Suicide Safety Planning Group Treatment: "Project Life Force"
Condition: Suicide
MeSH terms: Suicide
Study type: Interventional

Summary: 
      For suicidal individuals, minimizing future risk and fostering recovery are critical public
      health concerns, especially among Veterans, as very few effective interventions exist. This
      proposal tests a novel group psychotherapy treatment that combines emotion regulation skill
      based, and psychoeducational approaches, with suicide safety planning development and
      implementation.

      "Project Life Force" (PLF), a novel suicide safety planning group intervention has been
      designed to fill this critical gap and provide a mechanism to develop and enhance suicide
      safety planning over time. PLF, a 12-session, group psychotherapy intervention, combines
      Dialectical Behavioral Therapy (DBT) skill based and psychoeducational approaches, to enhance
      suicide safety planning development and implementation. Veterans revise their plans over
      several weeks while learning distress tolerance, emotion regulation, and friendship
      building/interpersonal skills to incorporate into their safety plans and also receive lessons
      on gun safety and minimizing access to lethal means. Sessions are augmented with 1) training
      in the use of a suicide safety planning mobile App to promote accessibility and maximize
      implementation, and 2) didactic information to bolster recovery, including fostering improved
      connection with the treatment team, and Veteran's family.
    

Detailed description: 
      Despite the enrichment of VA suicide prevention services and implementation of the national
      suicide hotline, Veteran suicide completions have risen to 22 per day and suicide attempts
      numbered over 15,000 in 2012. These data underscore the urgency of developing additional
      interventions targeting suicidal Veterans. The construction of a Suicide Safety Plan (SSP); a
      "best practice", is mandated throughout the VA system, and a vital component of the VA's
      coordinated effort at suicide prevention and recovery. The investigators' pilot data on
      patterns of SSP use in suicidal Veterans over a 30 day time frame demonstrates that only 65%
      of Veterans used their safety plans, coping strategies listed on the plan were often
      mismatched or inadequate to the individual's needs, and limited access to the SSP during
      times of stress negatively impacted its utility. To the investigators' knowledge, there are
      currently no recommended guidelines or mechanisms for refinement of the SSP in adult
      populations beyond its initial development. "Project Life Force" (PLF), a novel suicide
      safety planning group intervention has been designed to fill this critical gap and provide a
      mechanism to develop and enhance suicide safety planning over time. PLF, a 12-session, group
      psychotherapy intervention, combines Dialectical Behavioral Therapy (DBT) skill based and
      psychoeducational approaches, to enhance suicide safety planning development and
      implementation. Veterans revise their plans over several weeks while learning distress
      tolerance, emotion regulation, and friendship building/interpersonal skills to incorporate
      into their safety plans and also receive lessons on gun safety and minimizing access to
      lethal means. Sessions are augmented with 1) training in the use of a suicide safety planning
      mobile App to promote accessibility and maximize implementation, and 2) didactic information
      to bolster recovery, including fostering improved connection with the treatment team, and
      Veteran's family. Importantly, the group format mitigates loneliness and fosters increased
      "belongingness", both key risk factors for suicide. Additionally, PLF's weekly format
      facilitates VA-mandated monitoring for any Veteran placed on the suicide "high risk" list.

      Data from this project will test the intervention's feasibility, acceptability and
      preliminary efficacy and provide pilot data for a larger randomized clinical trial. The
      project is comprised of two phases. In Phase 1, the investigators will finalize the PLF
      intervention and accompanying manual and handouts. In Phase 2, the investigators will conduct
      an open label trial of PLF in 50 suicidal Veterans to evaluate the feasibility and
      acceptability of the intervention. The investigators will also test whether PLF affects
      outcomes of suicide ideation, depression, hopelessness, and outpatient compliance by
      examining clinically meaningful differences in these measures before and after PLF.
    

Intervention name(s): Project Life Force Group Treatment
Intervention type(s): Behavioral
Intervention description(s): PLF, a 12-session, group psychotherapy intervention, combines Dialectical Behavioral Therapy (DBT) skill based and psychoeducational approaches, to enhance suicide safety planning development and implementation. Veterans revise their plans over several weeks while learning distress tolerance, emotion regulation, and friendship building/interpersonal skills to incorporate into their safety plans and also receive lessons on gun safety and minimizing access to lethal means. Sessions are augmented with 1) training in the use of a suicide safety planning mobile App to promote accessibility and maximize implementation, and 2) didactic information to bolster recovery, including fostering improved connection with the treatment team, and Veteran's family. Importantly, the group format mitigates loneliness and fosters increased "belongingness", both key risk factors for suicide.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment