Adolescents Coping with Co-occurring Early Psychosis and Suicidality: A Parent Training Intervention (ACCEPT)

Young people with psychotic symptoms are at significantly elevated risk for suicidal behavior, particularly in the early years of onset. Yet, they are frequently excluded from suicide prevention trials, leaving a critical gap in available treatment options. Family involvement is a cornerstone of early psychosis care and suicide prevention, but few interventions address the parent-child dynamic in this high-risk group. Acceptance-based therapies, like Acceptance and Commitment Therapy (ACT), offer promising strategies to manage distress by fostering psychological flexibility and values-driven action. These interventions are also ripe for modifying to reduce distress in young people experiencing early psychotic symptoms, supporting their safety, and engaging their families as allies in recovery.

Dr. Shirley Yen used her AFSP grant funds to test the feasibility and acceptability of ACCEPT (Adolescents Coping with Co-occurring Early Psychosis Treatment), a novel, family-focused, acceptance-based intervention for youth ages 12–25 with both psychotic symptoms and suicidal ideation or behavior. Nine families were recruited from inpatient, outpatient, and partial hospital settings. The intervention included individual, family, and joint sessions, and focused on psychoeducation, emotion coaching, safety planning, and ACT-based skill-building. Results from five completers and three detailed case studies showed reductions in psychiatric symptoms and functional impairment, increased psychological flexibility, and no suicide attempts or hospitalizations during the study or follow-up period. Both youth and parents reported high satisfaction, and all case study participants achieved progress toward their valued goals. Though preliminary, these findings suggest ACCEPT may serve as a valuable adjunct or bridge for suicidal youth with psychosis, particularly in settings with limited access to full coordinated specialty care.

Citation: Foo, C.Y.S., Gaudiano, B.A., Friedman-Yakoobian, M. et al. Acceptance-Based Parent Training Intervention for Youths with Co-occurring Psychotic Symptoms and Suicidal Behaviors: a Case Series from an Open Trial. J Cogn Ther 17, 31–52 (2024). https://doi.org/10.1007/s41811-023-00181-1