A Systematic Review and Meta-Analysis: Psychotherapy Interventions for Reducing Suicidal Thoughts and Behaviors Among Black Youth

Abstract

Suicides continue to increase among youth, with substantial disparities among Black youth. Culturally responsive evidence-based interventions for Black youth are urgently needed to disrupt these inequities. This study aims to identify evidence-based psychotherapy interventions for suicidal thoughts and behaviors (STBs) among Black youth and examine how existing intervention manuals have integrated culturally- relevant content to Black youth. Literature searches were conducted to identify relevant articles comparing the effectiveness of interventions for STBs, study population with >30% Black youth, and youth participants up to the age of 25. Published articles and therapy manuals were analyzed on cultural adaptation and on seven content domains for cultural adaptation. Meta-analysis used a random-effects model and explored potential moderators. Of the 755 screened records, 13 studies met eligibility criteria and featured eight manualized interventions. Meta-analysis revealed significant effects in reducing STBs between treatment groups (Hedges' g=1.08 with 95% CI [.07, 2.09])) but low-quality evidence, significant heterogeneity, small sample sizes, and inconsistencies in outcome measures. Only one intervention, Adapted Coping with Stress (A-CWS), specifically focused on Black youth. Culturally relevant content was predominantly absent or contained brief descriptions. The most frequently included content was provider cultural competency training. The lack of representation of Black youth in treatment studies and sparse literature on culturally responsive treatments for Black youth and their families continues to stall significant advancements to disrupt current suicide trends disproportionately impacting Black youth. We identified several opportunities for implementing cultural adaptations of suicide interventions among Black youth.