Anxiety & Depression Association of America

A New Clinical Model for the Engagement of Latinx Youth with Suicidal Behavior

Purpose

This study will test a model of providing treatment to Latinx/Hispanic youth, who experience suicidal thoughts and behavior, and their caregivers. An affirmative and culturally relevant treatment will be provided to all youth and half of the families will be assigned to the additional support of a community health worker (CHW). Youth symptoms and family engagement to treatment will be followed for nine months. The potential benefit of adding the CHW intervention will be assessed.

Conditions

Suicide Ideation
Suicidal Behaviors
Depressive Symptoms

Eligibility

Eligible Ages: Between 12 Years and 18 Years
Eligible Genders: All
Accepts Healthy Volunteers: No

Inclusion Criteria

Latinx, defined as have been born in a Latin country or having at least one biological parent, grandparent or an ancestor that was born in a Latin country - Severe Suicidal Ideation (SI), defined as one of the following: - SIQ-JR > 22 or endorsing any critical items (2, 3, 4, 7, 8, 9) with at least "about 1x/month" - CDI-II > 15 and endorsing "I think about killing myself but would not do it" OR "I think about killing myself." - PHQ-9 > 10 & endorsing the item "Thoughts that you would be better off dead, or of hurting yourself in some way" with a frequency of "several days" or greater or endorsing the item "Has there been a time in the past month when you have had serious thoughts about ending your life? - Suicidal crisis within the past 12 months - Caregivers and adolescents fluent in Spanish or English language and legal guardian willing to participate

Exclusion Criteria

Participants will be referred to a different treatment program if their main clinical complaint is any of the following: - Behavioral (e.g., conduct disorder, or substance use disorder) - An eating disorder - Obsessive-compulsive disorder - A developmental issue (e.g., speech, occupational, families looking for assessments, treatment for autism) or a significant cognitive delay that may require specialized treatment adjustments.

Study Design

Phase: N/A
Study Type: Interventional
Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Masking: Double (Investigator, Outcomes Assessor)

Arm Groups

Arm	Description	Assigned Intervention
Active Comparator SCBT-SB (Only)	A culturally centered CBT treatment protocol called Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT-SB)	Behavioral: Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT-SB) SCBT-SB is a manualized psychosocial treatment protocol developed specifically with and for L/H youth with suicidal ideation and behaviors. Clinician, adolescents, and caregivers' manuals are available in both Spanish and English. SCBT-SB protocol's main conceptual framework and strategies are informed by Cognitive Behavioral Therapy concepts, psychoeducation, and adolescent parenting strategies. The intervention involves individual, caregivers, and family sessions. SCBT-SB, while maintaining the basic principles of CBT, was further developed to include developmental (e.g., identity), and cultural elements of L/H families (e.g., family communication, language). The protocol has two main phases. Phase 1, the Crisis Module, includes nine standard core sessions, and Phase 2, which proposes a flexible number of sessions, focused on the delivery of interchangeable coping skills modules and the acquisition of skills that reduce STB.
Experimental New Clinical Model: SCBT-SB + Community Health Worker	SCBT-SB treatment with the additional support of a community health worker (CHW)	Behavioral: SCBT-SB + CHW The New Clinical Model consist of one clinician delivering the SCBT-SB and one CHW per each family. The assigned clinician & CHW will meet at the beginning of treatment to discuss their assigned case and will have follow-up meetings as needed and at a minimum, once monthly. CHWs will support family engagement in treatment. CHWs will assess each family's social needs and concerns about treatment. The CHW intervention will 1) Assess social determinants of mental health; 2) Provide referrals and serve as a bridge to other community resources; 3) Provide psychoeducation on mental health and services to decrease stigma; and 4) Follow-up and provide support on recommended actions.

Recruiting Locations

More Details

Status: Recruiting
Sponsor: Bradley Hospital

Study Contact

Yovanska Duarte-Velez, PhD
401-432-1651
yovanska.duart-velez@brownhealth.org

Detailed Description

The objective of this proposal is to test a New Clinical Model to engage Latinx/Hispanic (L/H) youth and their caregivers in a culturally centered, evidence-based treatment for suicidal behaviors (SB). The Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT-SB) is an affirmative and culturally relevant treatment with empirical evidence supporting its use for L/H youth with suicidality. The New Clinical Model consists of the addition of community health workers (CHWs) to the SCBT-SB. CHWs are trusted members of their communities who provide education and connection to resources to L/H families in their native language. A community based participatory research approach is proposed and the Socio-Cultural Framework for Health Service Disparities will be the theoretical model used.