Baker, J. C., et al. (2024).
JAMA Network Open, 7(11), e2445913.
Abstract
Importance Suicide rates continue to increase in the US. Evidence-based treatments for suicide risk exist, but their effectiveness when delivered via telehealth remains unknown.
Objective To test the efficacy of brief cognitive behavioral therapy (BCBT) for reducing suicide attempts and suicidal ideation among high-risk adults when delivered via telehealth.
Design, Setting, and Participants This 2-group parallel randomized clinical trial comparing BCBT with present-centered therapy (PCT) was conducted from April 2021 to September 2023 with 1-year follow-up at an outpatient psychiatry and behavioral health clinic located in the midwestern US. Participants reporting suicidal ideation during the past week and/or suicidal behavior during the past month were recruited from clinic waiting lists, inpatient service, intermediate care, research match, and direct referrals from clinicians. A total of 768 participants were invited to participate, 112 were assessed for eligibility, and 98 were eligible and randomly assigned to a treatment condition. Data analysis was from April to September 2024.
Interventions Participants received either BCBT, an evidence-based suicide-focused treatment that teaches emotion regulation and reappraisal skills, or PCT, a goal-oriented treatment that helps participants identify adaptive responses to stressors. Participants were randomized using a computerized stratified randomization algorithm with 2 strata (sex and history of suicide attempts).
Conclusions and Relevance The findings of this randomized clinical trial suggest that BCBT delivered via video telehealth is effective for reducing suicide attempts among adults with recent suicidal thoughts and/or behaviors.
Here are some thoughts:
The study investigated the effectiveness of brief cognitive behavioral therapy (BCBT) delivered via telehealth for suicide prevention. Conducted from April 2021 to September 2023, the randomized clinical trial involved 96 adults with recent suicidal ideation or behaviors, comparing BCBT with present-centered therapy (PCT).
The research addressed a critical public health concern, noting that suicide rates in the US have increased by over 33% since 2000, with 49,449 suicides recorded in 2022. The study aimed to test whether BCBT could be effectively delivered through telehealth, a method that became increasingly prevalent during the COVID-19 pandemic.
Key findings revealed that participants receiving BCBT experienced significantly fewer suicide attempts compared to those in the PCT group. Specifically, participants in the BCBT group made 0.70 attempts per participant, while PCT participants averaged 1.40 attempts, representing a 41% reduced risk for suicide attempts. Both treatment groups showed significant reductions in suicidal ideation severity, with no statistically significant difference between them.
The study's design included 12 weekly individual sessions delivered remotely, with participants randomized across two strata: biological sex and history of suicide attempts. BCBT focused on teaching emotion regulation and cognitive reappraisal skills, while PCT provided a more supportive, less structured approach to addressing life stressors.
These findings are particularly significant as they demonstrate the potential of telehealth in delivering evidence-based suicide prevention interventions, potentially improving access to critical mental health services for high-risk individuals.
