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Randomized Controlled Trial
. 2015 Dec;45(16):3441-51.
doi: 10.1017/S0033291715001348. Epub 2015 Jul 13.

Cognitive-behavioural suicide prevention for male prisoners: a pilot randomized controlled trial

D Pratt  1 , N Tarrier  2 , G Dunn  3 , Y Awenat  1 , J Shaw  4 , F Ulph  1 , P Gooding  1
Affiliations
Randomized Controlled Trial

Cognitive-behavioural suicide prevention for male prisoners: a pilot randomized controlled trial

D Pratt et al. Psychol Med. 2015 Dec.

Abstract

Background: Prisoners have an exceptional risk of suicide. Cognitive-behavioural therapy for suicidal behaviour has been shown to offer considerable potential, but has yet to be formally evaluated within prisons. This study investigated the feasibility of delivering and evaluating a novel, manualized cognitive-behavioural suicide prevention (CBSP) therapy for suicidal male prisoners.

Method: A pilot randomized controlled trial of CBSP in addition to treatment as usual (CBSP; n = 31) compared with treatment as usual (TAU; n = 31) alone was conducted in a male prison in England. The primary outcome was self-injurious behaviour occurring within the past 6 months. Secondary outcomes were dimensions of suicidal ideation, psychiatric symptomatology, personality dysfunction and psychological determinants of suicide, including depression and hopelessness. The trial was prospectively registered (number ISRCTN59909209).

Results: Relative to TAU, participants receiving CBSP therapy achieved a significantly greater reduction in suicidal behaviours with a moderate treatment effect [Cohen's d = -0.72, 95% confidence interval -1.71 to 0.09; baseline mean TAU: 1.39 (S.D. = 3.28) v. CBSP: 1.06 (S.D. = 2.10), 6 months mean TAU: 1.48 (S.D. = 3.23) v. CBSP: 0.58 (S.D. = 1.52)]. Significant improvements were achieved on measures of psychiatric symptomatology and personality dysfunction. Improvements on psychological determinants of suicide were non-significant. More than half of the participants in the CBSP group achieved a clinically significant recovery by the end of therapy, compared with a quarter of the TAU group.

Conclusions: The delivery and evaluation of CBSP therapy within a prison is feasible. CBSP therapy offers significant promise in the prevention of prison suicide and an adequately powered randomized controlled trial is warranted.

Keywords: Cognitive therapy; prison; randomized controlled trials; suicide prevention.

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Figures

Figure 1
Figure 1. CONSORT flow diagram of participant progress through the PROSPeR trial.
Figure 2
Figure 2. Mean number of Self-Injurious Behaviours
See this image and copyright information in PMC

References

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