An intensive, short-term outpatient treatment program addressing a range of suicidal behaviors in young adults is proposed. The intervention is considered to be both preventive and promotive in nature. More specifically, patients accepted into the program have been identified as being at """"""""high risk"""""""" for future suicidal behaviors and the primary treatment objective is a demonstrable reduction in both the frequency and severity of future suicidal behaviors with an associated reduction in related symptomatology and the need or demand for future treatment. In general terms, the program hopes to improve individual adaptive capabilities. The primary research objective of the project is to test the program's long-term effectiveness, with comparison to traditional hospitalization as a control. The program targets 18 to 24 year old active-duty soldiers that have acknowledged current suicidal ideation or exhibited a range of suicidal behaviors. In some instances, brief hospitalization following an attempt or gesture will be necessary to ensure stabilization prior to entry into the program. The program is couched within a cognitive-behavioral framework and has three identifiable components: 1) psychoeducational, 2) problem-solving, and 3) experimental-affective. It is designed to be two weeks in duration (9 hrs/day), handle ten to twelve patients per """"""""treatment interval,"""""""" and will include the following daily activities: group therapy, didactic classes, exercise/group activity, and individual sessions. A rigorous experimental design (pre- and post-test with follow-up) will be utilized. Patients will be randomly assigned to one of the two treatment conditions. Measures of psychological distress, associated symptomatology, general psychopathology, suicidal ideation or behavior, and social/occupational functioning will be completed during initial intake, immediately following treatment, and at multiple follow-up points (3, 6, 12, 18, 24 mos.). Additionally, an intensive psychosocial history, including relevant diagnoses, will be completed at intake. The frequency and severity of any suicidal ideation or behavior, as well as emergency room presentations, will be monitored during the follow-up period. The military environment in which the study will be carried out allows for a unique opportunity to rigorously study a structured and replicable outpatient treatment alternative for suicidal young adults.
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