SPI+ and CAMS for Suicide Prevention in Teens
(ASSIST Trial)
Recruiting in Palo Alto (17 mi)
+1 other location
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Seattle Children's Hospital
Disqualifiers: Psychosis, Intellectual disability, Autism, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
To inform the effective management of adolescent suicide risk by evaluating promising treatments and developing the evidence-base for interventions that are well suited for widespread adoption, sustained quality, and impact.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Collaborative Assessment and Management of Suicidality (CAMS) for suicide prevention in teens?
The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based treatment that has shown effectiveness in adults and is being adapted for adolescents. It focuses on a collaborative approach between the patient and clinician to address suicidal thoughts and behaviors, supported by several studies and ongoing research.12345
Is the CAMS approach generally safe for use in humans?
How is the CAMS treatment for suicide prevention in teens different from other treatments?
The CAMS treatment is unique because it focuses on a collaborative approach between the patient and clinician to assess and manage suicidal thoughts, using a tool called the Suicide Status Form (SSF) to track and plan treatment. This method aims to enhance the therapeutic relationship and directly address the underlying reasons for suicidal thoughts, which is different from traditional treatments that may not involve such a personalized and interactive process.23789
Eligibility Criteria
This trial is for young people aged 11-17 who are experiencing suicidal thoughts or behaviors and have been admitted to acute care for these reasons. They must be able to give informed consent and understand English well enough for study assessments. It's not open to those with psychosis, intellectual disabilities, autism spectrum disorder, or unstable eating disorders.Inclusion Criteria
Endorse suicidal ideation and/or behavior
I was admitted to the hospital for feeling suicidal.
Provision of signed and dated informed consent form
See 1 more
Exclusion Criteria
Presence of eating disorder with unstable vitals
Limited English proficiency that would interfere with the ability to complete study assessments
Presence of intellectual disability
See 2 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive interventions such as CAMS, SPI+, or Treatment As Usual, with a minimum of 4 sessions and a maximum of 8 sessions
4-8 weeks
Weekly sessions
Follow-up
Participants are monitored for safety and effectiveness after treatment, with assessments at baseline, 2-week, 1-month, 2-month, 6-month, and 12-month timepoints
12 months
Assessments at multiple timepoints
Treatment Details
Interventions
- Collaborative Assessment and Management of Suicidality (CAMS) (Behavioural Intervention)
- Safety Planning Intervention+ (SPI+) (Behavioural Intervention)
- Treatment As Usual (Behavioural Intervention)
Trial OverviewThe trial is testing two specific interventions against the usual treatment: Safety Planning Intervention+ (SPI+) and Collaborative Assessment and Management of Suicidality (CAMS). The goal is to see which method better helps teens during high-risk periods when they're dealing with suicidal thoughts or actions.
Participant Groups
3Treatment groups
Active Control
Group I: Treatment As Usual (TAU)Active Control1 Intervention
Participants in this group will be studied as they proceed through treatment in the acute care setting and follow the intervention plan laid out in the discharge summary, per usual protocols at each facility. In both settings, the elements of typical care include crisis prevention planning, which outlines potential triggers, skills to use, and people and places to call in crisis, as well as referral to ongoing behavioral health treatment. We will not alter usual care but track recommendations, contacts and care through questionnaires the family completes as well as medical record review in order to understand the impact of the experimental conditions in relation to typical services.
Group II: Collaborative Assessment and Management of Suicidality (CAMS)Active Control1 Intervention
CAMS strategies focus on collaborative deconstruction and treatment of the patient-defined drivers- the problems that make suicide compelling to the patient- and utilizes these problem-focused treatment sessions to treat the drivers as directly related to wish to die. Participants will be assigned to CAMS for a minimum of 4 sessions and a maximum of eight sessions. This time frame, based on initial data from our pilot work with adolescents and emerging adults (18-25), suggests that a subset of participants resolve their STB in six to eight sessions. CAMS is a clinical intervention designed to modify how clinicians engage, assess and plan treatment with suicidal patients.
Group III: Safety Planning Intervention+ (SPI+)Active Control1 Intervention
SPI is focused on how the risk of suicidal crisis waxes and wanes over time. At times of heightened risk, a pre-specified and individualized plan targets the internal warning signs that become the cue to use the safety plan. SPI+ strategies focus on patient's narrative of the suicidal crisis and identifying solutions that are antithetical to progressing in a suicidal crisis. The brief structured intervention is conducted in six key steps. Youth in this condition will be offered weekly follow-up, with a minimum of 4 sessions and a maximum of 8 sessions. The goal is to create a crisis response plan to reduce risk when suicidal crises emerge. With adolescents, SPI+ consists of an individual session to elicit crisis narrative and motivation to utilize the safety plan through psychoeducation and follows six steps to achieve the adolescent's goals and return to safety when suicidal urges are high.
Collaborative Assessment and Management of Suicidality (CAMS) is already approved in United States for the following indications:
🇺🇸 Approved in United States as CAMS for:
- Suicidal ideation
- Suicidal behavior
- Adolescent suicide risk management
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Seattle Children'sSeattle, WA
Nationwide Children'sColumbus, OH
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Who Is Running the Clinical Trial?
