There is tremendous co-existence of alcohol use disorders and mental health disorders. More specifically, there is a substantial overlap between alcohol use disorders and mood disorders, with over one third of alcohol use disorder patients seeking treatment have comorbid major depression. Patients with comorbid alcohol use disorder and major depression are among those individuals with the highest risk for suicidal behavior. Despite these high levels of comorbidity and suicidal risk, there has been virtually no research developing or investigating treatments to reduce suicidal behavior in patients with comorbid alcohol use disorder and major depression. The overall aim of this study is to develop the T-SAD (Treatment of Suicide in Alcoholic and Depressed patients) treatment as an adjunctive treatment to reduce suicidal behavior for patients with comorbid alcohol use disorder and major depression who have made a recent suicide attempt, and to collect preliminary data on the efficacy of this treatment program. More specifically, we propose to: 1) Develop a comprehensive treatment manual for the T-SAD treatment - a multi-modal intervention which consists of an integration of motivational intervention, cognitive therapy, and family intervention administered by telephone. 2) Develop, implement and evaluate a therapist training program. 3) Develop and test the reliability and validity of competence and adherence rating scales that evaluate the training therapists' ability to perform the therapy and assess the reliable delivery of the treatment. 4) Conduct a randomized controlled pilot study in a sample of patients with alcohol use disorder and major depression who have made a recent suicide attempt to assess the feasibility and acceptability of the proposed treatment, and to provide an estimate of effect size in comparison to treatment as usual. This pilot study will lay the groundwork for a larger clinical trial (Phase II) evaluating the efficacy of this new treatment for suicide in this high-risk group of patients.
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