Suicidal Ideation, Suicide, Attempted
Conditions
Keywords
Suicide, Child, CAMS
Brief summary
The purpose of the study is to assess the feasibility and acceptability of CAMS-4Kids for children with suicidal ideation and/or behavior. During this open pilot trial, we will enhance treatment procedures, refine adherence measures, and develop a treatment manual. Our study sample will include 10 children, ages 5 - 11 years old, seeking outpatient services for suicidal ideation and/or behavior.
Detailed description
The Collaborative Assessment and Management of Suicidality (CAMS-Jobes, 2006; 2016) is an evidence-based, therapeutic framework for addressing suicide risk in the adult population. CAMS-4Kids, the research intervention used in this study, is a 10-session developmentally-sensitive adaptation of CAMS for children ages 5 - 11 years old. Within the CAMS framework, clinicians treat patient-identified issues that contribute to their suicidal thoughts and/or behavior called suicidal drivers. A clinical road map is provided through the Suicide Status Form (SSF) that guides treatment as an assessment, treatment planning, tracking and clinical outcome tool. Clinicians and children engage in the assessment and treatment planning sections of the SSF - Initial Form at the outset of treatment. A CAMS Stabilization Plan is also collaboratively developed which focuses on reducing access to lethal means, coping strategies, decreasing interpersonal isolation, and ways to address potential barriers to care. Subsequent CAMS-4Kids sessions include ongoing assessment and treatment plan reviews using the SSF - Interim Sessions Form. The CAMS Stabilization Plan is also reviewed and updated as clinically indicated. Treatment involves clinical interventions most appropriate to treat the patient's suicidal drivers. Clinical interventions may include coping cards, Hope Journal, behavioral activation, Virtual Hope Box, increasing social support, guided imagery, DBT relaxation skills, positive self-talk, and other cognitive-behavioral techniques. The conclusion of CAMS-4Kids occurs after 3 consecutive sessions of effectively managing suicidal ideation and behavior. The SSF Outcome/Dispositional Final Session Form is completed at the end of treatment.
Interventions
BEHAVIORALCAMS-4Kids
The Collaborative Assessment and Management of Suicidality (CAMS-Jobes, 2006; 2016) is an evidence-based, therapeutic framework for addressing suicide risk in the adult population. CAMS-4Kids, the research intervention used in this study, is a 10-session developmentally-sensitive adaptation of CAMS for children ages 5 - 11 years old.
Sponsors
The Catholic University of America
Nationwide Children's Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This study is an open pilot trial of one treatment without control or comparison group.
Eligibility
Sex/Gender
ALL
Age
5 Years to 11 Years
Healthy volunteers
No
Inclusion criteria
* children between the ages of 5 - 11 years old, inclusive, at the time of consent; * current suicidal ideation and/or behavior; * resides with primary caregiver who has legal authority to consent to research participation * client of outpatient Behavioral Health Services * Outpatient or Mood and Anxiety Program visit scheduled at least 4 weeks from the diagnostic assessment and/or discharge from the Crisis Stabilization Unit.
Exclusion criteria
* the inability to understand study procedures (e.g. developmental disabilities, severe cognitive impairments, actively psychotic) * inability of the child and/or parent to speak or read English * current participation in weekly therapy sessions with outpatient Behavioral Health Crisis Team
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CAMS-4Kids Suicide Status Form-4 (SSF-4) | Each session measured from baseline up to 12-week follow-up | The SSF-4 measures overall suicide risk. |
| Change from baseline in psychosocial functioning and impairment on the Columbia Impairment Scale (CIS) at treatment completion (up to 12 weeks), 3 months and 6 months. | Baseline, Treatment Completion (up to 12 weeks), 3 month and 6 month follow-up | The CIS is a valid 13-item child- and parent- report measure of psychosocial impairment with good internal consistency and test-retest reliability. Scores range from 0 (no problem) to 4 (very bad problem), with higher scores indicating worse outcomes. |
| Change from baseline in suicidal ideation and behavior on the Columbia-Suicide Severity Rating Scale (C-SSRS) at treatment completion (up to 12 weeks) 3 months and 6 months | Baseline, Treatment Completion (up to 12 weeks), 3 month and 6 month follow-up | The C-SSRS is a validated, semi-structured interview that assesses both suicidal behavior and suicidal ideation (yes/no, frequency), with flexible timepoints and multiple informants depending on administrator purpose and need. Scores range 0 (no ideation) to 5 (ideation with plan and intent), with higher numbers indicating worse outcomes. Suicidal behavior is present or absent, presence of behavior indicates worse outcomes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Client Satisfaction Questionnaire (CSQ-8) | Up to 12-week follow-up | The CSQ-8 is an 8 item measure of treatment satisfaction with services with both a parent and child version. |
| CAMS Rating Scale | Each session measured from baseline up to 12-week follow-up | The CAMS Rating scale measures CAMS treatment fidelity. |
| Therapeutic Alliance Scale for Children, Revised (TASC-r) | Up to 12-week follow-up | The TASC-r is a measure of the working child-therapist working relationship. |
| Therapeutic Alliance Scale for Caregivers and Parents (TASCP) | Up to 12-week follow-up | The TASCP is a measure of the working caregiver-therapist working relationship. |
Countries
United States
Outcome results
None listed