Group and Phone Follow-Up for Emotional Crisis
Recruiting in Palo Alto (17 mi)
+2 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Phase 3
Recruiting
Sponsor: University of Rochester
Disqualifiers: Under 18, Non-English, Psychotic, others
No Placebo Group
Pivotal Trial (Near Approval)
Prior Safety Data
Trial Summary
What is the purpose of this trial?This trial tests a new program called THRIVE for people in suicidal crises at Crisis Stabilization Centers. THRIVE includes group sessions, follow-up calls, and an app to help people feel more connected and less like a burden. The goal is to see if THRIVE helps people start treatment and feel better after leaving the center.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment Discharge / Safety Planning, Crisis Stabilization, Safety Planning, Discharge Planning, THRIVE (Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement), Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement?
Research shows that increasing hope can be a powerful healing force, as seen in studies where patients' hope levels improved significantly from admission to discharge. Additionally, recovery-oriented care and supportive psychotherapy have been linked to positive outcomes, such as increased hope and reduced anxiety, which are key components of the THRIVE approach.
12345Is the Group and Phone Follow-Up for Emotional Crisis treatment safe for humans?
The Seeking Safety program, which is similar to the Group and Phone Follow-Up for Emotional Crisis treatment, has been used safely in various studies with veterans and women with PTSD and substance use disorders. These studies did not report any major safety concerns, suggesting that the treatment is generally safe for humans.
678910What makes the THRIVE treatment unique for emotional crisis?
The THRIVE treatment is unique because it combines group and phone follow-up sessions to support individuals in emotional crisis, focusing on hope, recovery, interpersonal growth, values, and engagement. This approach is distinct from other treatments as it emphasizes ongoing support and personal growth through structured group interactions and follow-up, rather than just immediate crisis intervention.
1112131415Eligibility Criteria
This study is for adults experiencing an emotional crisis or suicidal thoughts who are admitted to a Crisis Stabilization Center (CSC). Participants must be able to communicate in English and provide emergency contact information. It's not suitable for individuals under 18, those with acute psychiatric instability like psychosis, or anyone unable to understand the study.Inclusion Criteria
Admission to CSC with suicidal crisis, as defined by active suicide ideation ascertained by the Columbia Suicide-Severity Rating scale, which the sites already routinely administer
Ability and willingness to provide information for and permission to contact one person in case of emergency or inability to reach the participant for follow-up
Exclusion Criteria
I cannot communicate in English with the researcher.
Acute psychiatric instability (e.g., psychotic symptoms). Most patients with psychosis are transferred to Emergency Departments instead of CSCs, so we do not expect many exclusions based on this criterion.
I am under 18 years old.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Crisis Stabilization Center Stay
Participants engage in a 'belonging and giving' group during their stay at the Crisis Stabilization Center
Duration not specified
In-person stay at CSC
Post-Discharge Follow-up
Participants receive recovery coaching calls for 4 weeks post-discharge to reinforce and troubleshoot plans for community connection and treatment
4 weeks
3-4 coaching calls (phone)
Extended Follow-up
Participants are monitored for treatment initiation, belongingness, and burdensomeness at 1 and 3 months post-discharge
3 months
Participant Groups
The trial is testing 'THRIVE', a follow-up care program designed for people after they've had a suicidal crisis. It includes personalized recovery planning and phone check-ins post-discharge from CSCs. The goal is to see if this approach helps people feel better compared to usual safety planning.
2Treatment groups
Experimental Treatment
Active Control
Group I: THRIVE + Discharge / Safety PlanningExperimental Treatment1 Intervention
Participants assigned to the intervention condition will receive THRIVE Crisis Recovery and Care Transition Program, which consists of group-based reflections on "giving and belonging" and a plan for community connection and treatment, followed by 3-4 coaching calls to reinforce and troubleshoot the plans.
Group II: Discharge / Safety Planning AloneActive Control1 Intervention
Participants assigned to the control condition will receive Discharge/Safety Planning as it is practiced by Connections Health Solutions per industry best practices.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Connections Health-Urgent Psychiatric CenterPhoenix, AZ
Connections Health-Crisis Response CenterTucson, AZ
Mental Health CooperativeNashville, TN
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Who Is Running the Clinical Trial?
University of RochesterLead Sponsor
Centerstone Research InstituteCollaborator
References
Assessment of hope in psychiatric and chemically dependent patients. [2019]Hope is recognized as a healing force, but has not been studied in some clinical populations. In this study, the Miller Hope Scale was used to measure hope near admission and at discharge for 192 psychiatric and chemically dependent inpatients. Hope scores near admission were significantly lower than the established norms for the instrument. Psychiatric patients were significantly lower in hope than chemically dependent patients at both times. At discharge, both subject groups approached the norms for the instrument. This study adds to the construct validity of the Miller Hope Scale and supports its use in clinical populations.
Transformation to a recovery-oriented model of care on a veterans administration inpatient unit. [2018]Recovery-oriented care is among the highest treatment priorities for the Veteran Health Administration, which has endorsed organizational change of mental health care to reflect recovery values. The purpose of this quality improvement project was to determine whether recovery interventions would yield positive outcomes when delivered on in inpatient psychiatry.
