The proposed project is a clinical trial of three different psychotherapeutic interventions for adolescent suicide attempters with RDC major depression. One hundred twenty (120) nonpsychotic, non-bipolar depressed suicide attempters aged 13-18, will be randomly assigned to one of three treatments: (1) cognitive-behavioral therapy (CBI); (2) systemic-behavioral family therapy (SBFT); or (3) non-directive supportive therapy. Treatment will be 12-16 sessions in length to be delivered over a 12 week period, and will be monitored for integrity with the therapeutic model through intensive training and supervision, use of therapy manual, and monitoring a rating of videotaped sessions.
The aims of the study are to test the following hypotheses: (1) Patients treated with CBT and SBFR relative to patients treated with NST will show greater improvements in the prevalence and severity of depression and suicidality and in social competence, (2) At 3, 6, 9, and 12 month follow-up, CBT- and SBFr-treated patients will continue to show decreased prevalence and severity of depression and suicidality and superior social competency compared to NST-treated patients. Those factors predictive of responses to CBT vs. SBFR will also be explored.
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