Evaluation of Structured Assessment and Mediating Factors of Suicide-Focused Group Therapy for Veterans Recently Discharged from Inpatient Psychiatry

Lora L. Johnson, Stephen S. O’Connor, Barbara Kaminer, Peter M. Gutierrez, Erin Carney, Brittany Groh, David A. Jobes

The current study investigated the impact of adding the Suicide Status Form (SSF) to a suicide-focused group therapy for veterans recently discharged from an inpatient psychiatry setting. A sample of 141 veterans was enrolled and randomized into a Usual Assessment Group Therapy or SSF-Assessment Group Therapy. Participants completed interviews at baseline, 1, and 3 months. No significant differences were observed between groups regarding group attendance (IRR = 1.01, Std. Err = 0.08, 95% CI = 0.87, 1.18) or client satisfaction (β = 0.23, Std. Err = 0.66, p = 0.73, d = -.25). No main effects were observed across the study on secondary outcomes of interest for suicidal ideation and overall symptom distress, although participants in both treatment conditions reported significant improvements on these outcomes over the course of the study. Patients in the Usual Assessment Group Therapy demonstrated greater reductions in overall symptom distress across the 3 month follow-up window (β = 6.08, Std. Err = 2.04, p = 0.003; f2 = 0.05). Follow-up path analyses revealed that more frequent session attendance was significantly related to less suicidal ideation at 1 month, higher working alliance between individual members and group facilitators was associated with greater suicidal ideation at 1-month, and higher group cohesion among group members at 1-month was significantly associated with less thwarted belongingness at 1-month. Although the SSF did not improve the impact of an existing suicide-focused group therapy, the study findings support future research on group treatments for suicidal veterans.