
      The trial will be conducted in a program where half of the clients are enrolled into either
      the original program (SPARC A which has a general focus on negative cognitions) or SPARC B
      (which will overlap significantly with SPARC A but targets in some sessions specific negative
      cognitions of perceived burdensomeness). The program is already structured so that each
      patient consistently attends either a morning or an afternoon track, with different
      therapists running each track. This allows for separate programs in each track. Clinically
      justifiable innovations are routinely introduced into the program usually in a stepwise
      fashion in one or another part by one set of therapists at a time. The investigators propose
      to take advantage of this partial introduction by assessing relative impact of SPARC A and
      SPARC B on depressive symptoms and suicide ideation. The investigators have no data to
      indicate that one program will be better than the other. The investigation will, however,
      allow the investigators to assess whether this innovation in fact is effective. Patients will
      not be randomized at the individual level, but rather their time slot (usually decided based
      on opening within the program) will place them into either SPARC A or SPARC B. The two
      programs are of identical length with numerous features in common, differing only in the
      specificity of the exercises and examples and their relevance to perceived burdensomeness.
      Routine assessments at entry and discharge from the program will not change based on study
      enrollment. However, suicide ideation, depressive symptoms, and negative cognitions
      (perceived burdensomeness and thwarted belongingness) will be more formally assessed at the
      one-month follow-up meeting or phone call which will add approximately 10 minutes to the
      contact.
    

Intervention name(s): SPARC B; SPARC A
Intervention type(s): Behavioral; Behavioral
Intervention description(s): SPARC B includes all aspects of the SPARC A clinical program, as well as targeting negative cognitions of perceived burdensomeness.; SPARC A is an existing clinical program with a general focus on negative cognitions.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: Half of the clients in the SPARC clinical program are enrolled into either the original program or SPARC B (which will overlap significantly with SPARC A but targets in some sessions specific negative cognitions of perceived burdensomeness). The program is already structured so that each patient consistently attends either a morning or an afternoon track, with different therapists running each track. This allows for separate programs in each track. Clinically justifiable innovations are routinely introduced into the program usually in a stepwise fashion in one or another part by one set of therapists at a time. We will assess relative impact of SPARC A and SPARC B on depressive symptoms and suicide ideation. Our investigation will allow us to assess whether this innovation is effective. Patients will not be randomized at the individual level, but rather their time slot (usually decided based on opening within the program) will place them into either SPARC A or SPARC B.
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment