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Cognitive Therapy for Suicide Prevention (CT-SP) and Adolescent Suicide: Assessing the Effect of CT-SP in Reducing Occurrence of Suicidal Behavior among Youths with a history Of Suicide Behavior and ideation.

Problem Statement

Suicide is one of the leading causes of death among youth. Approximately 4600 youths between the age of 10 and 24 lose their lives each year. Of these deaths, 45% are through firearms, 40% through suffocation and 8% through poisoning. In addition, around 9% of youths have confessed to planning, thinking and, or attempting suicide. Around 157,000 youths seek medical care as a result of self-inflicted injuries in the US alone. Suicidal and self-injurious behavior is a good predictor of future suicide attempts and therefore warrants interventions. Such individuals are 60% more likely to engage in another suicide attempt; consecutive attempts are more likely to lead to actual death (Brown & Jager-Hyman, 2014). Despite the economic, social and health impacts of suicidal behavior, there are few tested psychotherapies targeting the youth. According to the Surgeons General’s Call to Action to Prevent Suicide there is a need to develop and test more effective methods of preventing suicidal behavior, especially in high-risk patients (Stanley, et al., 2009). As such the proposed study seeks to assess the effectiveness of Cognitive Therapy for Suicide Prevention in reducing the reoccurrence of suicidal behavior among youths aged 10 to 20.

Importance to Psychology

According to Brown and Jager Hyman (2014), the current knowledge on various psychotherapeutic approaches to reducing suicidal behavior and ideation is limited owing to methodological limitations as well as various gaps. The two researchers have noted that most studies that utilize randomized control trials have shown the effectiveness of different therapeutic approaches in experimental settings and not in real life. Additionally, most studies have failed to take into considerations of various factors that affect suicidal behavior and ideation in real life settings. Also, there are few RCTs that have focused on the efficacy of psychotherapies in reducing suicidal behavior among the youth. As such, the proposed research will seek to fill these gaps by utilization of sound methodological approaches that consider extraneous factors that affect suicidal behavior and ideation.

Historical Background

The proposed study replicates a study by Stanley et al. (2009) on the efficacy of cognitive behavior therapy for suicide prevention among adolescents. However, the proposed study focuses on the efficacy of cognitive therapy for suicide prevention among the youth aged between 10 and 24. A systematic review by Brown and Jager-Hyman (2014) of the effectiveness of various psychotherapies in preventing suicide shows that despite the existence of multiple RCTs that measure the effectiveness of psychotherapies in reducing suicide, most focused on the effectiveness of the approaches in experimental settings. However, the two researchers point out that cognitive therapy for suicide has shown positive results in reducing suicidal behavior and ideation although few studies have vigorously tested the approach in the youth. Brown and Jager-Hyman point out that there is a need to examine the effectiveness of these various psychotherapies in a real life situation or the development of strategies that allow the measuring of efficacy in real life situations.

Annotated Bibliography

Brown, G., & Jager-Hyman, S. (2014). Evidence-Based Psychotherapies for Suicide Prevention: Future Directions. American Journal of Preventive Medicine, 47 (3s2), s1186-s194.

In this article, Brown and Jager-Hyman (2014), examine the “state of science” in regards to the efficacy of psychotherapies in reducing suicidal behavior and ideation. The systematic review focuses on studies that utilized randomized control trials. Brown and Jager-Hyman conclude that while most studies show that various approaches such as Cognitive behavioral therapy, cognitive therapy, and dialectical behavioral therapy are effective, most of the randomized trials that provide the evidence are biased and have inherent limitations. They point out that there is a need to carry out new RCTs that prove the effectiveness of the approaches in real life.

Stanley, B., Brown, G., Brent, D., Wells, K., Polling, K., Curry, J., . . . Hughes, J. (2009). Cognitive Behavior Therapy for Suicide Prevention (CBT-SP): Treatment Model, Feasibility and Acceptability. Journal of American Academy of Child and Adolescent Psychiatry, 48 (10), 1005-1013.

Stanley et al. (2009) focus on describing and defining the various components of the manual of cognitive behavior psychotherapy for suicide prevention (CBT-SP). In addition, they discuss a study on the feasibility of utilizing CBT-P in eliminating the suicidal behavior in adolescents aged between 13 and 19years. In the study, 110 students underwent CBT-SP for 12 sessions over six months. The study found that approach to be effective and acceptable to the students. Stanley et al., (2009) conclude it is time to measure the feasibility of the approach as the manual for the CBT-SP is already complete.

References

Brown, G., & Jager-Hyman, S. (2014). Evidence-Based Psychotherapies for Suicide Prevention: Future Directions. American Journal of Preventive Medicine, 47 (3s2), s1186-s194.

Stanley, B., Brown, G., Brent, D., Wells, K., Polling, K., Curry, J., . . . Hughes, J. (2009). Cognitive Behavior Therapy for Suicide Prevention (CBT-SP): Treatment Model, Feasibility and Acceptability. Journal of American Academy of Child and Adolescent Psychiatry, 48 (10), 1005-1013.

