Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART)

This pilot study investigated the potential to utilize adaptive treatment strategies for treating moderate to severe suicidal risk among college students. This article will describe the unique study design and report on feasibility and acceptability findings. A 2-stage Sequential Multiple Assignment...

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Bibliographic Details
Published in:Archives of suicide research 2018-10, Vol.22 (4), p.644-664
Main Authors: Pistorello, Jacqueline, Jobes, David A., Compton, Scott N., Locey, Nadia Samad, Walloch, Joseph C., Gallop, Robert, Au, Josephine S., Noose, Samantha K., Young, Maria, Johnson, Jacquelyn, Dickens, Yani, Chatham, Patricia, Jeffcoat, Tami, Dalto, Georgia, Goswami, Spondita
Format: Article
Language:English
Subjects:
adaptive strategies
CAMS
Client satisfaction
Clinical trials
College students
DBT
Dropping out
Evidence-based medicine
Feasibility
Fidelity
Health risk assessment
Intervention
Recruitment
SMART
suicidality
Suicide
Suicides & suicide attempts
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Summary:This pilot study investigated the potential to utilize adaptive treatment strategies for treating moderate to severe suicidal risk among college students. This article will describe the unique study design and report on feasibility and acceptability findings. A 2-stage Sequential Multiple Assignment Randomized Trial (SMART) was conducted: In Stage 1, 62 suicidal college students were randomized to either a suicide-focused or a treatment-as-usual condition (4-8 weeks). Those deemed insufficient responders were re-randomized to one of two Stage 2 interventions-both suicide-focused but one comprehensive and multimodal and the other flexible and theoretically agnostic (4-16 additional weeks). Recruitment rates were high, treatment dropout levels were lower than expected for the setting, study dropouts were rare, and counselors were able to deliver suicide-focused approaches with fidelity. Treatment satisfaction was high among clients and moderately high among counselors. Findings from this pilot show that a SMART is highly feasible and acceptable to suicidal college students, counselors, and campuses.
ISSN:1381-1118
1543-6136
DOI:10.1080/13811118.2017.1392915