Jennifer Lockman, Ph.D., assistant professor in the UAB Department of Psychiatry and Behavioral Neurobiology, has received a $3.4 million grant from the National Institute of Mental Health (NIMH) to lead a five-year, multi-
site randomized controlled trial evaluating a novel suicide recovery intervention for individuals receiving care in crisis stabilization centers.
The study will examine the effectiveness of THRIVE, (Toward Hope, Recovery, Interpersonal Connection, Values and Engagement) a brief, recovery-centered intervention designed to support individuals following a suicidal crisis.
Lockman said the project addresses a critical gap in suicide prevention research and practice.
“Crisis stabilization centers are rapidly growing throughout the country and have the capacity to treat suicidal persons,” Lockman said. “However, there are currently no evidence-based, brief, recovery-oriented interventions that can be implemented in this setting.”
THRIVE was developed to help individuals not only work on immediate crisis management, but also toward meaningful recovery. While many existing interventions focus primarily on safety planning and reducing immediate risk, THRIVE helps people stay physically safe from suicide while also emphasizing hope, personal values, interpersonal connection, and engagement in life.
The study will test a group-based, phone-follow-up version of THRIVE delivered by counselors and peer support specialists in crisis stabilization centers across three Crisis Stabilization Centers – Connections Health Solutions, in Phoenix, AZ, Mental Health Cooperative, in Nashville, TN, and Wellstone, Inc., in Huntsville, AL.
“Our goal is to determine whether THRIVE reduces suicide risk events, such as care escalations and suicide attempts, after patients are discharged,” Lockman said. “We will also examine barriers and facilitators to implementing the intervention in crisis centers so that it can be scaled more broadly if it proves effective. We will also examine the cost-effectiveness of the intervention and implementation needs and facilitators.”
In addition to evaluating clinical outcomes, researchers hope the study will generate important insights into how recovery-centered approaches can complement traditional suicide prevention efforts.
“Currently, the standard of care is to provide safety-focused treatments to patients in crisis settings,” Lockman said. “While those approaches are impactful for many people, individuals at the highest risk for suicide often lack self-reported motivation for ‘staying safe’ as an inherent part of the suicidal experience. We anticipate THRIVE builds capacity and motivation for wanting to not only stay safe, but truly live.”
Lockman believes THRIVE could provide clinicians with a new tool that helps patients not only survive a suicidal crisis but also reconnect with the aspects of life they find meaningful.
“We hope this intervention will help suicidal people engage in living in ways they personally value,” she said. “That has the potential to benefit all individuals experiencing suicidality, including those at the highest risk.”
The study may also expand the role of interdisciplinary care teams in suicide prevention. If successful, THRIVE would become the first recovery-centered suicide prevention intervention shown to be effective when delivered by a team that includes counselors and peer-support specialists.
“This study will help us better understand how people recover after a suicidal crisis and the degree to which THRIVE, as a recovery-centered intervention, facilitates that recovery,” Lockman said.
The project represents several firsts for the field. It is expected to be the first large multi-site randomized controlled trial of any psychological intervention conducted in crisis stabilization centers, the first randomized controlled trial of a recovery-centered intervention for suicide prevention and the first such trial to include peer-support specialists as intervention providers.
As crisis stabilization centers continue to expand nationwide, findings from the study could help establish new standards for delivering recovery-focused care and provide valuable evidence to guide future suicide prevention efforts.
“We are excited by all we will learn,” Lockman said. “We hope to use that knowledge to further advance recovery-centered interventions for suicide prevention and improve outcomes for people experiencing suicidal crises.”