Randomized Suicide Prevention Trial Using ASSIP and ACT in Suicide Attempters
NCT ID: NCT07132099
Last Updated: 2025-08-20
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
NA
60 participants
INTERVENTIONAL
2025-08-01
2025-10-31
Brief Summary
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In this study, 60 participants with a history of suicide attempts will be randomly assigned to three groups. One group will receive ASSIP in addition to treatment as usual (TAU), the second group will receive ACT alongside TAU, and the third group will be a control group receiving TAU only. The results will be assessed using the Beck Scale for Suicide Ideation (BSSI) and the Orbach \& Mikulincer Mental Pain Scale (OMMP) at three stages: pre-test, post-test, and follow-up.
The ultimate goal of this research is to provide valuable insights into the comparative effectiveness of ASSIP and ACT interventions for suicide attempters and to contribute to evidence-based suicide prevention strategies. The findings are expected to inform clinical practice and guide future research in this field.
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Detailed Description
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Suicide attempts are a major global public health concern and one of the leading causes of premature mortality, particularly among individuals aged 15 to 29 years. In Iran, as in many countries, suicide attempts represent a critical mental health issue requiring effective, evidence-based interventions. Two therapeutic approaches have demonstrated promising results in reducing suicidal ideation and preventing repeated attempts: the Attempted Suicide Short Intervention Program (ASSIP) and Acceptance and Commitment Therapy (ACT).
ASSIP is a brief, structured, narrative-based intervention developed to address the underlying personal crisis and cognitive-behavioral mechanisms that lead to suicidal behavior. It typically involves three to four sessions, followed by long-term follow-up contacts. ACT is a third-wave behavioral therapy aimed at increasing psychological flexibility and reducing experiential avoidance, often associated with suicidal crises.
Despite evidence supporting both methods internationally, little research has compared their effectiveness in the Iranian context.
Study Overview:
This randomized controlled trial will enroll 60 adults with a recent history of suicide attempt, identified through the Eslamshahr Health Network. Participants will be randomly assigned to one of three groups:
1. ASSIP plus treatment as usual (TAU)
2. ACT plus TAU
3. TAU only (control) Interventions will be delivered in an outpatient health center setting. The ASSIP group will receive three core sessions (with a possible fourth session) delivered according to the official ASSIP manual. The ACT group will receive four to five individual sessions following the "ACT for Life" protocol, specifically adapted for suicide prevention.
Assessment and Follow-up:
The primary outcomes are suicidal ideation and mental pain, assessed using validated Persian versions of the Beck Scale for Suicide Ideation (BSSI) and the Orbach \& Mikulincer Mental Pain Scale (OMMP). Assessments will occur at baseline (pre-test), immediately after treatment (post-test), and one month after intervention (follow-up). Data will be analyzed using SPSS v27, applying descriptive statistics, analysis of covariance, and post hoc comparisons.
Significance:
This study is expected to generate context-specific evidence on the comparative effectiveness of ASSIP and ACT in reducing suicidal ideation and mental (or psychological) pain in Iranian suicide attempters. The findings will help inform mental health services in Iran and contribute to global suicide prevention strategies by clarifying which short-term, evidence-based intervention is more effective and feasible in similar healthcare settings.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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ASSIP + TAU
Participants in this group receive the Attempted Suicide Short Intervention Program (ASSIP) in addition to treatment as usual (TAU).
Attempted Suicide Short Intervention Program (ASSIP)
This is a brief, structured, patient-centered therapy consisting of three to four face-to-face sessions. Each session typically lasts between 60 to 90 minutes. A fourth session may be added if clinically necessary.
Treatment as Usual (TAU)
Treatment as usual (TAU) is not a structured intervention within this study. It may include standard outpatient or inpatient services, pharmacotherapy, or no structured treatment, depending on individual circumstances.
ACT + TAU
Participants in this group receive Acceptance and Commitment Therapy (ACT) alongside treatment as usual (TAU).
