TERMINATED

Reducing Suicide Risk in Older Veterans Using Problem Solving Therapy

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Suicide is a national crisis, especially among older Veterans for whom evidence-based suicide prevention efforts are lacking. This proposal responds to the national priority to develop and improve interventions for suicide prevention, with a focus on at-risk older Veterans. The randomized control trial will compare VA usual care, which is suicide safety planning, with brief Problem Solving Therapy and suicide safety planning. This study uses Problem Solving Therapy because it has support from our pilot data and from secondary data analysis from other studies for reducing late life suicide risk. This treatment also has support for alleviating two key risk factors for late life suicide risk, functional disability and executive dysfunction, and thus this study will examine how older Veterans with varying levels of functional disability and executive functioning respond to treatment to inform future targeted implementation. In accordance with national priorities, existing infrastructure in Problem Solving Training could be expanded to support more rapid VA-wide implementation.

Official Title

Reducing Suicide Risk in Older Veterans With Mental Health Disorders Using Problem Solving Therapy

Quick Facts

Study Start:2022-01-24
Study Completion:2025-11-05
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:TERMINATED

Study ID

NCT04763330

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:55 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * \>= 55 years old
  2. * SI (past month) on the C-SSRS
  3. * No SI or imminent risk (will be excluded)
  4. * Eligibility now includes non-specific active suicidal thoughts to active SI with some planning (on C-SSRS item 3: "Have you been thinking about how you might do this") and/or some intent to act (on C-SSRS item 4: "Have you had these thoughts and had some intention of acting on them?") provided that those endorsing item 4 have an established relationship with a psychiatrist aware of this intent level (who is not also performing psychotherapy)
  5. * Those endorsing C-SSRS item 5: "Do you intend to carry out this plan?" would be considered at imminent risk and excluded
  6. * Presence of DSM-5 depressive disorder or anxiety disorder, specified or unspecified, or PTSD or subthreshold PTSD.
  7. * No diagnosis of dementia; evidence that cognitive impairment is not indicative of possible dementia based on a negative cognitive telephone screen (\<10 errors on the Blessed cognitive screen)
  8. * No diagnosis on MINI or medical record for psychotic symptoms or disorders, bipolar disorder, or severe OCD (mild or moderate OCD will be eligible)
  9. * No history of head injury past 12 months
  10. * No severe or unstable chronic medical illness or other severe or unstable respiratory, cardiovascular, neurologic, hepatic, hematopoietic, gastrointestinal or metabolic dysfunction
  11. * AUDIT Total score \<15 for men or \<13 for women (no current alcohol use disorder)
  12. * No substance use disorder of any type for illicit substances, no moderate or severe substance use disorder for cannabis/marijuana - on the MINI.
  13. * No prominent homicidal ideation
  14. * English language proficiency to engage in treatment
  15. * Sensory abilities sufficiently intact to engage in assessment and treatment
  16. * Not currently enrolled in individual psychotherapy for a mental health issue. Participants who are receiving mental health care are eligible if their current care includes treatment from a psychiatrist, supportive therapy, peer counseling or support, or participating in psychoeducational groups.
  17. * No current prescription for anti-psychotics if prescribed for a psychotic disorder
  18. * Anti-psychotics for depression without psychosis are eligible
  19. * Psychotropic medications (e.g., SSRIs) are also eligible
  1. * \< 55 years old
  2. * No SI (past month) or imminent risk on the C-SSRS will be excluded. Those endorsing C-SSRS item 5: "Do you intend to carry out this plan?" would be considered at imminent risk and excluded
  3. * No DSM-5 depressive disorder or anxiety disorder, or PTSD or subthreshold PTSD
  4. * Diagnosis of dementia; evidence that cognitive impairment is indicative of possible dementia based on a positive cognitive telephone screen (\>=10 errors on the Blessed cognitive screen)
  5. * Diagnosis on MINI or medical record for psychotic symptoms or disorders, bipolar disorder, or severe OCD (mild or moderate OCD will be eligible)
  6. * History of head injury past 12 months
  7. * Severe or unstable chronic medical illness or other severe or unstable respiratory, cardiovascular, neurologic, hepatic, hematopoietic, gastrointestinal or metabolic dysfunction
  8. * AUDIT Total score \>14 for men or \>12 for women (no current alcohol use disorder)
  9. * Substance use disorder of any type for illicit substances, moderate or severe substance use disorder for cannabis/marijuana - on the MINI.
  10. * Prominent homicidal ideation
  11. * Lacking English language proficiency to engage in treatment
  12. * Sensory abilities not sufficiently intact to engage in assessment and treatment
  13. * Currently enrolled in individual psychotherapy for a mental health issue. Participants who are receiving mental health care are eligible if their current care includes treatment from a psychiatrist, supportive therapy, peer counseling or support, or participating in psychoeducational groups.
  14. * Current prescription for anti-psychotics if prescribed for a psychotic disorder, and not prescribed for depression without psychosis

Contacts and Locations

Principal Investigator

Sherry A Beaudreau, PhD
PRINCIPAL_INVESTIGATOR
VA Palo Alto Health Care System, Palo Alto, CA

Study Locations (Sites)

VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, California, 94304-1207
United States
Syracuse VA Medical Center, Syracuse, NY
Syracuse, New York, 13210
United States

Collaborators and Investigators

Sponsor: VA Office of Research and Development

  • Sherry A Beaudreau, PhD, PRINCIPAL_INVESTIGATOR, VA Palo Alto Health Care System, Palo Alto, CA

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2022-01-24
Study Completion Date2025-11-05

Study Record Updates

Study Start Date2022-01-24
Study Completion Date2025-11-05

Terms related to this study

Keywords Provided by Researchers

  • older adult
  • Cognitive Behavioral Therapy
  • suicidal ideation
  • suicide prevention
  • executive functioning
  • functional disability

Additional Relevant MeSH Terms

  • Suicidal Ideation
  • Depressive Disorder
  • Anxiety Disorders
  • Post Traumatic Stress Disorder