Suicide AttemptBCBTNCT07567885
Brief Cognitive Behaviour Therapy to Prevent Suicide Reattempts: A Feasibility Study in Swedish Psychiatric Inpatient Care
A study testing Brief Cognitive Behaviour Therapy in people with Suicide Attempt, run by Karolinska Institutet at 1 site in Sweden.
Trial summary
The goal of this study is to determine whether Brief Cognitive Behaviour Therapy (BCBT), a four-session psychological treatment aimed at reducing suicide attempts, is acceptable and feasible to deliver during psychiatric inpatient care for adults who have been hospitalised following a suicide attempt or who are at… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Suicide Attempt
- What is being tested?
- Brief Cognitive Behaviour Therapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 32 participants
- Where
- 1 siteSweden
- Study dates
- 11 May 2026to 14 Dec 2027
- 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
- admitted following a suicide attempt within one week of admission or presenting with suicidal ideation with a plan and a prior suicide attempt within the last two years
- 18 years or older
Who cannot join
- current mania, current acute psychosis, or cognitive impairment
- expected inpatient stay shorter than four working days
- ongoing or planned electroconvulsive therapy
- psychiatric or somatic conditions leading to inability to provide informed consent
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Sweden1 site, 1 recruiting
- Recruiting
Psykiatri Sydväst
Stockholm
Christian Rück, +46704843392, christian.ruck@ki.se
About this study
The goal of this study is to determine whether Brief Cognitive Behaviour Therapy (BCBT), a four-session psychological treatment aimed at reducing suicide attempts, is acceptable and feasible to deliver during psychiatric inpatient care for adults who have been hospitalised following a suicide attempt or who are at high risk of suicide. The main questions it aims to answer are:
- Is BCBT acceptable among suicidal psychiatric inpatients, and in what ways can the treatment and its delivery be improved to enhance patient engagement and adherence?
- Is BCBT feasible from the perspectives of treating clinicians, clinic managers, and other relevant personnel, and what are the key facilitators and barriers to its implementation within routine inpatient psychiatric care in Sweden?
Read more
Participants will:
- Receive four structured BCBT therapy sessions delivered during hospitalisation, in addition to usual care
- Be contacted for follow-up assessments at 1 and 3 months after completing treatment
- Take part in an interview about the participants' experience with the treatment 1 month after completing it
Clinical staff, treating psychologists, and managers will also be interviewed to explore the participants' experiences, as well as barriers and facilitators to implementation. Overall, the findings from this study will inform the design of a future randomised trial to test the effectiveness of BCBT in reducing suicide attempts after discharge from inpatient psychiatric care.
Read the detailed description
Suicide attempts and self-harm represent major public health concerns, with approximately 11,000 individuals in Sweden requiring emergency or inpatient care each year following suicidal behaviour. The period immediately following discharge from psychiatric inpatient care is associated with an extremely elevated risk of suicide, with studies indicating up to a 200-fold increase compared to the general population. Despite this high-risk period, there is currently a lack of structured, evidence-based psychological interventions specifically designed for inpatient psychiatric settings, where care primarily focuses on pharmacological treatment and acute stabilisation.
Brief Cognitive Behaviour Therapy (BCBT) is a structured, four-session psychological intervention based on cognitive behavioural principles and specifically adapted to target suicidal behaviour. BCBT is grounded in the Fluid Vulnerability Theory of suicide, which conceptualises suicide risk as a dynamic process influenced by both enduring vulnerabilities and acute stressors. The intervention aims to reduce suicide risk by targeting modifiable cognitive, emotional, and behavioural processes, enhancing coping skills, and preventing the activation or escalation of suicidal crises.
This study is a single-arm feasibility study designed to evaluate the acceptability and feasibility of BCBT among adult psychiatric inpatients in Sweden. A total of 20 participants aged 18 years or older will be recruited from inpatient psychiatric units at Psykiatri Sydväst and Psykosvård Stockholm.