Acceptance and Commitment Therapy (ACT)
This intervention uses the "ACT for Life" protocol, which is designed to maximize recovery after suicidal crises. It consists of three components delivered over three to six individual sessions. The average number of sessions is four to five, with each session lasting approximately 60 minutes.
Treatment as Usual (TAU)
Treatment as usual (TAU) is not a structured intervention within this study. It may include standard outpatient or inpatient services, pharmacotherapy, or no structured treatment, depending on individual circumstances.
Control Group (TAU only)
This control group receives only treatment as usual (TAU).
Treatment as Usual (TAU)
Treatment as usual (TAU) is not a structured intervention within this study. It may include standard outpatient or inpatient services, pharmacotherapy, or no structured treatment, depending on individual circumstances.
Interventions
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Attempted Suicide Short Intervention Program (ASSIP)
This is a brief, structured, patient-centered therapy consisting of three to four face-to-face sessions. Each session typically lasts between 60 to 90 minutes. A fourth session may be added if clinically necessary.
Acceptance and Commitment Therapy (ACT)
This intervention uses the "ACT for Life" protocol, which is designed to maximize recovery after suicidal crises. It consists of three components delivered over three to six individual sessions. The average number of sessions is four to five, with each session lasting approximately 60 minutes.
Treatment as Usual (TAU)
Treatment as usual (TAU) is not a structured intervention within this study. It may include standard outpatient or inpatient services, pharmacotherapy, or no structured treatment, depending on individual circumstances.
Eligibility Criteria
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Inclusion Criteria
* Having the ability to read and write
* Providing informed consent to participate in the study
* Having at least one suicide attempt in the past 4 months
Exclusion Criteria
* Receiving concurrent structured psychological interventions (other than TAU) that may interfere with the study's treatment process.
* Lack of informed consent to participate in the study
* Substance abuse based on DSM-5 criteria
18 Years
ALL
No
Sponsors
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Ardakan University
OTHER
Responsible Party
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Hadiseh Yaghoobi
Researcher, Master of General Psychology Student
Principal Investigators
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Azadeh Choobforoushzadeh, PhD
Role: STUDY_DIRECTOR
Ardakan University
Marjan Fathi, Postdoctoral
Role: STUDY_DIRECTOR
Iran University of Medical Sciences
Locations
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The Imam Hossein District Health Center
Eslamshahr, Tehran Province, Iran
Countries
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Central Contacts
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Facility Contacts
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References
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Olfson M, Wall M, Wang S, Crystal S, Liu SM, Gerhard T, Blanco C. Short-term Suicide Risk After Psychiatric Hospital Discharge. JAMA Psychiatry. 2016 Nov 1;73(11):1119-1126. doi: 10.1001/jamapsychiatry.2016.2035.
World Health Organization. (2025). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide
Shneidman ES. The psychological pain assessment scale. Suicide Life Threat Behav. 1999 Winter;29(4):287-94. No abstract available.
Shirani Isfahani, N., Mohammadpanah Ardakan, A., & Rezapoor Mirsaaleh, M. (2023). Lived emotional experiences of women who attempt suicide. Journal of Health System Research, 19(4), 325-335. (in Persian)
Pompili M. On mental pain and suicide risk in modern psychiatry. Ann Gen Psychiatry. 2024 Jan 16;23(1):6. doi: 10.1186/s12991-024-00490-5.
Mojahedi M, Esmaeili A, Mahdizadeh K, Nakhaei MH, Salehiniya H, Sahranavard S. Trends of suicide attempts and factors related to completed suicide during the years 2014-2019 in South Khorasan province, Iran. Asian J Psychiatr. 2021 Nov;65:102825. doi: 10.1016/j.ajp.2021.102825. Epub 2021 Sep 2.