The relationship between personal growth and psychological functioning in individuals treated in a partial hospital setting. [2019]We examined whether current level of personal growth and changes in personal growth predicted treatment response among participants in a partial hospital setting.
The effect of the one-to-one interaction process with group supportive psychotherapy on the levels of hope, anxiety and self-care practice for patients that have experienced organ loss: an alternative nursing care model. [2012]This quasi-experimental research examined the effect of the one-to-one interaction process with group supportive psychotherapy on the levels of hope, anxiety and self-care practice for patients that have experienced organ loss. Eighty patients from the hospital units were selected by matched pairs and paired according to gender, interval of age, type and time length of organ loss. Simple-random sampling was used to allocate each subject in the experimental and control groups, which consisted of 40 pairs. Questionnaires included hope, anxiety and self-care practice assessments. The experimental treatments consisted of the one-to-one interaction process with group psychotherapy. The results showed that the patients that received treatments in the experimental group had higher mean scores regarding the differences in levels of hope, anxiety and self-care practice than those in the control group. This integrative approach is an alternative method for giving patients self-confidence in their self-care practice, in maintaining hope and in reducing anxiety. The method assisted patients in understanding their own problems and corrective actions so that they could be accepted by others by exchanging their feelings, thoughts, opinions and experiences through confrontation and self-exploration both individually and in group.
Giving Hope as a High Reliability Function of Health Care. [2023]We believe that reliably offering Hope should be one of the goals of the therapeutic relationship between clinician and patient. Establishing Hope as a target outcome creates opportunities for both patients and clinicians to find meaning in their journeys. This article defines Hope in a new way by quantifying Hope as the delta or increase in one's belief that a future positive state can be achieved.Though prior conceptual models of Hope have focused nearly exclusively on an individual's own agency and competence to achieve goals, we particularly emphasize the role of Other-specifically, that of the clinician-in promoting Hope for patients.We recommend a Hope Checklist for clinicians that incorporates (1) the process of eliciting and clarifying patient goals, (2) conveying the intent and ability to help, and (3) identifying realistic pathways forward with the specific intent to maximize patient confidence in the potential to achieve meaningful positive outcomes.
Multisite randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders. [2022]The authors compared the effectiveness of the Seeking Safety group, cognitive-behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women's Health Education [WHE]) within the National Institute on Drug Abuse's Clinical Trials Network. The authors randomized 353 women to receive 12 sessions of Seeking Safety (M = 6.2 sessions) or WHE (M = 6.0 sessions) with follow-up assessment 1 week and 3, 6, and 12 months posttreatment. Primary outcomes were the Clinician Administered PTSD Scale (CAPS), the PTSD Symptom Scale-Self Report (PSS-SR), and a substance use inventory (self-reported abstinence and percentage of days of use over 7 days). Intention-to-treat analysis showed large, clinically significant reductions in CAPS and PSS-SR symptoms (d = 1.94 and 1.12, respectively) but no reliable difference between conditions. Substance use outcomes were not significantly different over time between the two treatments and at follow-up showed no significant change from baseline. Study results do not favor Seeking Safety over WHE as an adjunct to substance use disorder treatment for women with PTSD and reflect considerable opportunity to improve clinical outcomes in community-based treatments for these co-occurring conditions.
A Comparison of Cognitive Processing Therapy and Seeking Safety for the Treatment of Posttraumatic Stress Disorder in Veterans. [2021]To compare the outcomes of Seeking Safety (SS) and cognitive processing therapy (CPT) in veterans with PTSD in a specialty clinic of an urban VA medical center. Retrospective chart review of electronic medical records was conducted for 420 veterans with PTSD who received treatment with either CPT (n = 227) or SS (n = 193) in group setting. 1) treatment completion rate, 2) self-reported PTSD symptom severity measured by PTSD checklist (PCL), and 3) additional mental health services received within 12 months after treatment. Data were analyzed for the 160 who had both a pre and post PCL documented in their charts. The final analysis sample included n = 94 for CPT and n = 66 for SS veterans with a mean age of 49.71[SD = 14] years, 24 women [15%]; mean baseline PCL score was 68.41 [9]. Significantly more veterans completed SS treatment (SS, 59 [89%] than CPT, 47 [50%] (p = <.001). However, PCL score decreases were significantly greater for patients who completed CPT treatment than those in SS (treatment x time interaction, 9.60 vs.4.98, respectively; difference, 4.62; t84 = 2.16; p = .02). The patients who received SS used significantly more mental health services of the PTSD clinical team than patients who completed CPT treatment (p = .01). The results of this study demonstrate the need for alternative approaches where dually diagnosed patients would not be delayed in their receipt of trauma-focused care - i.e., where treatment is initiated concurrently rather than sequentially to substance abuse treatment.
