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Motivational Interviewing-Enhanced Safety Planning for Adolescents at High Suicide Risk: A Pilot Randomized
E K Czyz1, C A King1, B J Biermann1
1a Department of Psychiatry , University of Michigan.
Summary
This study found that a motivational interview (MI)-enhanced safety planning intervention (MI-SafeCope) is feasible and acceptable for hospitalized teens at suicide risk. The intervention improved self-efficacy, coping, and safety plan use, showing promise for suicide prevention.
Area of Science:
- Psychiatry
- Clinical Psychology
- Public Health
Background:
- Hospitalized adolescents with suicide risk require effective interventions.
- Safety planning is a critical component of suicide prevention for at-risk youth.
- Motivational interviewing (MI) may enhance engagement and adherence to safety plans.
Purpose of the Study:
- To examine the feasibility and acceptability of a motivational interview (MI)-enhanced safety planning intervention (MI-SafeCope) for hospitalized adolescents at suicide risk.
- To explore proximal outcomes and potential mechanisms of change associated with the MI-SafeCope intervention.
- To assess the impact of MI-SafeCope on adolescent self-efficacy, coping behaviors, safety plan use, and parental motivation.
Main Methods:
- Pilot randomized controlled trial with 36 hospitalized adolescents (ages 13-17) with recent suicidal ideation or attempts.
- Participants were randomized to MI-SafeCope (individual/family sessions, postdischarge call) or treatment as usual.
- Feasibility and acceptability assessed via participation/retention rates and satisfaction; proximal outcomes measured at 2 weeks, 1, and 3 months, and daily for 4 weeks.
Main Results:
- High participation and retention rates, along with positive satisfaction ratings, indicate feasibility and acceptability of MI-SafeCope.
- Adolescents in the MI-SafeCope group showed significantly higher self-efficacy to refrain from suicidal action, greater reliance on self-coping, and increased safety plan use.
- Parents in the MI-SafeCope group reported higher motivation to encourage safety plan use.
Conclusions:
- Motivational interview (MI)-enhanced safety planning (MI-SafeCope) is a feasible and acceptable intervention for hospitalized adolescents at suicide risk.
- MI strategies show promise in improving adherence to safety plans, enhancing self-efficacy and coping skills, and increasing parental support for safety plan use.
- Daily-level assessments are beneficial for understanding individual responses to suicide-specific interventions.
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