Effectiveness of Attachment-Based Family Therapy for Suicidal Adolescents and Young Adults: A Systematic Review and Meta-Analysis

Effectiveness of Attachment-Based Family Therapy for Suicidal Adolescents and Young Adults: A Systematic Review and Meta-Analysis

Forfattere
Schulte-Frankenfeld, P. M. Breedvelt, J. J. F. Brouwer, M. E. van der Spek, N. Bosmans, G. Bockting, C. L.
Årstall
2024
Tidsskrift
Clinical Psychology in Europe
Volum
6
Sider
23
Background: Suicide is a leading cause of death among adolescents and young adults. While only few evidence-based treatments with limited efficacy are available, family processes have recently been posed as a possible alternative target for intervention. Here, we review the evidence for Attachment-Based Family Therapy (ABFT), a guideline-listed treatment targeting intrafamilial ruptures and building protective caregiver-child relationships. Method: PubMed, PsycINFO, Embase, and Scopus were searched for prospective trials on ABFT in youth published up until November 6(th), 2023, and including measures of suicidality. Results were independently screened by two researchers following PRISMA guidelines. Risk of bias was assessed using the Cochrane RoB-2 framework. A random effects meta-analysis was conducted on suicidal ideation and depressive symptoms post-intervention scores in randomized-controlled trials (RCTs). Results: Seven articles reporting on four RCTs (n = 287) and three open trials (n = 45) were identified. Mean age of participants was M-pooled = 15.2 years and the majority identified as female (similar to 80%). Overall, ABFT was not significantly more effective in reducing youth suicidal ideation, g(pooled) = 0.40, 95% CI [-0.12, 0.93], nor depressive symptoms, g(pooled) = 0.33, 95% CI [-0.18, 0.84], compared to investigated controls (Waitlist, (Enhanced) Treatment as Usual, Family-Enhanced Nondirective Supportive Therapy). Conclusion: Evidence is strongly limited, with few available trials, small sample sizes, high sample heterogeneity, attrition rates, and risk of bias. While not generally superior to other treatments, ABFT might still be a clinically valid option in specific cases and should be further investigated. Clinicians are currently recommended to apply caution when considering ABFT as stand-alone intervention for suicidal youth and to decide on a case-by-case basis.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Selvskading/selvmord

Tiltak

Psykologiske behandlingsmetoder

Familieterapi

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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