A pilot study of seeking safety therapy with OEF/OIF veterans. [2021]PTSD and substance use disorder (SUD) are highly prevalent among veterans returning from Iraq and Afghanistan (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF). Seeking Safety (SS) is a cognitive-behavioral psychotherapy for co-occurring PTSD/SUD. This pilot study with fourteen male OEF/OIF veterans suggests that SS may help to reduce alcohol use, PTSD, and depression in some participants at clinically significant levels, even when providing less than half of the full model. We emphasize several SS features as especially helpful: the case management component to help engage clients in further mental health and SUD care, offering PTSD as an entry point, and emphasis on community resources. Issues particular to veterans include reintegration to civilian life and supporting their connection with other veterans.
Impact of the seeking safety program on clinical outcomes among homeless female veterans with psychiatric disorders. [2022]Seeking Safety is a manualized cognitive-behavioral therapy intervention that is designed to treat clients with comorbid substance abuse and trauma histories. This study examined its effectiveness when used with homeless women veterans with psychiatric or substance abuse problems at 11 Department of Veterans Affairs medical centers that had Homeless Women Veterans Programs.
Dissemination and feasibility of a cognitive-behavioral treatment for substance use disorders and posttraumatic stress disorder in the Veterans Administration. [2022]This article describes a small dissemination effort and provides initial efficacy data for use of Seeking Safety, a cognitive-behavioral treatment for comorbid substance use disorders (SUD) and posttraumatic stress disorder (PTSD), in a VA setting. After providing a daylong interactive training in Seeking Safety to front-line clinicians, a cotherapist group practice model was implemented. Following 14 months of clinician training and an uncontrolled pilot study of four groups with 18 veterans, initial efficacy data indicate significant symptom reduction for patients and acceptability to clinicians. Findings are encouraging in that Seeking Safety treatment appears to have the potential to be beneficial for veterans with SUD-PTSD and also appeal to clinicians. Dissemination of Seeking Safety is feasible in the VA, yet there are likely barriers to sustaining it as a routine treatment. Recommendations for future dissemination are proposed, including ways VA administration can facilitate this process.
Use of support groups with adult female survivors of child sexual abuse. [2004]Adult survivors of child sexual abuse suffer from a variety of interpersonal and intrapersonal problems. The support group, with its emphasis on self-help and mutuality, represents a potentially powerful form of intervention to assist survivors in dealing with their sexual abuse and the problems resulting from it. In this article, the author explores the use of this form of group work, including the unique role of the group leader, the value of a time-limited approach, the stages of group development, and treatment themes.
Applying Yalom's principles to crisis work...some intriguing results. [2009]In this paper, the writer has shared some of the results of an innovative eight- to sixteen-week, open-ended crisis group developed at the Community Mental Health Center at Strong Memorial Hospital. The group has been running for over a year and a half. Some of the significant findings were that process interventions can be creatively used in a modified manner to enhance the group interaction, while maintaining the crisis-oriented focus. There were two dimensions of process commentary described, the sense data material of an individual, interpersonal nature, and the mass group interventions with a broader, group development focus. In addition, the secondary function of the group, which was to serve as an assessment tool for an individual's capabilities in long-term group work, proved to be reliable for eighteen out of the twenty members, eventually referred to other groups. A theoretical framework, based on Yalom's work, as well as the writer's synthesis of previous crisis group theory, was outlined. Two clinical illustrations were described, using the paradigm. In closing, the writer wishes to validate the impression that crisis group work is indeed an exciting, clinical adventure. Each week the gestalt of the group varies, so that the crisis therapist must remain a versatile strategist and sensitive role model of communication theory. The interweaving of process issues with more concrete, content-focused group work provides the members with an in-depth, sharply practical interpersonal arena for growth.
Women's safety in recovery: group therapy for patients with a history of childhood sexual abuse. [2004]The literature on group therapies for women with histories of childhood sexual abuse has focused on outpatient treatments. A model of group treatment for inpatients and partial hospital patients is described here. "Women's Safety in Recovery" is a first-stage trauma recovery group that promotes mastery of current life stressors and prevents regression through the use of psychoeducation about abuse effects, the practice of problem-solving skills, and supportive, topic-focused discussion. The group is structured in three one-week modules that patients can begin or leave at any time.
A systems model of short-term, open-ended group therapy. [2019]Because of rapid patient turnover and periodic therapist rotations, inpatient psychotherapy groups with open membership can sometimes appear to be forever beginning or forever ending. Described here is a model of group process that identifies four distinct stages of group development experienced by open-ended groups. Each of the four stages--called rebeginning, subgrouping, work phase, and termination--is characterized by attention to a particular boundary issue. In stages 1 to 3, the group members gradually move from establishing the group's separateness from other hospital systems to establishing alliances with the therapist and with each other to developing mutually supportive relationships. When several members are discharged, the group enters stage 4, during which it renews its efforts to fortify its external boundary. Therapeutic interventions appropriate to each stage of group development are discussed.
The crisis group--an outcome study. [2019]The authors describe the day-to-day functioning and outcome of an 8-session, active, crisis-oriented outpatient psychotherapy group. Symptoms of anxiety and depression improved significantly in participants of the crisis group; these changes were even more positive at 1-year follow-up. The authors speculate that the success of the crisis group can be attributed to the felicitous characteristics of the patients and to the group structure and function, which provided an excellent vehicle for crisis intervention management.