A pilot randomized control trial of a dyadic safety planning intervention: Safe actions for families to encourage recovery.

Abstract

A recent systematic review on family and suicide prevention efforts identified a lack of family-based interventions for adults. To address this gap, Safe Actions for Families to Encourage Recovery (SAFER) intervention was created. SAFER is a novel, manualized, four-session, family-based treatment intervention that provides the tools and structure to support family involvement in Safety Planning Intervention (SPI). The SAFER intervention includes the development of a Veteran, and a complementary supporting partner, SPI. This Stage II (2aii) randomized clinical trial evaluated preliminary efficacy of this innovative approach. Thirty-nine Veterans and an associated supporting partner were randomized to receive SAFER or currently mandated individual SPI (I-SPI). Veterans in SAFER, compared to I-SPI, exhibited significant monthly decrements in suicide ideation (B = −0.37; p = .032). Moreover, a treatment-by-time interaction emerged when predicting improvements in Veteran suicide-related coping (B = 0.08; p = .028) and

A qualitative study of supporters of adults following a suicide-related psychiatric emergency.

“…Although supporters described adaptive coping mechanisms to manage the stress of caregiving, it is possible that supporters may have minimized their own burdens and mental health challenges for the sake of the patient. Offering supporters the option to work with a mental health provider has been suggested as an empowerment-based approach to suicide prevention treatment (Grant et al, 2015) and is consistent with promising new treatments for suicide that include family components (e.g., Diamond et al, 2021; Goodman et al, 2022; King et al, 2019).…”

“…Interventions to promote the transition to specialty care, ensure a safe home environment, and increase social supports are critical suicide prevention strategies during these high-risk periods (Knesper, 2011). Family members, romantic partners, and close friends (hereafter referred to as “supporters”) of individuals at risk for suicide often play a key role in the implementation of safety and support measures (Goodman et al, 2022; Grant et al, 2015), yet supporters of adult patients are often not consulted or engaged in the development of transition care and safety plan recommendations for their loved one (Wyder et al, 2020), representing a lost opportunity to bolster care for patients and supporters. Supporters of individuals who have experienced psychiatric hospitalization report increased stress, stigma, disruptions in daily routines, economic strain, and changes in relationships following the hospitalization experience (Weller et al, 2015).…”

An open trial of VA CONNECT: Caring for Our Nation's Needs Electronically during the COVID-19 Transition

“…Results further attest to the potential utility of delivering e-mental health services to veterans who were socially and/or physically isolated due to the COVID-19 pandemic. Participation in VA CONNECT resulted in the development and refinement of a personalized Resilience and Safety Plan, adapted from evidence-based safety planning ( Goodman et al, 2020a , 2022 ; Stanley et al, 2008 , 2018 ). As with other action plans, the Resilience and Safety Plan created for VA CONNECT was collaboratively developed by each veteran with the support of study interventionists and other group members with the aim of mitigating subsequent stress related to COVID-19.…”

“…In response to the growing need to deliver telehealth interventions to a larger veteran audience, the authors developed VA Caring for Our Nation's Needs Electronically during the COVID-19 Transition (VA CONNECT) at the onset of the COVID-19 pandemic. VA CONNECT expands upon prior research highlighting the efficacy of building structured safety and wellness plans on symptoms related to suicide, depression, and anxiety to support at-risk individuals ( Cook et al, 2012 ; Goodman et al, 2020a , 2022 ; Kayman et al, 2016 ; Stanley and Brown, 2012). Throughout their participation in VA CONNECT, participants develop a personalized action plan, a written compilation of therapeutic skills and resources to increase coping ability and manage future stress during the COVID-19 pandemic.…”

Brief relationship support as a selective suicide prevention intervention: Piloting the Relationship Checkup in veteran couples with relationship and mental health concerns

“…Fortunately, recent years have seen growing attention to adult relationships through “indicated prevention”—treatments designed for families of individuals with recent ideation or attempts. Studies include a 6‐session conjoint safety planning protocol (Goodman et al, 2022), a 10‐session behavioral couple therapy program (Khalifian et al, 2022), a 15‐week intensive outpatient program (Anastasia et al, 2015), and a 6‐month post‐discharge telephone protocol (Miller et al, 2016). However, it can be difficult to engage supportive family members in times of crisis, with the largest study of a family approach after suicide‐related emergency department visits finding only 20% of patients had a family member engage in the treatment (Miller et al, 2017).…”