A Pilot Study of Collaborative Assessment and Management of Suicidality With Suicidal Children (CAMS-4Kids)

Study Overview
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Brief Summary
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The purpose of the study is to assess the feasibility and acceptability of CAMS-4Kids for children with suicidal ideation and/or behavior. During this open pilot trial, we will enhance treatment procedures, refine adherence measures, and develop a treatment manual. Our study sample will include 10 children, ages 5 - 11 years old, seeking outpatient services for suicidal ideation and/or behavior.

Detailed Description
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The Collaborative Assessment and Management of Suicidality (CAMS-Jobes, 2006; 2016) is an evidence-based, therapeutic framework for addressing suicide risk in the adult population. CAMS-4Kids, the research intervention used in this study, is a 10-session developmentally-sensitive adaptation of CAMS for children ages 5 - 11 years old. Within the CAMS framework, clinicians treat patient-identified issues that contribute to their suicidal thoughts and/or behavior called suicidal drivers. A clinical road map is provided through the Suicide Status Form (SSF) that guides treatment as an assessment, treatment planning, tracking and clinical outcome tool. Clinicians and children engage in the assessment and treatment planning sections of the SSF - Initial Form at the outset of treatment. A CAMS Stabilization Plan is also collaboratively developed which focuses on reducing access to lethal means, coping strategies, decreasing interpersonal isolation, and ways to address potential barriers to care. Subsequent CAMS-4Kids sessions include ongoing assessment and treatment plan reviews using the SSF - Interim Sessions Form. The CAMS Stabilization Plan is also reviewed and updated as clinically indicated. Treatment involves clinical interventions most appropriate to treat the patient's suicidal drivers. Clinical interventions may include coping cards, Hope Journal, behavioral activation, Virtual Hope Box, increasing social support, guided imagery, DBT relaxation skills, positive self-talk, and other cognitive-behavioral techniques. The conclusion of CAMS-4Kids occurs after 3 consecutive sessions of effectively managing suicidal ideation and behavior. The SSF Outcome/Dispositional Final Session Form is completed at the end of treatment.

Official Title
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A Pilot Study of Collaborative Assessment and Management of Suicidality (CAMS-Jobes, 2006; 2016) With Suicidal Children (CAMS-4Kids)

Conditions
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Suicidal Ideation, Suicide, Attempted

Intervention / Treatment
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* Behavioral: CAMS-4Kids


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children between the ages of 5 - 11 years old, inclusive, at the time of consent; current suicidal ideation and/or behavior; resides with primary caregiver who has legal authority to consent to research participation client of outpatient Behavioral Health Services Outpatient or Mood and Anxiety Program visit scheduled at least 4 weeks from the diagnostic assessment and/or discharge from the Crisis Stabilization Unit. Exclusion Criteria: the inability to understand study procedures (e.g. developmental disabilities, severe cognitive impairments, actively psychotic) inability of the child and/or parent to speak or read English current participation in weekly therapy sessions with outpatient Behavioral Health Crisis Team

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 11 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: This study is an open pilot trial of one treatment without control or comparison group.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CAMS-4Kids<br>Participants will receive up to 10 sessions of CAMS-4Kids | Behavioral: CAMS-4Kids<br>* The Collaborative Assessment and Management of Suicidality (CAMS-Jobes, 2006; 2016) is an evidence-based, therapeutic framework for addressing suicide risk in the adult population. CAMS-4Kids, the research intervention used in this study, is a 10-session developmentally-sensitive adaptation of CAMS for children ages 5 - 11 years old.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CAMS-4Kids Suicide Status Form-4 (SSF-4) | The SSF-4 measures overall suicide risk. | Each session measured from baseline up to 12-week follow-up | 
| Change from baseline in psychosocial functioning and impairment on the Columbia Impairment Scale (CIS) at treatment completion (up to 12 weeks), 3 months and 6 months. | The CIS is a valid 13-item child- and parent- report measure of psychosocial impairment with good internal consistency and test-retest reliability. Scores range from 0 (no problem) to 4 (very bad problem), with higher scores indicating worse outcomes. | Baseline, Treatment Completion (up to 12 weeks), 3 month and 6 month follow-up | 
| Change from baseline in suicidal ideation and behavior on the Columbia-Suicide Severity Rating Scale (C-SSRS) at treatment completion (up to 12 weeks) 3 months and 6 months | The C-SSRS is a validated, semi-structured interview that assesses both suicidal behavior and suicidal ideation (yes/no, frequency), with flexible timepoints and multiple informants depending on administrator purpose and need. Scores range 0 (no ideation) to 5 (ideation with plan and intent), with higher numbers indicating worse outcomes. Suicidal behavior is present or absent, presence of behavior indicates worse outcomes. | Baseline, Treatment Completion (up to 12 weeks), 3 month and 6 month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Client Satisfaction Questionnaire (CSQ-8) | The CSQ-8 is an 8 item measure of treatment satisfaction with services with both a parent and child version. | Up to 12-week follow-up | 
| Therapeutic Alliance Scale for Children, Revised (TASC-r) | The TASC-r is a measure of the working child-therapist working relationship. | Up to 12-week follow-up | 
| Therapeutic Alliance Scale for Caregivers and Parents (TASCP) | The TASCP is a measure of the working caregiver-therapist working relationship. | Up to 12-week follow-up | 
| CAMS Rating Scale | The CAMS Rating scale measures CAMS treatment fidelity. | Each session measured from baseline up to 12-week follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Suicide, Child, CAMS