DBT Skills Groups for Veterans at High Risk for Suicide Attempt

A Hybrid Effectiveness-Implementation Multisite Trial of a Dialectical Behavior Therapy Skills Group for Veterans at High-Risk for Suicide Attempt

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT05000749

Enrollment

156

Registered

2021-08-11

Start date

2023-04-30

Completion date

2027-02-26

Last updated

2026-01-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Suicide, Attempted

Keywords

suicide, attempted, dialectical behavior therapy, suicide attempt, emotion regulation

Brief summary

Veteran suicide death is a national crisis. Risk factors include emotion dysregulation, which occurs across mental health disorders. Dialectical behavior therapy (DBT) is an evidence-based suicide intervention that targets emotion dysregulation but is resource-intensive and not widely available at VHA. A more efficient evidence-based DBT Skills Group (DBT-SG) is associated with reduced suicidal ideation and emotion dysregulation and likely more feasible to implement at VHA. This is a randomized controlled trial to test whether DBT-SG in addition to VHA treatment-as-usual, compared to only VHA treatment-as-usual, reduces Veteran emotion dysregulation.

Detailed description

This is a randomized controlled trial at four VHA medical centers. Veterans will be randomized to VHA treatment-as-usual or VHA treatment-as-usual plus DBT-SG.

Interventions

BEHAVIORALDBT-SG

Dialectical Behavior Therapy Skills Group (DBT-SG) in addition to VHA treatment as usual. Group is 24 weekly sessions teaching skills in emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness.

BEHAVIORALVHA treatment as usual

VHA treatment as usual for Veterans at risk for suicide attempt

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

SINGLE (Outcomes Assessor)

Masking description

Outcomes assessors will be masked to study condition.

Intervention model description

Participants will be randomly assigned to one of two study conditions for the duration of the study.

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Veteran eligible for VHA care at participating site * two or more suicide attempts in lifetime, with one in past 12 months, on Columbia-Suicide Severity Rating Scale (C-SSRS) * current suicidal ideation (endorsing a suicidal ideation scale of at least 1 \[passive ideation\] on C-SSRS * emotion dysregulation (score 95 or greater on DERS) * can attend group sessions * willing to provide contact information for at least one person who can help locate the participant if study staff are unable to contact them (information for three contact persons will be requested; a participant must provide at least one contact person's information to be included in the study) * access to telephone; if insufficient access to videoteleconference and local facility is using remote procedures for study, willing to request access to VA-provided device

Exclusion criteria

* significant cognitive impairment (score \< 28 on modified Telephone Interview for Cognitive Status (mTICS) * inability to read English or communicate in spoken and written English * plan to move away or be unavailable in the next 18 months

Design outcomes

Primary

Measure	Time frame	Description
Change in Emotion dysregulation	Up to18 month follow-up	Emotion dysregulation will be assessed with the Difficulties in Emotion Regulation Scale, a self-report measure. The scale ranges 36-180 with a higher score indicating greater difficulties in emotion regulation.

Secondary

Measure	Time frame	Description
Coping	Up to 18 month follow-up	Coping skills will be assessed with the Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL), a self-report measure. The mean score ranges 0-3 with a higher score indicating greater use of coping strategies.
Columbia-Suicide Severity Rating Scale	Up to 18 month follow-up	The Columbia-Suicide Severity Rating Scale is a widely used interview measure of suicide risk. The number of suicide attempts during 18month follow-up will be reported (range 0 to infinity), with a higher score indicating more suicide attempts.

Countries

United States

Contacts

PRINCIPAL_INVESTIGATORSuzanne Decker, PhD

VA Connecticut Healthcare System West Haven Campus, West Haven, CT

PRINCIPAL_INVESTIGATORSteve Martino, PhD