CAMPUS - Feasibility Sub-Study
Condition: Suicide
MeSH terms: Suicide
Study type: Interventional

Summary: 
      Suicide is the 2nd leading cause of death among college students and suicidal ideation and
      suicide-related behaviors are a frequent presenting problem at college counseling centers
      (CCCs), which are overburdened. Studies show that some students respond rapidly to treatment,
      whereas others require considerably more resources. Evidence-based adaptive treatment
      strategies (ATSs) are needed to address this heterogeneity in responsivity and complexity.
      ATSs individualize treatment via decision rules specifying how the type and intensity of an
      intervention can be sequenced based on risk factors, response, or compliance.

      The purpose of this multisite study is to investigate the effectiveness of four adaptive
      treatment strategies (ATSs) to treat college students who report suicidal ideation when first
      seeking services at their college counseling center This multisite study will enroll
      moderately to severely suicidal college students in the "emerging adulthood" phase (ages
      18-25) seeking services at CCCs. This Sequential Multi-Assignment Randomized Trial (SMART)
      will have two stages of intervention. In Stage 1, 700 participants from four CCCs will be
      randomized to 4-8 weeks of: 1) a suicide-focused treatment - Collaborative Assessment and
      Management of Suicidality (CAMS) or 2) Treatment as Usual (TAU). Sufficient responders to
      either intervention will discontinue services/be stepped down. Non-responders will be
      re-randomized to one of two Stage 2 higher intensity/dosage intervention options for an
      additional 4-16 weeks: 1) CAMS (either continued or administered for the first time) or 2)
      Comprehensive Dialectical Behavior Therapy (DBT), which includes individual therapy, skills
      group, and phone/text coaching for the clients and peer consultation for the counselors.
    

Detailed description: 
      We will enroll moderately to severely suicidal college students in the "emerging adulthood"
      phase (ages 18-25) seeking services at CCCs. Eighty-Five participants (N=85) from four CCCs
      will be randomized to one of three treatments delivered via a hybrid model: (1) a
      suicide-focused treatment - Collaborative Assessment and Management of Suicidality (CAMS) for
      4-8 weeks (n=35); (2) Treatment as Usual (TAU) for 4-8 weeks (n=15); or (3) Comprehensive
      Dialectical Behavior Therapy (DBT) for 16 weeks (n=35), which includes individual therapy,
      skills training, phone/text coaching for the clients, and peer consultation for the
      counselors.

      Sufficient responders to CAMS or TAU will discontinue services/be stepped down after 4-8
      weeks. Non-responders to CAMS or TAU will be re-randomized to one of two higher
      intensity/dosage intervention options for an additional 8 weeks of treatment: (1) CAMS
      (either continued or administered for the first time) or (2) Comprehensive DBT.

      For the feasibility study, we will also enroll 12 CCC counselors (3 per site) who will serve
      as study counselor participants and periodically complete measures focused on the experience
      of counselors working with suicidal college students.
    

Intervention name(s): TAU - Phase 1; CAMS - Phase 1; DBT - Phase 1 and 2; CAMS - Phase 2; DBT - Phase 2
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): 4-8 weeks of TAU treatment; 4-8 weeks of CAMS treatment; up to 16 weeks of DBT treatment; Up to 8 weeks of CAMS treatment; Up to 8 weeks of DBT treatment
Allocation: Randomized
Intervention model: Sequential Assignment
Intervention model description: Participants will be randomized to one of three treatments delivered via a hybrid model: (1) a suicide-focused treatment - Collaborative Assessment and Management of Suicidality (CAMS) for 4-8 weeks (n=35); (2) Treatment as Usual (TAU) for 4-8 weeks (n=15); or (3) Comprehensive Dialectical Behavior Therapy (DBT) for 16 weeks (n=35), which includes individual therapy, skills training, phone/text coaching for the clients, and peer consultation for the counselors.
Sufficient responders to CAMS or TAU will discontinue services/be stepped down after 4-8 weeks. Non-responders to CAMS or TAU will be re-randomized to one of two higher intensity/dosage intervention options for an additional 8 weeks of treatment: (1) CAMS (either continued or administered for the first time) or (2) Comprehensive DBT.
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Dialectical Behavior Therapy (DBT); Collaborative Assessment and Management of Suicide (CAMS); University Students