Abstract
Attachment-Based Family Therapy (ABFT) is the only empirically supported family therapy model designed to treat adolescent depression, including those at risk for suicide, and their families. ABFT aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. To study the effectiveness of ABFT compared with Treatment as Usual (TAU) in reducing suicidal ideation in clinically depressed adolescents. Sixty adolescents (86.7% girls), aged 13 to 18 years (M = 14.9), with major depressive disorder referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions according to the treatment manual. Suicidal ideation was measured with the Suicidal Ideation Questionnaire-Junior at 4, 6, 8, 10, 12, 14, and 16 weeks. Linear mixed models were fitted to test our hypothesis, time was the only factor to have a significant effect on suicidal ideation t(31.05) = −3.32, p < .01. Participants in both treatment groups reported significantly reduced suicidal ideation, but the majority were still in the clinical range after 16 weeks of treatment. ABFT was not associated with more favorable outcomes than TAU. Findings must be interpreted with caution given the study limitations.
Highlights
Suicide is one of the leading causes of death in adolescents worldwide (Glenn et al, 2020; WHO, 2020)
In a recent study, designed to examine the effectiveness of Attachment Based Family therapy (ABFT) compared to Treatment as usual (TAU) in reducing depressive symptoms, we found no differences between the two treatment options (Waraan et al, 2020)
Because ABFT has been shown to be especially efficient in reducing suicidal ideation, we hypothesized that patients receiving ABFT would show greater reduction in suicidal ideation than adolescents receiving TAU
Summary
Suicide is one of the leading causes of death in adolescents worldwide (Glenn et al, 2020; WHO, 2020). Cognitive behavioral therapy and Interpersonal psychotherapy have emerged as well-established treatment approaches for youth with MDD (Eckshtain et al, 2020; Weersing et al, 2017). Continued efforts to improve treatment for these youth are warranted and one promising direction is family therapy. Relationships can both maintain symptoms of depression, including suicidal ideation, and serve as a protective factor. Increased family focus may be one pathway to improving the effect of psychotherapy for depressed youth with suicidal ideation. Among treatment approaches with a family focus is Attachment Based Family therapy (ABFT), which has been shown to be efficacious in reducing suicidal ideation (Diamond et al, 2010, 2018). Because ABFT has been shown to be especially efficient in reducing suicidal ideation, we hypothesized that patients receiving ABFT would show greater reduction in suicidal ideation than adolescents receiving TAU
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