A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality (CAMS) Versus Treatment as Usual (TAU) for Suicidal College Students

Abstract

This randomized controlled trial compared the Collaborative Assessment and Management of Suicidality (CAMS) and Treatment as Usual (TAU) for suicidal college students within a feasibility trial. Sixty-two suicidal college students were randomized to CAMS (n = 33) or TAU (n = 29). We hypothesized that those receiving CAMS would show more improvement in suicide-related measures, and effects would be moderated by borderline personality disorder (BPD), prior suicide attempts, and age. Both treatment groups showed improvements in all outcome variables; CAMS had a significantly higher impact on depression and suicidal ideation when measured weekly during care and was more likely than TAU to decrease hopelessness among students with fewer BPD features, no suicide attempt history, and older age. Conversely, TAU did better for students with BPD features and history of multiple suicide attempts.

Keywords:

• Collaborative Assessment and Management of Suicidality
• college students
• counseling center
• suicidal ideation
• suicidal risk

ACKNOWLEDGMENTS

The authors would like to thank the University of Nevada, Reno Counseling Services, Dr. Cindy Marczynski, and other members of the staff for supporting the integration of this study into a working clinic and students for agreeing to participate in this study.

DISCLOSURE STATEMENT

Dr. Jobes has grant funding from the National Institute of Mental Health and the American Foundation for Suicide Prevention; he receives book royalties from Guilford Press and the American Psychological Association; and he is a co-owner of CAMS-care, LLC which is a professional training and consultation company. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Notes

1 The current outcome study is limited to Stage 1 only of a feasibility trial. In Stage 2 clients who insufficiently responded to Stage 1 care were randomized to 4-16 weeks of CAMS or Dialectical Behavior Therapy (DBT). But with only n = 12 clients progressing to Stage 2 of this feasibility study, there was insufficient power to detect any experimental effects.

Additional information

Funding

The research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number [R34MH104714] (PI: J. Pistorello).

Notes on contributors

Jacqueline Pistorello

Jacqueline Pistorello, PhD, Director of Counseling Services, University of Nevada, Reno. Dr. Pistorello specializes in mindfulness and acceptance-based approaches for the prevention and treatment of mental health problems among college students.

David A. Jobes

David A. Jobes, PhD, Professor of Psychology, Associate Director of Clinical Training, and Director of the Suicide Prevention Lab at The Catholic University of America in Washington, DC. Dr. Jobes is the developer of the CAMS.

Robert Gallop

Robert Gallop, PhD, Professor of Mathematics, West Chester University, West Chester, PA. Dr. Gallop specializes in biostatistics, longitudinal data analysis, causal modeling, and informative missing data.

Scott N. Compton

Scott N. Compton, PhD, Associate Professor in Psychiatry and Behavioral Sciences, Duke University Medical Center. Dr. Compton specializes in anxiety disorders, Cognitive Behavioral Therapy, children and adolescents, and trichotillomania.

Nadia Samad Locey

Nadia Samad Locey, PhD, Research Faculty, Counseling Services, University of Nevada, Reno. Dr. Locey specializes in Cognitive Behavioral Therapy and Dialectical Behavior Therapy for adolescents and adults.

Josephine S. Au

Josephine S. Au, PhD, Research Associate, Suicide Prevention Lab at The Catholic University of America in Washington, DC.; Postdoctoral Fellow in Child and Adolescent Psychiatry, McLean Hospital/Clinical Fellow in Psychology in the Department of Psychiatry, Harvard Medical School. Dr. Au studies suicide assessment and interventions in adolescents and young adults.

Samantha K. Noose

Samantha K. Noose, MA, Doctoral student in the Clinical Psychology Ph.D. program at the University of Tennessee, Knoxville. Ms. Noose is interested in the development of psychopathology in childhood and adolescence, particularly difficulties with emotion regulation, and the impact of parental psychopathology and parenting stress on child development.

Joseph C. Walloch

Joseph C. Walloch, PsyD, Assistant Director/Director of Clinical Services, University of Nebraska, Lincoln. Dr. Walloch specializes in borderline personality disorder, suicidality, non-suicidal self-injurious behaviors, disordered eating, depression, anxiety, men’s issues, and LGBTQ populations.

Jacquelyn Johnson

Jacquelyn Johnson, PsyD, Dr. Johnson is currently in private practice in Los Angeles, CA, specializing in diversity and multiculturalism in adolescents and adults.

Maria Young

Maria Young, LCSW Licensed Clinical Social Worker, Counseling Services, University of Nevada, Reno. Ms. Young specializes in depression, suicidality, non-suicidal self-injury, anxiety, imposter phenomenon, stress management, self-esteem, self-compassion, grief and loss, mindfulness, utilization of yoga in therapy, and interpersonal and family relationships.

Yani Dickens

Yani Dickens, PhD, Associate Director, Director of Training, Counseling Services, University of Nevada, Reno. Dr. Dickens specializes in sport psychology consulting, eating disorders prevention and treatment, and diversity as well as applying Cognitive and Dialectical Behavior Therapies to stress, anxiety, depression, eating, and personality disorders.

Patricia Chatham

Patricia Chatham, PhD, Dr. Chatham was a licensed psychologist and supervisor at Counseling Services at the University of Nevada, Reno until her retirement. She has also served as the Director of Training of the Psychology Service at the VA Sierra Nevada Health Care System.

Tami Jeffcoat

Tami Jeffcoat, PhD, Licensed Psychologist, Blue Tara Psychological Services. Dr. Jeffcoat specializes in Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Functional Analytic Psychotherapy, and Cognitive Behavioral Therapy.