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Brief Cognitive Behaviour Therapy to Prevent Suicide Reattempts: A Feasibility Study in Swedish Psychiatric Inpatient Care (BCBT)

13 augustus 2026 bijgewerkt door: Christian Rück, Karolinska Institutet

The goal of this study is to determine whether Brief Cognitive Behaviour Therapy (BCBT), a four-session psychological treatment aimed at reducing suicide attempts, is acceptable and feasible to deliver during psychiatric inpatient care for adults who have been hospitalised following a suicide attempt or who are at high risk of suicide. The main questions it aims to answer are:

  1. Is BCBT acceptable among suicidal psychiatric inpatients, and in what ways can the treatment and its delivery be improved to enhance patient engagement and adherence?
  2. Is BCBT feasible from the perspectives of treating clinicians, clinic managers, and other relevant personnel, and what are the key facilitators and barriers to its implementation within routine inpatient psychiatric care in Sweden?

Participants will:

  • Receive four structured BCBT therapy sessions delivered during hospitalisation, in addition to usual care
  • Be contacted for follow-up assessments at 1 and 3 months after completing treatment
  • Take part in an interview about the participants' experience with the treatment 1 month after completing it

Clinical staff, treating psychologists, and managers will also be interviewed to explore the participants' experiences, as well as barriers and facilitators to implementation. Overall, the findings from this study will inform the design of a future randomised trial to test the effectiveness of BCBT in reducing suicide attempts after discharge from inpatient psychiatric care.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Suicide attempts and self-harm represent major public health concerns, with approximately 11,000 individuals in Sweden requiring emergency or inpatient care each year following suicidal behaviour. The period immediately following discharge from psychiatric inpatient care is associated with an extremely elevated risk of suicide, with studies indicating up to a 200-fold increase compared to the general population. Despite this high-risk period, there is currently a lack of structured, evidence-based psychological interventions specifically designed for inpatient psychiatric settings, where care primarily focuses on pharmacological treatment and acute stabilisation.

Brief Cognitive Behaviour Therapy (BCBT) is a structured, four-session psychological intervention based on cognitive behavioural principles and specifically adapted to target suicidal behaviour. BCBT is grounded in the Fluid Vulnerability Theory of suicide, which conceptualises suicide risk as a dynamic process influenced by both enduring vulnerabilities and acute stressors. The intervention aims to reduce suicide risk by targeting modifiable cognitive, emotional, and behavioural processes, enhancing coping skills, and preventing the activation or escalation of suicidal crises.

This study is a single-arm feasibility study designed to evaluate the acceptability and feasibility of BCBT among adult psychiatric inpatients in Sweden. A total of 20 participants aged 18 years or older will be recruited from inpatient psychiatric units at Psykiatri Sydväst and Psykosvård Stockholm.

Participants will receive four individual BCBT sessions delivered by trained clinical psychologists during the participants' inpatient stay. Each session lasts approximately 60-90 minutes and focuses on specific therapeutic components. The first session includes psychoeducation, a narrative of the suicide attempt, and development of an individualised case conceptualisation and safety plan. The second session focuses on cognitive flexibility and identifying reasons for living, including the creation of a "hope box". The third session addresses restriction of access to lethal means and development of coping strategies, including coping cards. The fourth session focuses on consolidation of skills and relapse prevention, including guided imagery exercises to prepare for future crises. If discharge occurs before completion, sessions may be continued after discharge. All participants will continue to receive treatment as usual in accordance with standard inpatient care.

In addition, semi-structured qualitative interviews will be conducted with patients, focusing on the acceptability, perceived effects, and satisfaction with the treatment. The investigators will also conduct semi-structured qualitative interviews with treating psychologists, clinical staff, and managers (approximately 8-12 participants). These interviews aim to explore feasibility, and barriers and facilitators to implementation of BCBT in routine inpatient psychiatric care.

Studietype

Ingrijpend

Inschrijving (Geschat)

32

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

  • Zweden
      • Stockholm, Zweden
        • Werving
        • Psykiatri Sydväst
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  • admitted following a suicide attempt within one week of admission or presenting with suicidal ideation with a plan and a prior suicide attempt within the last two years
  • 18 years or older

Exclusion Criteria:

  • current mania, current acute psychosis, or cognitive impairment
  • expected inpatient stay shorter than four working days
  • ongoing or planned electroconvulsive therapy
  • psychiatric or somatic conditions leading to inability to provide informed consent

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: BCBT
Participants will receive four individual BCBT sessions delivered by trained clinical psychologists during their inpatient stay. Each session lasts approximately 60-90 minutes and focuses on specific therapeutic components. The first session includes psychoeducation, a narrative of the suicide attempt, and development of an individualised case conceptualisation and safety plan. The second session focuses on cognitive flexibility and identifying reasons for living, including the creation of a "hope box". The third session addresses restriction of access to lethal means and development of coping strategies, including coping cards. The fourth session focuses on consolidation of skills and relapse prevention, including guided imagery exercises to prepare for future crises. If discharge occurs before completion, sessions may be continued after discharge.
Gedragsmatig: Brief Cognitive Behaviour Therapy
Brief Cognitive Behaviour Therapy to prevent suicide reattempts

