A Feasibility Open Trial of App-Enhanced Brief CBT for Suicidal Inpatients

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the feasibility of integrating Brief Cognitive-Behavioral Therapy (BCBT) counseling with a software application (app) to prevent future suicidal thoughts and behaviors.

Detailed Description
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Participants will provide written informed consent. Participants will complete up to 4 sessions of BCBT (depending on length of stay) incorporating the use of a SmartPhone app. This study treatment will be completed in addition to usual care in an open trial design. Assessments will be completed at intake, discharge, and 1-, 2-, and 3-month follow-up.

Official Title
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A Feasibility Open Trial of App-Enhanced Brief CBT for Suicidal Inpatients

Conditions
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Suicidal and Self-injurious Behavior

Intervention / Treatment
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* Behavioral: App-Enhanced Brief Cognitive-Behavioral Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of suicide attempt (lifetime) AND active ideation (with or without plan or intent) on admission Own and have access to their phone (iPhone or Android with capability to download apps) during their inpatient stay Ability to understand the nature of the study and provide written informed consent Willing and able to provide at least two verifiable contacts for emergency or tracking purposes Expected length of stay long enough to complete the entire treatment protocol Exclusion Criteria: Not fluent in English Experiencing current mania or psychosis Have lifetime history of schizophrenia spectrum disorder, intellectual disability, or organic brain illness Inpatient treatment plan includes detox protocol or electroconvulsive therapy Any other psychiatric or medical condition that in the investigator's opinion would preclude informed consent or participation in the trial

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 24 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
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: App-Enhanced Brief Cognitive-Behavioral Therapy<br>Up to 4 in-person sessions | Behavioral: App-Enhanced Brief Cognitive-Behavioral Therapy<br>* BCBT is a cognitive-behavioral intervention designed to target core skills deficits among suicidal individuals. App-enhanced BCBT incorporates the use of a SmartPhone app during the therapy sessions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Client Satisfaction at Discharge | The Client Satisfaction Questionnaire (CSQ) contains 8 multiple choice items and 1 open response item for Comments, and assesses the acceptability and satisfaction of the study treatment. Items are rated from 1 to 4, with higher numbers representing greater satisfaction with the treatment. The mean and standard deviation for the CSQ will be reported utilizing all available data. | Assessed at completion of inpatient treatment (average of 16 days from admission) | 
| App Usability at Discharge | The System Usability Scale (SUS) contains 10 items assessing the usability of digital technology. Items are rated from 1 to 5 with higher numbers representing stronger agreement with usability statements. The mean and standard deviation for the SUS will be reported utilizing all available data. | Assessed at completion of inpatient treatment (average of 16 days from admission) | 
| Frequency of suicide attempts | Frequency (percentage) of participants who made a suicide attempt over the entire follow-up period | 3 months post-discharge from inpatient unit | 
| Suicidal Ideation Baseline | The Adult Suicide Ideation Questionnaire (ASIQ) is a 25-item self-report scale that assesses suicidal ideation on a 7-point scale, with possible total scores ranging from 0 to 150. Higher scores indicate more severe suicidal ideation. Means and standard deviations will be reported utilizing all available data. | Baseline (before receiving BCBT intervention) | 
| Suicidal Ideation at Discharge | The Adult Suicide Ideation Questionnaire (ASIQ) is a 25-item self-report scale that assesses suicidal ideation on a 7-point scale, with possible total scores ranging from 0 to 150. Higher scores indicate more severe suicidal ideation. Means and standard deviations will be reported utilizing all available data. | Assessed at completion of inpatient treatment (average of 16 days from admission) | 
| Suicidal Ideation 1 month | The Adult Suicide Ideation Questionnaire (ASIQ) is a 25-item self-report scale that assesses suicidal ideation on a 7-point scale, with possible total scores ranging from 0 to 150. Higher scores indicate more severe suicidal ideation. Means and standard deviations will be reported utilizing all available data. | 1 month after discharge | 
| Suicidal Ideation 2 months | The Adult Suicide Ideation Questionnaire (ASIQ) is a 25-item self-report scale that assesses suicidal ideation on a 7-point scale, with possible total scores ranging from 0 to 150. Higher scores indicate more severe suicidal ideation. Means and standard deviations will be reported utilizing all available data. | 2 months after discharge | 
| Suicidal Ideation 3 months | The Adult Suicide Ideation Questionnaire (ASIQ) is a 25-item self-report scale that assesses suicidal ideation on a 7-point scale, with possible total scores ranging from 0 to 150. Higher scores indicate more severe suicidal ideation. Means and standard deviations will be reported utilizing all available data. | 3 months after discharge |