Participants will receive four individual BCBT sessions delivered by trained clinical psychologists during the participants' inpatient stay. Each session lasts approximately 60-90 minutes and focuses on specific therapeutic components. The first session includes psychoeducation, a narrative of the suicide attempt, and development of an individualised case conceptualisation and safety plan. The second session focuses on cognitive flexibility and identifying reasons for living, including the creation of a "hope box". The third session addresses restriction of access to lethal means and development of coping strategies, including coping cards. The fourth session focuses on consolidation of skills and relapse prevention, including guided imagery exercises to prepare for future crises. If discharge occurs before completion, sessions may be continued after discharge. All participants will continue to receive treatment as usual in accordance with standard inpatient care.
In addition, semi-structured qualitative interviews will be conducted with patients, focusing on the acceptability, perceived effects, and satisfaction with the treatment. The investigators will also conduct semi-structured qualitative interviews with treating psychologists, clinical staff, and managers (approximately 8-12 participants). These interviews aim to explore feasibility, and barriers and facilitators to implementation of BCBT in routine inpatient psychiatric care.
- Conditions
- Suicide Attempt
- Being tested
- Brief Cognitive Behaviour Therapy
- Medical subject headings
- Suicide, Attempted
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Brief Cognitive Behaviour TherapyBehavioural
Brief Cognitive Behaviour Therapy to prevent suicide reattempts
| Study group | Role | What they receive |
|---|---|---|
| BCBT | Experimental | Participants will receive four individual BCBT sessions delivered by trained clinical psychologists during their inpatient stay. Each session lasts approximately 60-90 minutes and focuses on specific therapeutic components. The first session includes psychoeducation, a narrative of the suicide attempt, and development of an individualised case conceptualisation and safety plan. The second session focuses on cognitive flexibility and identifying reasons for living, including the creation of a "hope box". The third session addresses restriction of access to lethal means and development of coping strategies, including coping cards. The fourth session focuses on consolidation of skills and relapse prevention, including guided imagery exercises to prepare for future crises. If discharge occurs before completion, sessions may be continued after discharge. Receives: Behavioral: Brief Cognitive Behaviour Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Treatment completion
Proportion of participants completing 3 or more BCBT sessions
Measured: Posttreatment assessment performed within two working days after the final treatment session.
Treatment satisfaction
Patient-reported treatment satisfaction assessed using the Client Satisfaction Questionnaire (CSQ-8). The CSQ-8 is an 8-item scale, with each item rated on a four-point Likert scale (1-4), giving a total score ranging from 8 to 32, with higher scores indicating greater treatment satisfaction.
Measured: Posttreatment assessment performed within two working days after the final treatment session.
Retention
Proportion of participants completing follow-up assessments at 1 and 3 months
Measured: 1- and 3-month follow-up after the final treatment session
Secondary outcomes (9)
Decline rate
Proportion of potentially eligible participants who are approached but decline study participation
Measured: From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Recruitment pace
Average monthly recruitment rate
Measured: From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Likelihood of treatment component use
Patient-reported likelihood of using each treatment component (safety plan, reasons for living list, hope box, restriction of lethal means, coping cards), rated from 0-10 for each treatment component, with higher scores indicating a higher likelihood of using the component.
Measured: During the 4-session treatment period (planned for 4 consecutive days), assessed at each session
Use and perceived helpfulness of treatment components
Patient-reported extent of use and perceived helpfulness of treatment components (safety plan, reasons for living list, hope box, restriction of lethal means, coping cards) rated with 6 items on a 0-10 scale, with higher scores indicating a higher extent of use and perceived helpfulness of the component.
Measured: 1- and 3-month follow-up after the final treatment session
Adverse events and negative effects of treatment
Negative effects of treatment are assessed at each treatment session, as well as at posttreatment and follow-up
Measured: During the 4-session treatment period (planned for 4 consecutive days), assessed at each session; posttreatment assessment (performed within 2 working days after the final treatment session); and 1- and 3-month follow-up after the final treatment session
Semi-structured interviews with personnel
Semi-structured interviews with treating psychologists, clinical personnel at the wards and managers focusing on perceived feasibility, barriers and facilitators to implementation
Measured: Interviews will be conducted within 1 month after recruitment of the final patient (n=20) is completed (anticipated recruitment duration: approximately 6 months)
Semi-structured interviews with patients
Semi-structured interviews with patients to explore perceived effects, acceptability and satisfaction with the treatment
Measured: Interviews will be conducted on the same day, directly following the 1-month follow-up assessment (i.e., one month after the final treatment session).
