Category: Suicide and Self-Injury
Shirley Yen, Ph.D. (she/her/hers)
Associate Professor
Harvard Medical School
Newton, Massachusetts
Elizabeth McCauley, PhD, ABPP (she/her/hers)
Professor
University of Washington
Seattle, Washington
Anthony Spirito, ABPP, Ph.D. (he/him/his)
Professor
Alpert Medical School of Brown University
Mattapoisett, Massachusetts
Shirley Yen, Ph.D. (she/her/hers)
Associate Professor
Harvard Medical School
Newton, Massachusetts
Katherine Tezanos, Ph.D. (she/her/hers)
Post-doctoral Fellow
Alpert Medical School of Brown University
Providence, Rhode Island
Natalia Macrynikola, Ph.D. (she/her/hers)
Postdoctoral Fellow
Beth Israel Deaconess Medical Center / Harvard Medical School
Boston, Massachusetts
Jennifer Wolff, Ph.D. (she/her/hers)
Associate Professor
Alpert Medical School of Brown University
Providence, Rhode Island
Given the increasing rates of suicidal behavior in youth over the past decade, novel approaches to targeting suicide-related behaviors in this population are certainly warranted. In this symposium, we present an example of an intervention development project from its initial development to the current state of testing its implementation, in three inpatient clinical settings.
In the first presentation, we present our research data that supported the examination of a novel target (i.e., positive affect). We will discuss the decision to modify and/or develop a new adjunctive intervention, and hence, the development of an acceptance-based approach to positive affect, Skills to Enhance Positivity (STEP).
Our second presentation will describe results from two pilot trials of STEP, with patients recruited from an inpatient adolescent psychiatric unit,in which we examine feasibility, acceptability, and preliminary clinical outcomes. The first was an open trial of 19 participants and the second was a pilot randomized controlled trial of STEP vs. enhanced treatment as usual (n=52). Our studies yielded promising results across a number of metrics, which will be presented.
The third presentation will be focused on the digital remote delivery of STEP via text messaging. STEP utilizes multiple modes of delivery – four in-person sessions delivered during the inpatient admission, and three months of text messaging following discharge. We will present text engagement rates as well as predictors for engagement – questions that are essential given the growth in interest in digital health.
Our fourth presentation will describe various adaptations that we have explored including delivering STEP as a group intervention in a pilot RCT to outpatient young adults, and the development of videos to supplement in-person sessions, to enhance the feasibility of delivery.
Our final presentation will describe clinician feedback on our current multi-site RCT of STEP at three adolescent inpatient psychiatric units. We will describe the changes we made in response to clinical feedback on the best ways to implement an adjunctive intervention in the context of multiple ongoing clinical demands on unit staff and staffing shortages.
Our objective is to present a programmatic line of treatment development from collection of pilot data to establish the need for a novel intervention, to development and pilot testing, to adaptation and implementation. Thus our presentations reflect various stages in this process with some data already published, and some data still to be collected. We believe that this overview and example of a treatment development project will be informative to researchers who are seeking to adapt or develop new interventions, as well as clinicians implementing evidence based treatments to their clinical settings, to reduce suicidal behavior in at-risk youth.
