The impact of family factors on adolescent intensive outpatient psychotherapy outcomes for suicidal thoughts, behaviors, and depression

BackgroundAlthough they constitute well-established risk factors for suicidal thoughts and behaviors (STBs), few studies have investigated how family factors such as family cohesion and family conflict influence the trajectory of treatment response among depressed and suicidal adolescents. In this study, we examined the association between baseline family factors and response to an intensive outpatient program (IOP) for STBs in adolescents. MethodsParticipants (n=637) completed self-report questionnaires of family cohesion and family conflict at baseline and weekly self-reports of depression and STBs throughout IOP-treatment. We calculated multi-level regression models to tests for interaction effects of days of treatment x family factor levels, and explored further potential demographic and clinical moderators.ResultsHigher levels of family cohesion correlated with more reduction of STBs over time (β=-0.11). Moreover, the effects of family factors on treatment were moderated by patient age, ethnic minority status, and symptom severity.DiscussionSTBs and depression improved with IOP, with family factors partially moderating treatment response. These effects seem to be particularly prominent in older and ethnically minoritized adolescents, and those with more severe suicidal ideation. Future studies should elucidate how family factors influence and potentially co-vary with changes in STBs during treatment to better understand these effects.