Skills to enhance positivity in suicidal adolescents: Results from a pilot randomized clinical trial

ABSTRACT

The objective of this study was to examine the feasibility, acceptability and preliminary effects of an intervention, Skills to Enhance Positivity (STEP) that aims to increase attention to positive emotions and experiences and to decrease suicidal events. STEP involves four in-person individual sessions delivered during an inpatient psychiatric admission, followed by one month of weekly phone calls and daily text messages with mood monitoring and skills practice. A pilot randomized controlled trial of STEP vs. enhanced treatment as usual (ETAU) was conducted with 52 adolescents. Results indicated that on average 83% of the sessions were completed and that on 70% of the days, participants engaged with the text-messaging component of the intervention. Acceptability for both in-person and text-messaging components was also high, with satisfaction ratings averaging between good and excellent. STEP participants reported fewer suicide events than ETAU participants (6 vs. 13) after six months of follow-up.

KEYWORDS:

• Adolescents
• suicidal behaviors
• positive affect
• mindfulness
• gratitude
• savoring
• text message intervention
• digital health

Acknowledgments

This work was supported by the National Institute of Mental Health under Grant R34 MH101272 to Dr. Yen. Dr. Mereish was supported by Grant K08 AA025011. Dr. Peters was supported by K23 MH112889. We would like to thank all the study participants and their families for participating in this research, the doctors and staff from our recruitment site for their support of our work, and research assistants (Adam Chuong, Hye In (Sarah) Lee) that helped make this study possible.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institute of Mental Health [R34 MH101272].