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Treatment completion
Tijdsspanne: Posttreatment assessment performed within two working days after the final treatment session.
Proportion of participants completing 3 or more BCBT sessions
Posttreatment assessment performed within two working days after the final treatment session.
Treatment satisfaction
Tijdsspanne: Posttreatment assessment performed within two working days after the final treatment session.
Patient-reported treatment satisfaction assessed using the Client Satisfaction Questionnaire (CSQ-8). The CSQ-8 is an 8-item scale, with each item rated on a four-point Likert scale (1-4), giving a total score ranging from 8 to 32, with higher scores indicating greater treatment satisfaction.
Posttreatment assessment performed within two working days after the final treatment session.
Retention
Tijdsspanne: 1- and 3-month follow-up after the final treatment session
Proportion of participants completing follow-up assessments at 1 and 3 months
1- and 3-month follow-up after the final treatment session

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Decline rate
Tijdsspanne: From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Proportion of potentially eligible participants who are approached but decline study participation
From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Recruitment pace
Tijdsspanne: From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Average monthly recruitment rate
From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Likelihood of treatment component use
Tijdsspanne: During the 4-session treatment period (planned for 4 consecutive days), assessed at each session
Patient-reported likelihood of using each treatment component (safety plan, reasons for living list, hope box, restriction of lethal means, coping cards), rated from 0-10 for each treatment component, with higher scores indicating a higher likelihood of using the component.
During the 4-session treatment period (planned for 4 consecutive days), assessed at each session
Use and perceived helpfulness of treatment components
Tijdsspanne: 1- and 3-month follow-up after the final treatment session
Patient-reported extent of use and perceived helpfulness of treatment components (safety plan, reasons for living list, hope box, restriction of lethal means, coping cards) rated with 6 items on a 0-10 scale, with higher scores indicating a higher extent of use and perceived helpfulness of the component.
1- and 3-month follow-up after the final treatment session
Adverse events and negative effects of treatment
Tijdsspanne: During the 4-session treatment period (planned for 4 consecutive days), assessed at each session; posttreatment assessment (performed within 2 working days after the final treatment session); and 1- and 3-month follow-up after the final treatment session
Negative effects of treatment are assessed at each treatment session, as well as at posttreatment and follow-up
During the 4-session treatment period (planned for 4 consecutive days), assessed at each session; posttreatment assessment (performed within 2 working days after the final treatment session); and 1- and 3-month follow-up after the final treatment session
Semi-structured interviews with personnel
Tijdsspanne: Interviews will be conducted within 1 month after recruitment of the final patient (n=20) is completed (anticipated recruitment duration: approximately 6 months)
Semi-structured interviews with treating psychologists, clinical personnel at the wards and managers focusing on perceived feasibility, barriers and facilitators to implementation
Interviews will be conducted within 1 month after recruitment of the final patient (n=20) is completed (anticipated recruitment duration: approximately 6 months)
Semi-structured interviews with patients
Tijdsspanne: Interviews will be conducted on the same day, directly following the 1-month follow-up assessment (i.e., one month after the final treatment session).
Semi-structured interviews with patients to explore perceived effects, acceptability and satisfaction with the treatment
Interviews will be conducted on the same day, directly following the 1-month follow-up assessment (i.e., one month after the final treatment session).
Suicidal ideation
Tijdsspanne: Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.
Suicidal ideation will be measured using the Columbia-Suicide Severity Rating Scale (C-SSRS) intensity subscale covering 5 items rated from 0/1 to 5, and summed for a total score of 2-25, with higher scores representing a higher intensity of suicidal ideation.
Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.
Suicide attempts
Tijdsspanne: Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.
The total number of suicide attempts between discharge and the 3-month follow-up. A suicide attempt is defined here using the Columbia-Suicide Severity Rating Scale (C-SSRS) definition of "Actual attempt" or "Interrupted attempt".
Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Karolinska Institutet

Medewerkers

Region Stockholm

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

11 mei 2026

Primaire voltooiing (Geschat)

14 december 2026

Studie voltooiing (Geschat)

14 december 2027

Studieregistratiedata

Eerst ingediend

20 april 2026

Eerst ingediend dat voldeed aan de QC-criteria

28 april 2026

Eerst geplaatst (Werkelijk)

5 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

17 augustus 2026

Laatste update ingediend die voldeed aan QC-criteria

13 augustus 2026

Laatst geverifieerd

1 april 2026

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 2025-08835-01.
  • 2025-00188 (Ander subsidie-/financieringsnummer: The Swedish Research Council for Health, Working Life and Welfare (FORTE))

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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