Cognitive Therapy for Suicide Prevention: A Randomized Pilot with Suicidal Youth Experiencing Homelessness

  • Natasha SlesnickEmail author
  • Jing Zhang
  • Xin Feng
  • Qiong Wu
  • Laura Walsh
  • Darcy Haag Granello
Original Article


Homeless youth have extremely high rates of suicidal ideation and attempts, but limited research has evaluated the efficacy of suicide prevention interventions. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a local drop-in center. Of interest was (1) whether the proposed sample of eligible youth could be identified, (2) whether youth could be engaged and retained in the prevention intervention, and (3) whether the intervention was associated with reduced suicidal ideation, our primary outcome measure. In particular, youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) (N = 75) or TAU alone (N = 75). Findings showed that the proposed sample of eligible youth could be identified and engaged in the study, and all youth showed a significant decline in suicidal ideation over time, with a faster decline among youth assigned to CTSP. These findings suggest that (1) at-risk suicidal youth can be identified and engaged outside of hospital emergency rooms, such as in drop-in centers, and (2) intervention added to TAU can strengthen reductions in suicidal ideation. Ultimately, attention towards reducing suicide risk among these youth has the potential to reduce premature mortality, hospitalization and loss of human capital.


Suicidal ideation Suicide attempts Homeless youth 



This work was supported by NIDA Grant # R34DA037845 to the first author.

Compliance with Ethical Standards

Conflict of interest

Natasha Slesnick, Jing Zhang, Xin Feng, Qiong Wu, Laura Walsh and Darcy Haag Granello declare that they have no conflict of interest.

Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Interested youth who also reported current or recent suicidal ideation reviewed and signed an informed consent statement.

Animal Rights

No animal studies were carried out by the authors for this article.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Human Sciences, College of Education and Human EcologyThe Ohio State UniversityColumbusUSA
  2. 2.Department of Human Development and Family StudiesKent State UniversityKentUSA
  3. 3.Department of Family and Child SciencesFlorida State UniversityTallahasseeUSA
  4. 4.Department of Educational Studies, College of Education and Human EcologyThe Ohio State UniversityColumbusUSA

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