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SuicideNCT07132099

Randomized Suicide Prevention Trial Using ASSIP and ACT in Suicide Attempters

A study testing Attempted Suicide Short Intervention Program (ASSIP), Acceptance and Commitment Therapy (ACT) and Treatment as Usual (TAU) in people with Suicide and Suicide Ideation, run by Ardakan University at 1 site in Iran.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a randomized controlled trial that aims to compare the effectiveness of two psychological treatment approaches: the Attempted Suicide Short Intervention Program (ASSIP) and Acceptance and Commitment Therapy (ACT). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Suicide, Suicide Ideation
What is being tested?
Attempted Suicide Short Intervention Program (ASSIP), Acceptance and Commitment Therapy (ACT) and Treatment as Usual (TAU)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteIran
Study dates
1 Aug 2025to Oct 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Being 18 years of age or older
  • 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

Who cannot join

  • Having a severe psychiatric or physical illness that interferes with the treatment process
  • 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

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Hadiseh Yaghoobi, MA Student contact

+98 9913338890

yaghoobih98@gmail.com

Azadeh Choobforoushzadeh, PhD contact

+98 9127025535

azadechoobforoush@ardakan.ac.ir

Iran1 site, 1 recruiting
  • The Imam Hossein District Health Center

    Eslamshahr, Tehran Province

    Marjan Fathi, Suicidology, Postdoctoral, +98 9123103905, marjan1215@gmail.com

    Hadiseh Yaghoobi, MSc General Psychology

    Recruiting

Other trials in Iran

About this study

Official title: RCT Comparing ASSIP and ACT on Mental Pain and Suicidal Ideation in Individuals With Suicide Attempts

This is a randomized controlled trial that aims to compare the effectiveness of two psychological treatment approaches: the Attempted Suicide Short Intervention Program (ASSIP) and Acceptance and Commitment Therapy (ACT). The study seeks to determine which of these two methods is more effective in reducing suicidal ideation and mental pain in individuals who have recently attempted suicide.

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.

Read the detailed description

Background and Rationale:

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.

Being tested
Attempted Suicide Short Intervention Program (ASSIP), Acceptance and Commitment Therapy (ACT), Treatment as Usual (TAU)
Keywords
Attempted Suicide Short Intervention Program, Acceptance and Commitment Therapy, Suicidal Ideation, Mental Pain, Suicide attempt, ASSIP, ACT
Medical subject headings
Suicide, Suicidal Ideation, Suicide, Attempted

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Attempted Suicide Short Intervention Program (ASSIP)Behavioural

    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)Behavioural

    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)Other

    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.

Study groups in NCT07132099
Study groupRoleWhat they receive
ASSIP + TAUExperimentalParticipants in this group receive the Attempted Suicide Short Intervention Program (ASSIP) in addition to treatment as usual (TAU).
Receives: Behavioral: Attempted Suicide Short Intervention Program (ASSIP); Other: Treatment as Usual (TAU)
ACT + TAUExperimentalParticipants in this group receive Acceptance and Commitment Therapy (ACT) alongside treatment as usual (TAU).
Receives: Behavioral: Acceptance and Commitment Therapy (ACT); Other: Treatment as Usual (TAU)
Control Group (TAU only)OtherThis control group receives only treatment as usual (TAU).
Receives: Other: Treatment as Usual (TAU)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mental Pain

    This measure assesses the intensity of mental pain using the 44-item Orbach \& Mikulincer Mental Pain Scale (OMMP). The scale has nine subscales to measure various aspects of mental pain, including inevitability, lack of control, narcissism/worthlessness, emotional turmoil, numbness, alienation, confusion, social withdrawal, and emptiness (meaninglessness).

    Measured: pre-intervention, immediately following the intervention, and at 1-month follow-up

  2. Suicidal Ideation

    This measure assesses suicidal thoughts, attitudes, and behaviors using the 19-item self-report Beck Scale for Suicide Ideation (BSSI). Each item is rated on a Likert scale from 0 to 2, with a total score ranging from 0 to 38. A score of 0-5 indicates no suicidal ideation, 6-19 suggests the presence of suicidal thoughts, and 20-38 signifies a high level of suicide ideation and planning.

    Measured: pre-intervention, immediately following the intervention, and at 1-month follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Aug 2025
  2. Study start1 Aug 2025
  3. Primary completion21 Sep 2025 (estimated)
  4. Study completionOct 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This study is a randomized controlled trial with three parallel groups. Participants will be randomly assigned to one of these three groups. The first group will receive ASSIP alongside treatment as usual (TAU) , the second group will receive ACT alongside TAU , and the third group (the control group) will receive only TAU. All groups will receive their interventions simultaneously and in parallel for the duration of the study.
Masking
Single blind
Who is masked
Participant
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07132099
Sponsor's protocol ID
IR.ARDAKAN.REC.1404.002
Status last verified
Aug 2025
First submitted
11 Aug 2025
Last updated
20 Aug 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The individual participant data (IPD) will not be shared due to the highly sensitive and confidential nature of the data collected from suicide attempters. The protocol for this study will be published in a scientific journal upon peer review approval. Furthermore, after data collection and analysis are complete, the results will be published in a scientific journal following peer review approval.

Publications

  • 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.

    PubMed 27654151
  • 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.

    PubMed 10636323
  • 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.

    PubMed 38229110
  • 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.

    PubMed 34562752
  • 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)

  • Rizvi A, Harmer B, Saadabadi A. Suicidal Ideation. 2024 Apr 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK565877/

    PubMed 33351435
  • 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.

    PubMed 26930055
  • 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.

    PubMed 37898519
  • 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.

    PubMed 28564699
  • 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.

    PubMed 38258293
  • 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.

    PubMed 35902215

Questions about this trial

What is this clinical trial studying?

A study testing Attempted Suicide Short Intervention Program (ASSIP), Acceptance and Commitment Therapy (ACT) and Treatment as Usual (TAU) in people with Suicide and Suicide Ideation, run by Ardakan University at 1 site in Iran.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 20 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Iran. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hadiseh Yaghoobi, MA Student (+98 9913338890, yaghoobih98@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mental Pain (time frame: pre-intervention, immediately following the intervention, and at 1-month follow-up). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07132099, which also lists 21 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Aug 2025.

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