A DBT Intervention to Support Parents of Teens at Risk for Suicide in the Transition From Inpatient to Outpatient Care

The transition from inpatient to outpatient care for youth with self-injurious thoughts and behaviors (SITBs) is an extremely high-risk period for suicide attempts and death by suicide (Chung et al., 2017). Parent support is during this transition is urgently needed, as parents play a critical role in keeping the teen safe at home during the gap between inpatient and outpatient care. At present, there is limited research on interventions that address this high-risk transition period, and no interventions that focus exclusively on parents. The purpose of the present study is to conduct a pilot effectiveness trial of a parent support intervention (DBT-PI) for parents of youth hospitalized for SITBs. Intervention components are based on prior research, best-practice recommendations and known risk factors for suicide in adolescents. Participants will be parents of youth hospitalized for suicidal ideation, suicide attempts and/or non-suicidal self-injury. The research will consist of two phases. Phase 1 will focus on optimizing the treatment manual based on data from a small open trial of the intervention (n = 5) and feedback from key stakeholder groups (adolescents, parents, inpatient providers, outpatient providers and parent survivors of suicide loss). Phase 2 will be a pilot randomized clinical trial (RCT) with n = 30 sets of parents randomly assigned to receive either the parent support intervention (DBT-PI) + inpatient treatment as usual (I-TAU) or I-TAU alone. Outcome measures will include: 1) the feasibility and acceptability of the intervention; 2) improvements in parent functioning (including depressive symptoms, emotion dysregulation, caregiver strain, family conflict and parent perceived self-efficacy to keep their teen safe); and 3) youth suicidal thoughts and behaviors. Supporting parents to manage safety and establish outpatient services is a critical target of suicide prevention efforts that may lead to reduction in SITBs and death by suicide.