Intensive Crisis Intervention
Intensive Crisis Intervention (ICI) for Adolescent Suicidal Behavior
Jennifer Hughes
213 participants
Jun 3, 2024
INTERVENTIONAL
Conditions
Summary
The study's purpose is to improve the clinical management of severe crises experienced by youth with psychiatric disorders by examining a brief, evidence-based alternative to inpatient psychiatric care.
Eligibility
Inclusion Criteria7
- Youth between the ages of 12 years 0 months and 17 years 6 months at time of consent
- Present to the Nationwide Children's Hospital (NCH) Psychiatric Crisis Department (PCD) or NCH Psychiatry Consult Liaison (CL) Service with suicidal ideation and/or behavior as the primary referral
- Be eligible for admission to both YCSU and APIU based on PCD or CL clinician's clinical judgement
- Patient and legal guardian must be willing to be admitted to either YCSU or APIU
- Youth obtains a score of ≥23 on the Concise Health Risk Tracking Self-Report (CHRT-SR)
- Youth resides with a primary caretaker who has legal authority to consent for participation in research
- Legal guardian must attend the PCD or CL evaluation
Exclusion Criteria3
- Participants who are unable to understand study procedures (e.g., intellectual disability, actively psychotic)
- Inability to speak or read English adequately to understand and complete study consent and procedures
- YCSU clinicians, PCD staff, and NCH-BH leaders will be invited to participate based on their roles in the system-of-care.
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Interventions
ICI is a brief (Average Length of Stay \[ALOS\]: M±SD=4.5±1.4 days), intensive family-centered, skills-based alternative to traditional inpatient psychiatric care. Adolescents participate in 2-3 individual sessions and 1-2 family sessions daily. Based on the cognitive-behavioral model of suicidality, ICI emphasizes that learned, maladaptive cognitive, behavioral, and affective responses to stressors contributing to suicidal behavior can be changed. Master's-level clinicians facilitate this process by engaging adolescents and their families in developing more effective coping skills when faced with potential triggers to suicidal crises.
APIU provides comprehensive assessment and treatment services to children and adolescents with significant psychiatric difficulties and to their families using a multidisciplinary approach. Symptoms and behaviors that led to admission are targeted through a milieu-based model of care and therapeutic group programming. The multidisciplinary treatment team includes a child and adolescent psychiatrist, often in collaboration with an advanced practice provider, psychologist, psychiatric nursing staff including trained mental health specialists, behavioral healthcare clinicians, care managers, rehabilitative care staff, teachers, and parent partners. Average length of stay is 9-11 days. An individualized treatment plan is developed by the entire treatment team, including the patient and caregivers, and includes initial planning for discharge with the primary treatment goal being stabilization of acute psychiatric symptoms. Programming is based on a trauma-informed biopsychosocial approach.
Locations(1)
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NCT06476886