Seattle Children's HospitalLead Sponsor
Nationwide Children's HospitalCollaborator
References
[Treatment of suicidal patients: The Collaborative Assessment and Management of Suicidality]. [2022]There is still a need for more knowledge about effective methods of assessing and treating the suicidal patient. The method The Collaborative Assessment and Management of Suicidality (CAMS) was tested on a group of out-patients.
Validating the Suicide Status Form for the Collaborative Assessment and Management of Suicidality in a Psychiatric Adolescent Sample. [2020]For adults, the Collaborative Assessment and Management of Suicidality (CAMS; Jobes, (2006, Managing suicidal risk: A collaborative approach, New York, Guilford) and Jobes, (2016, Managing suicidal risk: A collaborative approach, New York, Guilford)) is a treatment framework with replicated evidenced-based support for effectiveness. The current study is a psychometric validation of the Suicide Status Form (SSF-IV), the main assessment and treatment planning tool for CAMS, in an adolescent psychiatric sample.
The Collaborative Assessment and Management of Suicidality (CAMS): an evolving evidence-based clinical approach to suicidal risk. [2022]The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based clinical intervention that has significantly evolved over 25 years of clinical research. CAMS is best understood as a therapeutic framework that emphasizes a unique collaborative assessment and treatment planning process between the suicidal patient and clinician. This process is designed to enhance the therapeutic alliance and increase treatment motivation in the suicidal patient. Central to the CAMS approach is the use of the Suicide Status Form (SSF), which is a multipurpose clinical assessment, treatment planning, tracking, and outcome tool. The original development of CAMS was largely rooted in SSF-based quantitative and qualitative assessment of suicidal risk. As this line of research progressed, CAMS emerged as a problem-focused clinical intervention that is designed to target and treat suicidal "drivers" and ultimately eliminate suicidal coping. To date, CAMS (and the clinical use of the SSF) has been supported by six published correlational studies and one randomized clinical trial (RCT). Currently, two well-powered RCTs are under way, and various new CAMS-related projects are also being pursued. The clinical and empirical evolution of CAMS-how it was developed and what are the next steps for this clinical approach-are described here.
Implementing an evidence-based approach to working with suicidal inpatients. [2009]In this article, the authors describe the implementation of a new approach to working with suicidal patients in an inpatient psychiatric facility. The Collaborative Assessment and Management of Suicidality (CAMS) has been under development for almost two decades, but has rarely been implemented or studied in an inpatient setting. Here the authors describe the context for this project, the nature of the CAMS intervention in this setting, the structure for the research aspect of the project, and some of the implementation issues that have arisen as the project has unfolded. The authors conclude that a solid foundation has been laid for an initiative that will both enhance assessment and treatment of at-risk patients and contribute to a body of knowledge that is currently lacking in evidence for interventions with suicidal patients.
Successful Treatment of Suicidal Risk. [2022]In this article we focused on analyzing surveyed patient-generated responses based on two outcome questions derived from a suicide-specific framework called the Collaborative Assessment and Management of Suicidality (CAMS): Q1 - "Were there any aspects of your treatment that were particularly helpful to you? If so, please describe these. Be as specific as possible." Q2 - "What have you learned from your clinical care that could help you if you became suicidal in the future?"
Reducing short term suicide risk after hospitalization: A randomized controlled trial of the Collaborative Assessment and Management of Suicidality. [2023]This study compared the "next day appointment" (NDA) use of the Collaborative Assessment and Management of Suicidality (CAMS) to treatment as usual (TAU) for individuals discharged from the hospital following a suicide-related crisis. We hypothesized that CAMS would significantly reduce suicidal thoughts and behaviors as well as improve psychological distress, quality of life/overall functioning, treatment retention and patient satisfaction.
A systematic review of efficacy of Collaborative Assessment and Management of Suicidality (CAMS) in managing suicide risk and deliberate self-harm in adult populations. [2022]Evaluate the efficacy of Collaborative Assessment and Management of Suicidality (CAMS) in managing suicide risk and deliberate self-harm in adults.
Collaborative Assessment and Management of Suicidality (CAMS) compared to treatment as usual (TAU) for suicidal patients: study protocol for a randomized controlled trial. [2022]Collaborative Assessment and Management of Suicidality (CAMS) is a therapeutic framework that appears promising to reduce suicidal ideation and suicidal cognition. CAMS has not previously been evaluated in a standard specialized mental health care setting for patients with suicidal problems in general. In this pragmatic randomized controlled trial (RCT) we will investigate if CAMS is more effective than treatment as usual (TAU) in reducing suicidal thoughts and behaviors. Effects will also be investigated on mental health and symptom relief in general and upon readmissions to inpatient units.
The collaborative assessment and management of suicide (CAMS): an important model for mental health services to consider. [2019]The collaborative assessment and management of suicide (CAMS) model has been developed over 25 years providing mental health clinicians with a flexible, evidenced-based, collaborative and ethically informed way of addressing suicidality with service users. This paper briefly overviews the CAMS model and its advantages and advocates for its use in mental health services both nationally and internationally.