Citation

Diefenbach GJ, Rudd MD, Merling LF, Davies C, Katz BW, Tolin DF. Cogn. Behav. Pract. 2021; 28(2): 224-240.

Copyright

(Copyright © 2021, Association for Advancement of Behavior Therapy, Publisher Elsevier Publishing)

DOI

10.1016/j.cbpra.2020.09.010

PMID

unavailable

Abstract

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone. © 2021

Language: en

Keywords

adult; human; suicide; female; case report; treatment; pilot study; suicidal ideation; depression; suicide attempt; suicidal behavior; clinical trial; crisis intervention; treatment outcome; clinical article; length of stay; self report; priority journal; middle aged; intervention study; mental patient; hospital patient; follow up; hospital discharge; cooperation; patient satisfaction; hospital care; skill; standardization; Article; evidence based practice; feasibility study; treatment duration; open study; young adult; cognitive behavioral therapy; attitude assessment; preliminary data; multidisciplinary team; Client Satisfaction Questionnaire; cognitive behavioral; hospitalized; patient attendance