Developing a Brief Adjunct Intervention to Reduce Suicidal Thoughts and Behavior in Youth: Compassionate Mind Training Teen.

Suicide is the second leading cause of death among 15 to 24-year-olds. To address this significant public health concern, this study seeks to adapt a brief intervention to decrease suicidal thoughts and behaviors (STBs), Compassionate Mind Training Teen (CMT Teen), for adolescents receiving treatment in partial psychiatric hospitalization programs. The original CMT-Pupil intervention has been shown to reduce anxiety symptoms in middle school students in the UK but has not been studied in treatment settings and in adolescents at high risk for suicide. We aim to address this gap by adapting CMT to adolescents with acute mental health symptoms to be used in conjunction with treatment as usual (supportive individual, group, and family therapy and safety planning).

As part of the CMT Teen, we will assess specific ways that lack of self-compassion and increased self-criticism present for each teen to personalize treatment and teach skills to recognize self-critical cognitions, practice self-compassion, and replace self-criticism with self-compassionate correction. CMT Teen will include 1) two in-person sessions to personalize and deliver the intervention with adolescents during their partial hospitalization programming, 2) daily phone app surveys to assess STBs, self-criticism, and self-compassion, and 3) phone app reminder messages for two weeks post-discharge. The phone app messages will include personalized reminders of skills learned during in-person sessions.

We will first develop and refine the content of CMT Teen to youth with STBs based on qualitative interviews with adolescents (n=12), caregivers (n=12), and clinicians (n=12) in the program. We will then train the milieu staff at the partial hospitalization programs in delivering CMT Teen. Lastly, we will recruit 14 to 17-year-old adolescents from the partial hospitalization programs with recent (past month) STBs and elevated self-criticism to examine the acceptability, appropriateness, and feasibility of CMT Teen in an open trial (n=36). We will also examine the preliminary effects of the CMT Teen on STBs.

Our team has ample experience in suicide risk research and treatment development studies, as well as expertise in the proposed methodology and analytic approach. PI has successfully completed studies with similar populations and has established recruitment strategies and productive collaborations with the treatment teams at the partial hospitalization programs.

The proposed treatment is an innovative adaptation of CMT suited for the treatment settings for youth at high risk for suicide. It is the first to target self-compassion and self-criticism in teens at an increased suicide risk. A personalized medicine approach of incorporating youth feedback into intervention development, a clear focus on skills, a modular design to allow any mental health professionals and milieu staff to deliver it easily, and the use of technology commonly used by teens as one of the treatment delivery modalities increase its relevance for adolescents, scalability, and potential impact on reducing youth suicide risk.