Coping long term with active suicide in adolescents: Results from a pilot randomized controlled trial

To adapt the Coping Long Term with Active Suicide Program (CLASP) for use with adolescents (CLASP-A) and to assess its feasibility and acceptability on an inpatient psychiatric unit. CLASP-A entailed three individual sessions and one family session, followed by a series of outpatient phone calls to adolescent and a designated parent/guardian over 6 months of follow-up.

The open trial phase involved 17 adolescent/parent pairs, followed by a pilot randomized controlled trial (RCT) in which adolescent/parent pairs were randomized to CLASP-A (n = 25) or enhanced treatment as usual (ETAU; n = 25). Assessments were completed at baseline, 3- and 6-month follow-ups.

In the open trial, average in-person session attendance was 67%, and study treatment satisfaction was high. To enhance feasibility, we adapted CLASP-A to be completed in three individual sessions for the RCT; 77% of the sessions were completed and study satisfaction remained high in adolescents (3.32/4.0) and parents (3.62/4.0). There were no significant differences between groups in number of suicide attempts or readmissions during follow-up.

Data indicate feasibility and acceptability of CLASP-A. However, the absence of treatment effects between groups raises questions regarding CLASP's potential efficacy with adolescents or the need for more extensive adaptations for adolescents.