The Impact of Family Factors on Adolescent Intensive Outpatient Psychotherapy Outcomes for Suicidal Thoughts, Behaviors, and Depression

AI Summary

Greater baseline family cohesion predicts larger reductions in suicidal thoughts and behaviours during intensive outpatient treatment (β = -0.11).
Family cohesion and conflict effects on treatment were moderated by age, ethnic minority status, and baseline symptom severity.
Overall STBs and depression improved with IOP; further research should analyse how family factors co-vary with symptom change during treatment.

Suicide Life Threat Behav. 2026 Jun;56(3):e70104. doi: 10.1111/sltb.70104.

ABSTRACT

BACKGROUND: Although 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.

METHODS: Participants (n = 637) either reported their satisfaction with family cohesion or family conflict levels at baseline and provided weekly self-reports of depression and STBs throughout IOP treatment. We calculated multi-level regression models to test for the interaction effects of treatment-day × family-factor-levels and explored further demographic and clinical moderators.

RESULTS: Higher levels of family cohesion correlated with more reduction of STBs over time (β = -0.11). Moreover, the effects of family cohesion and family conflict on treatment were moderated by patient age, ethnic minority status, and symptom severity.

DISCUSSION: STBs and depression improved with IOP, with family cohesion partially moderating treatment response. Differences due to family factors were more prominent in older and ethnically minoritized adolescents, and those with more severe symptoms. Future studies should elucidate how family factors co-vary with changes in STBs during treatment to better understand these effects.

PMID:42084212 | DOI:10.1111/sltb.70104

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