Assignment 9

Begin Chapter 1: Formulation of Research Questions of your Doctoral Project

Chapter One provides an overview of your study. Here you clearly address four questions: why (the background of your study); what (your study’s problem statement); how (the purpose of your study); and who (the significance of your study, in terms of who stands to benefit).

The background of your study (why?) includes: why you are studying this particular problem, whether adding to the general body of literature and theory in psychology, applying theory to clinical practice, or completing a qualitative analysis. Here you also include historical information, as well as statistical information in key areas of your study.

Your study’s problem statement (what?) includes stating the problem in specific terms, and using the literature, what specific area you will be examining. This discussion should mirror the focus of your literature review. (The literature review will be presented in Chapter 2.)

The purpose of your study (how?) introduces your methodology (theoretical or qualitative), or how you plan to conduct your study. Also included here are your research questions and an introduction to your theoretical framework for the study.

The significance of your study (who?) addresses: who will benefit from your study, and how they will benefit. Articulate specifically how the study will contribute to the existing theoretical literature and/or qualitative findings within psychology.

Other sections in Chapter One include: limitations of your study (elements over which you have no control in your study), delimitations (elements you can control, such as who or what you will include vs. exclude within the boundaries of your study), and definitions of key terms. Regarding limitation and delimitations, these should be addressed and discussed candidly. For example, the relatively small number of subjects in a case study doctoral project might limit your findings in terms of its range of applicability. But what such a design sacrifices in generalization of findings may be compensated for by the depth of the findings which such a design reveals. Such issues should be frankly discussed. Identifying them does not weaken your doctoral project; rather, it strengthens your project by building the reader’s confidence in your judgment as a scholar and careful researcher.

Refer to the Doctoral Project Manual located under the course “Resources” tab for these, and further, detailed instructions.

Assignment Outcomes

Formulate research questions

Assess the literature in addressing those questions

Demonstrate ethical behavior in regard to information and information technology

DOCTORAL PROJECT MANUAL

PSY 89997-PSY 89999

All rights reserved.

CalSouthern Faculty and/or Doctoral Candidates may reproduce any part of this document

for use in conjunction with their assignments at the University

January 2014

TABLE OF CONTENTS

SECTION ONE: THE DOCTORAL PROJECT

Doctoral Project Committee 1

Enrollment … 1

Continuous Enrollment .1

Selecting the Doctoral Project Topic .1

Prospectus 2

SECTION TWO: THE DOCTORAL PROJECT COMMITTEE

Composition and Selection of the Committee .3

Responsibilities of the Committee 3

Functions of the Committee Members 5

Functions of the Chair 6

Working with the Committee Chair 7

SECTION THREE: PROCEDURE FOR OBTAINING ETHIC’S APPLICATION

Doctoral Project Involving no Human Subjects 8

Doctoral Project Involving Human Subjects 8

Institutional Review Board Application Process 8

Researcher Responsibility 8

Ethical Principles 9

SECTION FOUR: FORMAT SPECIFICATIONS

Requirements 11

Manuscript Submission 11

Format/Text Spacing 11

Margins 12

Title 12

Running Head 12

Pagination 12

Headings 12

Length 12

References 12

Table of Contents 13

Tables, Charts, and Photographs 13

Arrangement 13

SECTION FIVE: GENERAL INFORMATION

Submission …….14

Release Agreement 14

Regulations Regarding Joint Authorship 14

Publishing of Doctoral Projects 14

Copyrighting of Doctoral Project 14

SECTION SIX: RESEARCH APPROACHES TO THE DOCTORAL PROJECT

Theoretical Study 15

Qualitative Study 15

Structure of the Doctoral Project 15

Chapter One: Overview of the Study 15

Introduction 15

Problem Statement 15

Background of the Study 15

Purpose of the Study 16

Significance of the Study 16

Theoretical Framework 16

Research Questions 16

Limitations of the Study 16

Delimitations of the Study 16

Definition of Key Terms 16

Chapter Two: Review of the Literature 16

Chapter Three: Methodology 17

Theoretical Study 17

Qualitative Study 17

Re-statement of the Problem and Overview 17

Subjects 17

Data Collection 17

Data Analysis 18

Chapter Four: Results 18

Theoretical Study 18

Qualitative Study 18

Chapter Five: Discussion of Findings 18

Implications and Recommendations… 18

Conclusions 19

Reference List and Appendices 19

Abstract. 19

SECTION SEVEN: THE ORAL DEFENSE

Process 21

Proctor Information for Oral Defenses via Video Conferencing 21

Oral Defense Format 21

After the Oral Defense 22

SECTION EIGHT: APPENDICES

Appendix A: Sample List of Doctoral Project Titles. 24

Appendix B: Institutional Review Board Application 26

Appendix C: IRB Questions for Research with Human Subjects 28

Appendix D: Sample Statements of Informed Consent 29

Example I 29

Example II 30

Example III 31

Appendix E: Informed Consent Guidelines for Research with Human Subjects. 32

Appendix F: Sample Copyright Release Agreement 33

Appendix G: Guidelines for Evaluation of the Manuscript 34

Appendix H: Doctoral Project Assessment Rubric for the Manuscript… 36

Appendix I: Doctoral Project Manuscript Checklist. …………. 39

Appendix J: Sample Proctor Form…………. 41

Appendix K: Assessment of the Oral Defense…………. 42

Appendix L: Sample Approval Page…………. 45

Appendix M: Tips for Completing the Doctoral Project…………. 46

SECTION ONE:

