What is the mechanism of action of this treatment?

The most common treatments for suicide attempts, such as DBT Skills Group (DBT-SG), work by targeting emotion dysregulation, a core issue in suicidal ideation and attempts. DBT-SG teaches patients skills to manage intense emotions, improve interpersonal effectiveness, and reduce self-destructive behaviors. This approach is crucial for patients as it directly addresses the emotional instability and impulsivity that often lead to suicide attempts, providing them with tools to regulate their emotions and cope with distress, thereby reducing the risk of future attempts.

What side effects are associated with this type of intervention?

The most common treatments for reducing suicide attempts, such as Dialectical Behavior Therapy (DBT), Mentalization-Based Therapy (MBT), and Transference-Focused Therapy (TFT), generally have side effects related to the intensity and emotional nature of the therapy. Patients may experience increased emotional distress, anxiety, or agitation, especially during the initial stages of treatment as they confront difficult emotions and behaviors. Additionally, the time commitment and the need for consistent participation can be challenging for some individuals. However, these therapies are generally well-tolerated and the benefits often outweigh the side effects, particularly in reducing suicidal ideation and attempts.

What prior FDA approvals exist?

The FDA has not specifically approved any psychotherapeutic interventions like DBT Skills Group (DBT-SG) for the treatment of suicide attempts. However, DBT, which targets emotion dysregulation, is an evidence-based therapy known to reduce suicidal ideation and attempts. Pharmacologically, the FDA has approved medications such as clozapine for reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder. While these treatments are not identical to DBT-SG, they share a focus on managing underlying psychological issues to mitigate suicide risk.

What other types of research exist?

Promising alternatives to DBT Skills Group (DBT-SG) for reducing suicidal ideation and attempts include: 1) Cognitive Behavioral Therapy (CBT), which has been effective in treating various mental health disorders and reducing suicidal thoughts. 2) Mindfulness-Based Cognitive Therapy (MBCT), which combines cognitive therapy with mindfulness strategies to help patients manage their emotions and reduce suicidal ideation. 3) Intensive Short-Term Dynamic Psychotherapy (ISTDP), which focuses on emotional regulation and has shown promise in treating treatment-resistant depression. 4) Transference-Focused Psychotherapy (TFP), which is designed to help patients understand and manage their emotions and interpersonal relationships. These therapies offer alternative approaches to emotion regulation and have demonstrated efficacy in clinical trials.

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DBT Skills Group for Suicide Risk

N/A

Recruiting

Led By Steve Martino, PhD

Research Sponsored by VA Office of Research and Development

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Be older than 18 years old

Must not have

Inability to read English or communicate in spoken and written English

Timeline

Screening 3 weeks

Treatment Varies

Follow Up up to18 month follow-up

Awards & highlights

No Placebo-Only Group

Summary

This trial tests if adding a group therapy that teaches emotion management skills (DBT-SG) to usual care can reduce suicide attempts among Veterans. The therapy aims to help Veterans better control their emotions, which may lower their risk of suicide. Dialectical Behavior Therapy (DBT) is a well-supported intervention for reducing suicide attempts in individuals with emotion dysregulation.

Who is the study for?

This trial is for Veterans with current suicidal thoughts or past suicide attempts, who can attend group sessions and are eligible for VHA care. They must have had at least two suicide attempts, one recently, struggle with managing emotions (score of 110+ on DERS), and be able to communicate in English. Those with significant cognitive issues or plans to move within 18 months cannot join.

What is being tested?

The study is testing if a DBT Skills Group (DBT-SG) alongside usual VHA treatments helps reduce suicide attempts more than just the usual treatment alone. It's a randomized controlled trial where participants are randomly placed into either the test group receiving DBT-SG plus standard care or a control group getting only standard care.

What are the potential side effects?

Since this trial involves therapy groups rather than medication, there aren't typical side effects like you'd see with drugs. However, discussing sensitive topics could potentially cause emotional discomfort or distress.

Eligibility Criteria

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

Select...

I cannot read or communicate in English.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ up to18 month follow-up

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~up to18 month follow-up

This trial's timeline: 3 weeks for screening, Varies for treatment, and up to18 month follow-up for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Columbia-Suicide Severity Rating Scale

Secondary study objectives

Change in Emotion dysregulation

Coping

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: DBT-SG plus VHA treatment as usualExperimental Treatment2 Interventions

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.

Group II: VHA treatment as usualActive Control1 Intervention

VHA treatment as usual for Veterans at risk for suicide attempt

0 / 1Eligibility criteria met

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.

Mechanism Of Action

Side Effect Profile

Prior Approvals

Other Research

The most common treatments for suicide attempts, such as DBT Skills Group (DBT-SG), work by targeting emotion dysregulation, a core issue in suicidal ideation and attempts. DBT-SG teaches patients skills to manage intense emotions, improve interpersonal effectiveness, and reduce self-destructive behaviors. This approach is crucial for patients as it directly addresses the emotional instability and impulsivity that often lead to suicide attempts, providing them with tools to regulate their emotions and cope with distress, thereby reducing the risk of future attempts.

Living through distress: a skills training group for reducing deliberate self-harm.