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

your-teen-has-just-made-a-suicide-attempt-now-what_medium_smallWhen 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.

ABFT introduces five tasks aimed at reducing family distress and improving family functioning, including:

  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 an 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 together 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).

People who received 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 EUC. Eleven percent of teens in the ABFT group made subsequent attempts compared with 22% of teens who received EUC.  Both groups showed decreased depression over the course of treatment, though ABFT showed a somewhat quicker decline.

Key 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.

Publications from AFSP grant

  • Diamond, GM, Diamond, GS, Liddle HA. (2000) The Therapist-Parent Alliance in Family-Based Therapy for Adolescents. JCLP/ In Session Psychother Prac, 56(8): 1037-1050.
  • Diamond, GS, Reis, BF, Diamond, GM, Siqueland, L, Isaacs, L. (2002) Attachment-Based Family Therapy for depressed adolescents:  A treatment development study. J Am Acad Child Adolesc Psychi, 41(10):  1190-1196.
  • Diamond, GS, Diamond GM, Hogue A. (2007) Attachment-Based Family Therapy: Adherence and differentiation.  J Marital Fam Ther, 33(2), 177–191
  • Diamond, GS., Wintersteen,MB, Brown, GK, Diamond, GM, Gallop, R, Shelef, K, Levy, S, (2010) Attachment-Based Family Therapy for Adolescents with Suicidal Ideation: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychi, 49(2): 122-131.
  • Bevans, KB, Diamond, GS, Levy, S. (2012) Screening for Adolescents’ Internalizing Symptoms in Primary Care: Item Response theory Analysis of the Behavioral Health Screen Depression, Anxiety, and Suicidal Risk Scales.  J Dev & Beh Ped, 33(4): 283-290.
  • Shpigel, MS, Diamond, GM, Diamond, GS. (2012) Changes in parenting behaviors, attachment, depressive symptoms and suicidal ideation in Attachment Based Family Therapy for depressive and suicidal adolescents. doi: 10.1111/j.1752-0606.2012.00295.x. J Marital Fam Ther, 38 (S1), 271–283.
  • Diamond, G, Creed, T, Gillham, J, Gallop, R, Hamilton, JL. (2012) Sexual Trauma History Does not Moderate Treatment Outcome in Attachment-Based Family Therapy (ABFT) for Adolescents With Suicide Ideation. J Fam Psychol 26 (4), 595–605.

Guy S. Diamond, Ph.D. is the Professor Emeritus at the University of Pennsylvania School of Medicine and Associate Professor at Drexel University in the College of Nursing and Health Professions. At Drexel, he is the Director of the Center for Family Intervention Science (CFIS) and the Director of the Ph.D. program in Couple and Family Therapy. In 1997 Dr. Diamond received a Pilot Grant from AFSP to develop a adapt ABFT for suicidal teens and their family as previously its focus was families with a depressed teenage.  In 2008, he received a Distinguished Investigator Grant to conduct a pilot evaluation study of ABFT.


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