Randomized Controlled Trial: Behavioral Outcomes of Socio-Cognitive Behavioral Therapy for Suicidal Behaviors in Latinx Adolescents.

Abstract

OBJECTIVE To evaluate the effectiveness of Socio-Cognitive Behavioral Therapy for Suicidal Behavior compared to treatment as usual in reducing suicide-related behavioral outcomes among Latinx adolescents. METHOD A randomized clinical trial comparing Socio-Cognitive Behavioral Therapy for Suicidal Behavior, a culturally centered treatment protocol, to treatment as usual in a sample of 114 Latinx adolescents recruited after a suicidal crisis. Socio-Cognitive Behavioral Therapy for Suicidal Behavior addresses cognitive and behavioral skills as well as central issues in adolescent identity formation, parenting skills, family interactions, and communication. This report describes the study sample, attrition rates, treatment engagement, and outcomes for suicide attempts, suicidal events, and non-suicidal self-injuries. RESULTS Intent-to-treat analyses showed significant differences in treatment outcomes between conditions at the 6-month follow-up after baseline. At 6-months, Socio-Cognitive Behavioral Therapy for Suicidal Behavior halved the rate of suicide attempts (relative risk, RR = 0.50, 95% confidence interval, CI [0.12, 0.89], p = .01), and similarly reduced the risk of suicidal events (RR = 0.57, 95% CI [0.21, 0.92], p = .02), and NSSI (RR = .62, 95% CI [0.29, 0.96], p = .03) relative to patients enrolled in treatment as usual. Sub-group analyses suggest the effects were similar for those who identify as LGBTQ+ (n = 67). There were no differences by condition in any behavioral outcomes at 12-months. CONCLUSION This study is the first randomized clinical trial in the United States focused exclusively on Latinx adolescents with suicidal behaviors. Socio-Cognitive Behavioral Therapy for Suicidal Behavior led to better 6-month treatment outcomes for Latinx adolescents than treatment as usual demonstrating that a culturally and identity-informed CBT treatment can significantly reduce suicide attempts, suicidal events, and non-suicidal self-injuries in this high-risk population.