THE DOCTORAL PROJECT

The Doctoral Project represents the capstone of the doctoral candidate’s entire doctoral studies and deserves the doctoral candidate’s fullest attention. Because of the specialized nature of the Doctoral Project, the concise academic writing style and processes may seem intimidating; the purpose of this manual is to help demystify this process. Although Doctoral Project topics exhibit as much diversity and individuality as doctoral candidates themselves, the candidate’s writing process is governed by standardized guidelines. Many of the guidelines are intended as suggestions or inspiration for how to proceed to best present the unique topic, research, and findings from the candidate’s research. Other guidelines outline the technical or procedural requirements for completing the Doctoral Project process at California Southern University.

Doctoral Project Committee

The Committee consists of at least three members: the Chair and two other Committee Members. The Chair is designated as the one who guides the doctoral candidate through the procedural steps of completing the Doctoral Project and who is primarily responsible for managing the candidate through the writing and research processes. The Committee Members serve as consultants and as quality control monitors of the Doctoral Project. A detailed description of each Committee Member’s duties is included in Section Two of this manual.

Continuous Enrollment

A potential candidate for the PsyD degree must not have a lapse in enrollment in the series of Doctoral Project courses. If additional time is needed to complete any of the courses, the doctoral candidate must request an extension and re-enroll in the appropriate course and pay the tuition for that course. Continuous enrollment will only be permitted when the doctoral candidate demonstrates satisfactory academic progress toward completing the Doctoral Project requirements. The Doctoral Project Chair and Committee Members determine satisfactory academic progress.

Selecting the Doctoral Project Topic

The University encourages Doctoral Projects that extend the work of the doctoral candidate’s profession into emerging fields of inquiry which address contemporary issues. The doctoral candidate is encouraged to select a topic that falls within the scope of his or her expertise, interest, and career objectives.

The candidate may select and reject several topics before the right topic finally resonates. Usually, initial ideas in a Doctoral Project are revised several times. There are several reasons why ideas are revised: the topic is too broad; the topic is too narrow; time-limit constraints exist, and/or accessibility of subjects hinders the scope of the study. During the process of selection, it is advisable for the candidate to conduct preliminary library research. For example, exploring Doctoral Project Abstracts for a wide range of research methods is useful. For a Sample List of Doctoral Projects Topics, see Appendix A.

The doctoral candidate will find it worthwhile to spend time researching and possibly rejecting a topic. This process creates a solid foundation for exploring the subject the doctoral candidate initially chooses. Often efforts devoted to those abandoned topics have a way of resurfacing for consideration in future projects.

Prospectus

The candidate will complete a Research Prospectus which is a brief overview of the Doctoral Project, giving the reader sufficient information about the work the candidate is proposing, providing information on how the candidate plans to do the research, and explaining the value of this work. The document is 1-2 pages and will be completed in the first Doctoral Project course, PSY 89997A.

Structure of Doctoral Project

Chapter One: Overview of the Study

The focus of Chapter One is an overview of the research study which includes:

1. Introduction

The introduction puts the study in perspective for the reader. The introduction also acquaints the reader with the topic and the methodology used to study the problem.

2. Problem Statement – The What

The statement describes the societal situation and the problem that the doctoral

candidate will address by conducting the project. The problem statement illustrates why the topic is appropriate, worthwhile, and feasible.

3. Background of the Study – The Why

Why is this topic being studied? Why is the problem of pressing societal

concern or theoretical interest? Information to be included is historical and

statistical.

4. Purpose of the Study

The candidate details what he or she wants to accomplish in the study through the Purpose of the Study section.

5. Significance of the Study – The Who

The significance of the study addresses who will benefit from the study and

how they will benefit. The doctoral candidate articulates specifically how the

study will contribute to the existing theoretical literature and/or qualitative

findings within psychology.

6. Theoretical Framework – The How

The candidate will identify how the study will be designed and conducted whether as a theoretical research study or a qualitative study.

7. Research Questions –

The candidate will identify the results that are expected to emerge from the study. The questions are posed in a short declarative sentence and are written prior to the beginning of the study.

8. Limitations of the study

The candidate must address the elements over which he or she has no control. For various reasons, limitations of the study could be determined by such factors as location and sample size.

9. Delimitations

The doctoral candidate needs to present factors that he or she can control during the study such as who or what are included or excluded within the boundaries of the study.

10. Definitions of Key Terms

All pertinent terms will need to be defined within the scope of the study.

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