Your Teen Has Just Made a Suicide Attempt, Now What?

BACKGROUND:

When family members struggle emotionally the dynamic at home is disrupted. American Foundation for Suicide Prevention (AFSP) Distinguished Investigator Guy Diamond, Ph.D., has developed Attachment Based Family Therapy (ABFT) for suicidal teens to help families reconnect and better manage communication and problem solving.

QUESTION: How can families offer support to teens who have attempted suicide?

STUDY

ABFT introduces five tasks aimed at reducing family distress and improving family functioning. These include:

1. As a first step, teens and their parents start by working together to improve their relationships; followed by
2. Teens meet one-on-one with their therapists to build and alliance and identify core family struggles and ways to address those struggles;
3. Parents meet one-on-one with the therapist to restore family harmony by accessing love and empathy, and learning new parenting skills;
4. Next, the teens and their parents regroup and meet to identify and discuss problems and practice their new communication and problem-solving skills together;
5. As a final step, the family engages in tasks aimed at increasing the adolescent’s ability to function more effectively.

After developing and pilot testing the treatment, Dr. Diamond received a larger grant from the National Institute of Mental Health (NIMH) for a more definitive evaluation. Sixty-six families participated and were randomly assigned to ABFT or Enhanced Usual Care (EUC).

RESULTS

Those receiving ABFT were more likely to stay in treatment (65%) than those who received EUC (6%) Assessments done 24 weeks after the baseline assessment revealed that suicidal, ideation declined more among teens who received ABFT than those who received EUC. Both groups shoed decreased depression over the course of treatment, though ABFT showed a somewhat quicker decline.

TAKEAWAYS

-Attachment Based Family Therapy (ABFT) shows promise for suicidal teens and their families

-An adaptation of ABFT for LGB teens also shows promise as an effective family intervention

-In many instances family balance can be accomplished with treatments such as ABFT and sustained efforts by family members and trained family therapists

Guy S. Diamond, Ph.D.
Associate Professor, College of Nursing and Health Professions
Drexel University
Grant Title: Development of a Family-Based Therapy for Depressed and Suicidal Adolescents
2007 Pilot Research Grant

Grant-Related Publications:

Diamond, G. M., Diamond, G. S., & Liddle, H. A. (2000). The therapist-parent alliance in family-based therapy for adolescents. Journal Of Clinical Psychology, 56(8), 1037-1050.

Diamond, G. S., Reis, B. F., Diamond, G. M., Siqueland, L., & Isaacs, L. (2002). Attachment-based family therapy for depressed adolescents: a treatment development study. Journal Of The American Academy Of Child And Adolescent Psychiatry, 41(10), 1190-1196.

Diamond, G. M., Diamond, G. S., & Hogue, A. (2007). Attachment-based family therapy: adherence and differentiation. Journal Of Marital And Family Therapy, 33(2), 177-191

Diamond, G. S., Wintersteen, M. B., Brown, G. K., Diamond, G. M., Gallop, R., Shelef, K., & Levy, S. (2010). Attachment-based family therapy for adolescents with suicidal ideation: a randomized controlled trial. Journal Of The American Academy Of Child And Adolescent Psychiatry, 49(2), 122-131.

Bevans, K. B., Diamond, G., & Levy, S. (2012). Screening for adolescents' internalizing symptoms in primary care: item response theory analysis of the behavior health screen depression, anxiety, and suicidal risk scales. Journal Of Developmental And Behavioral Pediatrics: JDBP, 33(4), 283-290. doi:10.1097/DBP.0b013e31824eaa9a

Shpigel, M. S., Diamond, G. M., & Diamond, G. S. (2012). Changes in parenting behaviors, attachment, depressive symptoms, and suicidal ideation in attachment-based family therapy for depressive and suicidal adolescents. Journal Of Marital And Family Therapy, 38 Suppl 1271-283. doi:10.1111/j.1752-0606.2012.00295.x

Diamond, G., Creed, T., Gillham, J., Gallop, R., & Hamilton, J. L. (2012). Sexual trauma history does not moderate treatment outcome in Attachment-Based Family Therapy (ABFT) for adolescents with suicide ideation. Journal Of Family Psychology: JFP: Journal Of The Division Of Family Psychology Of The American Psychological Association (Division 43), 26(4), 595-605. doi:10.1037/a0028414