RecruitingNot ApplicableNCT07294001

Shame-Focused Cognitive Behavioral Therapy For Reducing Suicide Risk In Adolescent Psychiatric Inpatients (SF-CBT)

A Pilot Randomized Controlled Trial Of Shame-Focused Cognitive Behavioral Therapy For Suicide Prevention In Adolescent Psychiatric Inpatients

Sponsor

Peking University

Enrollment

42 participants

Start Date

Aug 10, 2025

Study Type

INTERVENTIONAL

Conditions

Suicidal Ideation Suicidal Behavior Shame Adolescent Suicide

Summary

This pilot randomized controlled trial (RCT) aims to evaluate the feasibility, acceptability, and preliminary efficacy of Shame-Focused Cognitive Behavioral Therapy (SF-CBT) among high-risk psychiatric inpatient adolescents. Shame has been identified as a critical psychological mechanism underlying suicidal ideation and behavior, yet few interventions directly target it. SF-CBT is a structured, manualized intervention designed to reduce shame, improve coping strategies, and lower suicide risk. Approximately 42 adolescents aged 13-18 years, admitted for recent suicide attempt or severe suicidal ideation, will be randomized in a 2:1 ratio to receive either SF-CBT or supportive therapy (ST). Both conditions include 7 individual sessions for adolescents and 3 structured psychoeducation sessions for parents/guardians. Primary outcomes include feasibility metrics (recruitment, retention, adherence, fidelity, adverse events) and acceptability ratings from adolescents, parents, and therapists. Secondary outcomes include changes in suicidal ideation, suicidal behavior, shame, and coping styles, assessed at baseline, post-treatment, and 1-, 3-, and 6-month follow-ups. Findings will inform refinement of the intervention manual, establish feasibility benchmarks, and provide effect size estimates to guide a subsequent large-scale RCT.

Eligibility

Min Age: 13 YearsMax Age: 18 Years

Inclusion Criteria6

Adolescents aged 13-18 years, male or female.
Recent suicide risk, defined as:
At least one suicide attempt in the past month, or Current suicidal ideation within the past month (with or without plan/intent) and at least one previous attempt.
Elevated shame level (baseline score ≥ 9 on the External and Internal Shame Scale, EISS).
Adequate cognitive capacity to participate in interviews and assessments.
Parent/legal guardian (or designated responsible adult authorized by guardian) provides informed consent and agrees to participate.

Exclusion Criteria5

Current manic episode.
History of schizophrenia spectrum disorder, intellectual disability, or organic brain disease.
Severe psychiatric or medical conditions that impair capacity for consent or participation.
Expected to receive electroconvulsive therapy (ECT) during hospitalization.
Anticipated inpatient stay shorter than 14 days (to ensure intervention completion).

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Interventions

BEHAVIORALShame-Focused Cognitive Behavioral Therapy (SF-CBT)

A structured, manualized individual psychotherapy program consisting of 7 sessions (50-60 minutes each), delivered during hospitalization. The intervention includes modules on motivation building, emotional recognition, behavior chain analysis, shame coping strategies, self-esteem enhancement, and relapse prevention. In addition, caregivers participate in 3 psychoeducation sessions covering empathic communication, crisis response, and boundary management, supplemented by AI-assisted scenario simulations.

BEHAVIORALSupportive Therapy (ST)

A supportive counseling program consisting of 7 sessions (50-60 minutes each), focusing on relationship building, emotional support, and adaptation to hospitalization. Caregivers in this arm also receive 3 psychoeducation sessions identical to those in the experimental arm, covering communication, crisis management, and boundary setting, with AI-assisted practice.