Program

Nov 06, 2012

OVERVIEW

LifeSPAN is a cognitively-based therapy for acutely suicidal patients with psychosis. The aim is to enhance the detection and monitoring of young high-suicide-risk patients, while also treating their mental illness. In a randomized controlled trial, there were no significant differences between intervention and control groups in changes on rated suicidality (suicidal ideation, and suicide attempts) in the 10 weeks prior to each assessment, with individuals in the LifeSPAN and the control group both showing improvement. However, LifeSPAN participants showed greater improvement in measures of hopelessness and quality of life at 10 weeks’ and 6 months’ follow ups.

DESCRIPTION OF PROGRAM

Target population: Suicidal adolescents, youth, and young adults (ages 15-29) with early psychosis.

LifeSPAN therapy consists of 8-10 individual sessions provided by a psychologist. There are four phases within LifeSPAN: initial engagement; suicide risk assessment/formulation; cognitive modules; and final closure/handover. The first two phases serve as a risk assessment and to identify the topics and possible triggers to target in the next phase of therapy. The third phase includes eight modules. These were developed to address and analyze the patient’s suicidality, the rationale for suicide, the quality of hopelessness, and the reasons for living. In addition, there are modules that cover problem-solving, psychosis, stress management, and social skills training. During the final phase, the patient and therapist identify early warning signs and triggers for suicide behaviors, and negotiate suicide protective strategies.

EVALUATION OF PROGRAM

Power, P.J.R, Bell, R. J, Mills, R., Herrman-Doig, T., Davern, M. Henry, L. Yuen, H.P., Khademy-Deljo, A., McGorry, P.D. (2003). Suicide prevention in first episode psychosis: The development of a randomized controlled trial of cognitive therapy for acutely suicidal patients with early psychosis. Australian and New Zealand Journal of Psychiatry, 37, 414-420.

Evaluated Population: Fifty-six patients with first episode psychosis were referred to LifeSPAN and agreed to participate.

Approach:  All patients at the Early Psychosis Prevention and Intervention Centre (EPPIC; ages 15-29) who scored between 4 and 7 on the Expanded Version 4 of the Brief Psychiatric Rating Scale (BPRS), suicidality sub-score, were referred for consideration of LifeSPAN Therapy. A score of 4 equates to “suicidal thoughts frequently without intent or plan,” and 7 equates to a “specific suicidal plan and intent or suicide attempt”. If patents agreed to participate, they were included in a randomized controlled trial of LIfeSPAN Therapy. Patients were excluded if they had attended the service for more than a year.

The treatment group received LifeSPAN therapy in addition to standard clinical care at EPPIC, while the control group received standard clinical care only. Ratings for both groups were conducted at three time points: entry into the trial; at 10 weeks (after final session); and a 6-month follow-up. Patients completing 8 or more sessions were deemed to have completed LifeSPAN Therapy.

Results: Both treatment and control patients improved progressively on ratings of suicide ideation and the number of suicide attempts. There was no significant difference between the groups in the relative change in ratings between each time point, but the treatment group did show larger average decline in suicidal ideation. The LifeSPAN group demonstrated greater improvement on a measure of  hopelessness and in quality of life at at the 10-weeks and 6-months follow-ups .

KEYWORDS: adolescents, youth, young adults, clinic-provider-based, counseling/therapy, anxiety disorders/symptoms, depression/mood disorders, other mental health.

Program information last updated on 11/06/2012

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