This Mentored Patient-Oriented Research Cancer Development Award (K23) outlines a training program that supports the candidate's goal to become an independent investigator with expertise in psychotherapy research that aims to reduce suicidal ideation and behavior in depressed adolescents. While adolescent suicide remains a major public health problem, little is known about effective treatments for at-risk youth. Dialectical Behavior Therapy (DBT) has been shown to be effective for suicidal (female) adults in at least one randomized controlled trial. These findings call for replication and encourager further investigation of DBT and its potential value as a treatment for adolescents. Depression has been demonstrated to be a primary risk factor for adolescent suicide and therefore, is a likely target for intervention. The candidate has outlined a five-year research program that proposes to extend previous work by adapting DBT as a treatment for suicidal adolescents who meet criteria for a DSM-IV depressive disorder and by exploring possible gender differences with respect to the treatment's acceptability and efficacy. The core project involves the conduct of a pilot controlled clinical trial to investigate the feasibility of the modified DBT intervention. The ultimate goal of the training program is to develop the skills, methods, and resources the candidate will need to test the efficacy of the new treatment in a larger randomized controlled trial, to be specified in a R01 application in the fourth year of the award period. The proposed training program integrates formal coursework consultation with established clinical investigators, and supervised research activities that will enable the candidate consultation with establish clinical investigators, and supervised research activities that will enable the candidate (1) to gain advanced training in methods of implementing Dialectical Behavior Therapy in a research setting; (2) to acquire skills in conducting clinical trials of psychotherapy interventions for children and adolescents; and (3) to develop comprehensive knowledge of the ethical, legal and safety issues relevant to suicide intervention research.
