Magazine article Clinical Psychiatry News

Improved Family Dynamics Help Suicidal Teens: From the Annual Conference of the American Association of Suicidology

Magazine article Clinical Psychiatry News

Improved Family Dynamics Help Suicidal Teens: From the Annual Conference of the American Association of Suicidology

Article excerpt

PORTLAND, ORE. - In a randomized trial, attachment-based family therapy helped depressed, suicidal adolescents more than other approaches even if they had been sexually abused, a factor associated with worse outcomes with other therapies.

The goal of attachment-based family therapy (ABFT) is to strengthen family cohesion as a buffer against adolescent suicidal thinking, depression, and risk behaviors. Parents and teenagers work individually with therapists on communication, trust, self-esteem, and other issues, and then work on them together in family sessions.

The process "puts the burden of change on all the family members," not just the adolescent, said Matthew B. Wintersteen, Ph.D., director of research in the division of child and adolescent psychiatry at Thomas Jefferson University, Philadelphia.

In the trial, 35 adolescents aged 12-17 were randomized to 12 weeks of ABFT; 31 others were referred to 12 weeks of family or individual therapy from community providers and stayed in weekly phone contact with the researchers.

All of the adolescents were depressed and had severe, persistent suicidal ideation; 80% (53) were female and three-quarters were African American. Thirty reported histories of sexual abuse and were more likely to have attempted suicide in the past.

The ABFT group averaged about nine sessions over a period of 12 weeks, while the community care group averaged three. Subjects' progress was assessed by interviews and psychological scoring before, during, and after treatment.

In the end, "everybody got significantly better; [the] ABFT [group] just did better," Dr. Wintersteen said.

For example, 87% (30) in the ABFT group met criteria for clinical recovery from suicidal ideation, compared with 52% (16) in the community care group. Twelve weeks after treatment ended, 70% (25) in the ABFT group had maintained the benefits; just 35% (11) in the community care group had done the same. …

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