Approximately 9 percent of adolescents in the United States attempt suicide each year. Adolescents who have previously attempted suicide are about eight times more likely to reattempt than adolescents who have not previously attempted. Given the magnitude of this problem, it is surprising that no empirically validated treatment exists for this high-risk population. The goal of this small grant proposal is to conduct a pilot study comparing an experimental treatment to a routine treatment control condition. Adolescents presenting to a large, urban children's hospital for medical treatment following an attempt will be eligible for participation in the study. Following a standard psychiatric evaluation, adolescents referred for outpatient psychotherapy and their guardian(s) will be approached to obtain consent for participation in the study. Those for whom consent is received will be randomized to one of two conditions, with 25 subjects assigned to the experimental treatment and 25 subjects assigned to the routine treatment condition. The experimental treatment consists of six sessions that target two areas shown to be deficient in adolescent suicide attempters: problem solving and affect management for anger and depressed mood. The routine treatment condition consists of a comparable number of sessions in an unstructured format typical of community treatment for this problem. Outcome data will be collected from adolescents and their guardian(s) during 3- and 6-month clinic follow-up interviews. The goal of the experimental treatment is to increase problem solving and decrease anger, depressed mood, and suicidal ideation at 3 months following an attempt compared to the routine treatment condition as well as maintain these changes and reduce repeat suicide attempts 6 months following an attempt.
