The Menninger Clinic recently announced the publication of a controlled comparison trial finding that Collaborative Assessment and Management of Suicidality (CAMS) helps to accelerate the benefits of treatment for suicidal psychiatric patients during hospitalization and post discharge.
CAMS is a suicide-specific intervention that provides a framework for therapists to work with patients to develop a shared understanding of the suicidal process while creating a plan for stabilization during and after treatment. Addressing psychological vulnerabilities to suicidality such as hopelessness and self-hatred, CAMS has primarily been an outpatient intervention.
The study, the first to evaluate CAMS in an inpatient psychiatric setting with a large sample size, was published in the March issue of Psychiatry Research
by principal investigator Thomas E. Ellis
, PsyD, ABPP, pictured, a senior staff psychologist at Menninger, together with colleagues Katrina Rufino
, PhD, and Jon G. Allen
, PhD, a former director of Psychology at Menninger.
Ellis and team conducted the study at Menninger, where patients participate in at least two individual psychotherapy sessions per week, group therapy, family interventions, medication management and nursing care as well as participation in a therapeutic community.
Study Details and Results
The study included 104 patients, half of whom received the CAMS intervention, the other half of whom received usual intensive treatment. The difference between the CAMS group and the Treatment as Usual (TAU) group was that individual therapists in the CAMS group made use of the CAMS treatment framework. Patients in the CAMS group received at least six of their individual therapy sessions from Menninger clinical social workers or doctoral-level psychologists who were trained by CAMS creator David Jobes, PhD. On average, patients in the study were at Menninger for 59.5 days.
Using the evidence-based Beck Scale for Suicide Ideation (BSS) and the Columbia-Suicide Severity Rating Scale (C-SSRS) as assessment indicators, the study results show that patients in both groups improved while in treatment at Menninger, but that patients in the CAMS group showed more improvement at discharge than patients in the TAU group.
Not only did the CAMS group improve on suicide-specific measures, the participants’ levels of depression, well-being and psychological adaptability also improved more than the TAU group at discharge. On the BSS, patients in the CAMS group averaged 13.75 at admissions and 4.82 at discharge. In contrast, the TAU group averaged 15.06 on the BSS at admissions and 9.35 at discharge. Similarly, patients in the CAMS group averaged 15.92 on the C-SSRS at admissions and 5.35 at discharge while the TAU group averaged 16.46 at admissions and 9.08 at discharge.
When reassessed at two, 12 and 24 weeks following discharge, patients in the TAU group eventually achieved gains comparable to those of patients in the CAMS group at discharge. Patients in both groups maintained these gains at least six months after discharge.
“One way of viewing these results is to think of CAMS as an accelerant that speeds up symptom reduction relative to usual care,” said Ellis. “This study is a significant advancement in the sense that we now have clinical evidence supporting CAMS as an effective inpatient intervention for patients who present with suicide ideation.”
Further detailing the significance of this study, Ellis adds that the study suggests the importance of addressing suicidality as a primary problem and focus for treatment regardless of a patient’s co-morbid diagnoses. He notes that Menninger’s patient population was ideal for the study because more than 80 percent of the hospital’s patients are diagnosed with three or more psychiatric disorders.
“We’ve moved from addressing suicidality as a symptom of illness to viewing suicidal ideation and behavior as a primary target of a suicide-specific intervention,” said Jobes, who is a professor of psychology and associate director of clinical training at The Catholic University of America. “Menninger is at the forefront of this work, and I applaud Dr. Ellis and his team for embarking on this research program, examining how CAMS treatment impacts patients during hospitalization and post-discharge.”
This particular study follows a series of other suicide-related studies the researchers have conducted at Menninger with funding support from the Bernice Peltier Huber Charitable Trust and The Menninger Clinic Foundation.