SAFER: A brief intervention involving family members in suicide safety planning

尽管丰富了退伍军人自杀预防服务，并实施了国家 自杀热线，老兵自杀已上升至每天22人，自杀未遂 2012年，这一数字超过了15,000。这些数据突显了开发更多 针对有自杀倾向的退伍军人的干预。进一步进行自杀治疗的一个潜在途径 康复努力是制定最大限度地增加家庭支持的战略，然而几乎没有 对于有自杀倾向的退伍军人，存在家庭干预。建立自杀安全计划(SSP)； “最佳实践”是整个退伍军人制度的要求，也是退伍军人制度的重要组成部分。 协调努力预防自杀和康复。我们关于SSP使用模式的试点数据 有自杀倾向的退伍军人强调了与家人或亲密朋友分享该计划的重要性。 然而，受访者也注意到，他们接触他人的能力存在重大障碍 当你陷入困境时。据我们所知，目前还没有推荐的指南或 将家庭纳入安全规划的机制，尽管这是计划的一个步骤。 “鼓励家庭康复的安全行动”(SAFER)--一种新的自杀安全规划 家庭干预旨在填补这一关键空白，并提供一种机制 就安全计划进行沟通。SAFER，4个疗程，家庭干预，结合 关于自杀和自杀安全规划的教育和沟通技能培训 循证实践。其目的是促进有关自杀安全规划的交流。 并制定退伍军人和家庭成员安全计划。 该项目的数据将检验干预的可行性、可接受性和初步效果 在一项第二阶段(Rounaville等人，2001年)的小规模随机临床试验中，60例中度自杀 风险退伍军人及其家庭成员。比较条件将是安全规划 没有家人的参与，加上每周的电话报到。退伍军人的主要结果包括 减少自杀念头/行为。退伍军人的次要结果包括减少自杀 认知(无望、感觉到的负担、受挫的归属感)和 抑郁和改善主观社会支持。家庭成员的主要结果包括 减轻照顾者负担和改善与自杀相关的应对和继发结果 家庭赋权。

Despite the enrichment of VA suicide prevention services and implementation of the national suicide hotline, Veteran suicide completions have risen to 22 per day and suicide attempts numbered over 15,000 in 2012. These data underscore the urgency of developing additional interventions targeting suicidal Veterans. One potential avenue to further suicide treatment and rehabilitation efforts is to develop strategies that maximize family support, however almost no family interventions exist for suicidal Veterans. The construction of a Suicide Safety Plan (SSP); a “best practice,” is mandated throughout the VA system, and a vital component of the VA’s coordinated effort at suicide prevention and recovery. Our pilot data on patterns of SSP use in suicidal Veterans highlighted the importance of sharing the plan with family or close friends. However, respondents also noted significant obstacles in their ability to reach out to others when in distress. To our knowledge, there are currently no recommended guidelines or mechanisms for involving family in safety planning, despite its inclusion as a step of the plan. “Safe Actions for Families to Encourage Recovery” (SAFER) a novel suicide safety planning family intervention has been designed to fill this critical gap and provide a mechanism to communicate about safety planning. SAFER, a 4-session, family intervention, combines education about suicide and suicide safety planning with communication skills training from evidence-based practices. The aim is to facilitate communication about suicide safety planning and to develop both a Veteran and family member safety plan. Data from this project will test the intervention’s feasibility, acceptability and preliminary efficacy in a Stage II (Rounsaville et al, 2001) small-scale randomized clinical trial in 60 moderate suicide risk Veterans and their family members. The comparison condition will be safety planning without family involvement plus weekly check-in phone calls. Primary Veteran outcomes include reducing suicidal ideation/behavior. Secondary Veteran outcomes include reducing suicidal cognitions (hopelessness, perceived burdensomeness, thwarted belongingness) and depression and improving subjective social support. Family member primary outcomes include reducing caregiver burden and secondary outcomes of improving suicide-related coping and family empowerment.