Dynamic Deconstructive Psychotherapy Versus Brief Intervention and Contact for Suicidal Adolescents and Young Adults

The purpose of this clinical trial is to assess whether 6 months of treatment with Dynamic Deconstructive Psychotherapy (DDP) is more effective for reducing thoughts of suicide in suicidal adolescents and young adults than usual care in the community supplemented with Brief Intervention and Contact (BIC). DDP and BIC are two evidence-based practices shown to be more effective than usual care at reducing suicidality. Participants will be randomly assigned to receive DDP treatment with safety planning and optional medication management or BIC treatment with safety planning and optional medication management. Participants in both groups will receive the assigned treatment at SUNY Upstate Medical University's Psychiatry High Risk Program (PHRP). Each participant is anticipated to take part in this trial for up to one year.

Inclusion Criteria: * CSSRS suicide ideation of ≥ 2 and PHQ-9 item 9 of ≥ 1 * Ages 14 through 40 years old of both genders * Fluency in English * Willingness to enter outpatient treatment as evidenced by psychiatric consultation at the PHRP and attending a first session with their intake therapist * Willingness to be video-recorded * Completion of baseline outcomes measures Exclusion Criteria: * Previous or current clinical diagnosis of schizophrenia, schizoaffective disorder or autism spectrum disorder as ascertained by self-report on the PHRP intake packet, or on their electronic medical records, or by psychiatric evaluation at the PHRP * BMI \< 18 for adults ≥ 18 years old, and BMI \< 17 for adolescents * Concurrent use of weekly ECT, ketamine, or esketamine * IQ \< 80 on the Peabody Picture Vocabulary Test * Current or previous treatment with Dynamic Deconstructive Psychotherapy