Karami, J., Begian Kuleh Marz, M. J., Momeni, Kh., & Elahi, A. (2018). Measurement of psychological pain: Psychometric properties and confirmatory factor analysis of the One-Dimensional Multidimensional Pain Questionnaire (OMMP). Health Psychology, 7(25), 146-172. (in Persian)
Hosseini, A., Jamshidi, T., Sedghi, S., Jalali, M., & Shamsi, F. (2019). Effectiveness of a suicide prevention training program based on SOS in reducing suicidal ideation and depression in girls. Journal of Nursing and Midwifery, 17(3), 192-203. (in Persian)
Harmer B, Lee S, Rizvi A, Saadabadi A. Suicidal Ideation. 2024 Apr 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK565877/
Gysin-Maillart A, Schwab S, Soravia L, Megert M, Michel K. A Novel Brief Therapy for Patients Who Attempt Suicide: A 24-months Follow-Up Randomized Controlled Study of the Attempted Suicide Short Intervention Program (ASSIP). PLoS Med. 2016 Mar 1;13(3):e1001968. doi: 10.1371/journal.pmed.1001968. eCollection 2016 Mar.
Feyzollahi S, Narimany M, Mosazadeh T. (2021). Effectiveness of Acceptance and Commitment Therapy on Suicidal Thoughts, Self-concealment and Cognitive Emotion Regulation in Women with Suicidal Thoughts. Rooyesh. 10(2), 69-80. (in Persian)
Favril L, Yu R, Geddes JR, Fazel S. Individual-level risk factors for suicide mortality in the general population: an umbrella review. Lancet Public Health. 2023 Nov;8(11):e868-e877. doi: 10.1016/S2468-2667(23)00207-4.
Chung DT, Ryan CJ, Hadzi-Pavlovic D, Singh SP, Stanton C, Large MM. Suicide Rates After Discharge From Psychiatric Facilities: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2017 Jul 1;74(7):694-702. doi: 10.1001/jamapsychiatry.2017.1044.
Chun HS, Michel K, Lee KU. A Case of Suicide Attempt Treated With Attempted Suicide Short Intervention Program. Psychiatry Investig. 2024 Feb;21(2):216-217. doi: 10.30773/pi.2023.0279. Epub 2024 Jan 24. No abstract available.
Charvet C, Boutron I, Morvan Y, Le Berre C, Touboul S, Gaillard R, Fried E, Chevance A. How to measure mental pain: a systematic review assessing measures of mental pain. Evid Based Ment Health. 2022 Nov;25(4):e4. doi: 10.1136/ebmental-2021-300350. Epub 2022 Jul 28.
Cassell EJ. Diagnosing suffering: a perspective. Ann Intern Med. 1999 Oct 5;131(7):531-4. doi: 10.7326/0003-4819-131-7-199910050-00009.
Barnes, S. M., Smith, G. P., Monteith, L. L., Gerber, H. R., & Bahraini, N. H. (2017). ACT for Life: Using Acceptance and Commitment Therapy to Understand and Prevent Suicide. In U. Kumar (Ed.), Handbook of Suicidal Behaviour, 485-504.
Barnes, S. M., Borges, L. M., Smith, G. P., Walser, R. D., Forster, J. E., & Bahraini, N. H. (2021). Acceptance and commitment therapy to promote recovery from suicidal crises: A randomized controlled acceptability and feasibility trial of ACT for life. Journal of Contextual Behavioral Science, 20, 35-45.
Alamdarian, H., Ibrahimi, M., Hadad, A., & Ghasemi, A. (2023). Predicting suicidal tendencies based on self-compassion and psychological flexibility in married women with multiple sclerosis. Journal of Sabzevar University of Medical Sciences, 30(3), 311-301. (in Persian)
ASSIP. (n.d.). Attempted Suicide Short Intervention Program. http://www.assip.ch/
Related Links
Access external resources that provide additional context or updates about the study.
Official website of the Attempted Suicide Short Intervention Program (ASSIP). This website provides general information and background on the ASSIP protocol used in this study.
Official website of the World Health Organization (WHO) with information and facts about suicide. This resource provides background statistics and data on suicide, which are referenced in the study's protocol.
Other Identifiers
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IR.ARDAKAN.REC.1404.002
Identifier Type: -
Identifier Source: org_study_id
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