Suicidal ideation
Suicidal ideation will be measured using the Columbia-Suicide Severity Rating Scale (C-SSRS) intensity subscale covering 5 items rated from 0/1 to 5, and summed for a total score of 2-25, with higher scores representing a higher intensity of suicidal ideation.
Measured: Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.
Suicide attempts
The total number of suicide attempts between discharge and the 3-month follow-up. A suicide attempt is defined here using the Columbia-Suicide Severity Rating Scale (C-SSRS) definition of "Actual attempt" or "Interrupted attempt".
Measured: Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 May 2026
- Study start11 May 2026
- Primary completion14 Dec 2026 (estimated)
- Study completion14 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Suicide AttemptStudies of the same condition, open and under way.
- More trials run by Karolinska InstitutetThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 32 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Karolinska Institutet
- Sponsor type
- University, hospital or other
- Collaborators
- Region Stockholm
- Responsible party
- Principal investigator, Christian Rück, Karolinska Institutet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07567885
- Sponsor's protocol ID
- 2025-08835-01.
- Other IDs
- 2025-00188, 2025
- Acronym
- BCBT
- Status last verified
- Apr 2026
- First submitted
- 20 Apr 2026
- Last updated
- 17 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 17 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Brief Cognitive Behaviour Therapy to Prevent Suicide Reattempts: A Feasibility Study in Swedish Psychiatric Inpatient Care
- ClinicalTrials.gov ID
- NCT07567885
- Acronym / sponsor ID
- BCBT / 2025-08835-01.
- Conditions
- Suicide Attempt
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 32 participants (estimated)
- Lead sponsor
- Karolinska InstitutetUniversity, hospital or other
- Collaborators
- Region Stockholm
- Study start
- 11 May 2026 (actual)
- Primary completion
- 14 Dec 2026 (estimated)
- Study completion
- 14 Dec 2027 (estimated)
- First posted
- 5 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this study is to determine whether Brief Cognitive Behaviour Therapy (BCBT), a four-session psychological treatment aimed at reducing suicide attempts, is acceptable and feasible to deliver during psychiatric inpatient care for adults who have been hospitalised following a suicide attempt or who are at high risk of suicide. The main questions it aims to answer are:
- Is BCBT acceptable among suicidal psychiatric inpatients, and in what ways can the treatment and its delivery be improved to enhance patient engagement and adherence?
- Is BCBT feasible from the perspectives of treating clinicians, clinic managers, and other relevant personnel, and what are the key facilitators and barriers to its implementation within routine inpatient psychiatric care in Sweden?
Participants will:
- Receive four structured BCBT therapy sessions delivered during hospitalisation, in addition to usual care
- Be contacted for follow-up assessments at 1 and 3 months after completing treatment
- Take part in an interview about the participants' experience with the treatment 1 month after completing it
Clinical staff, treating psychologists, and managers will also be interviewed to explore the participants' experiences, as well as barriers and facilitators to implementation. Overall, the findings from this study will inform the design of a future randomised trial to test the effectiveness of BCBT in reducing suicide attempts after discharge from inpatient psychiatric care.
Detailed description
Suicide attempts and self-harm represent major public health concerns, with approximately 11,000 individuals in Sweden requiring emergency or inpatient care each year following suicidal behaviour. The period immediately following discharge from psychiatric inpatient care is associated with an extremely elevated risk of suicide, with studies indicating up to a 200-fold increase compared to the general population. Despite this high-risk period, there is currently a lack of structured, evidence-based psychological interventions specifically designed for inpatient psychiatric settings, where care primarily focuses on pharmacological treatment and acute stabilisation.
Brief Cognitive Behaviour Therapy (BCBT) is a structured, four-session psychological intervention based on cognitive behavioural principles and specifically adapted to target suicidal behaviour. BCBT is grounded in the Fluid Vulnerability Theory of suicide, which conceptualises suicide risk as a dynamic process influenced by both enduring vulnerabilities and acute stressors. The intervention aims to reduce suicide risk by targeting modifiable cognitive, emotional, and behavioural processes, enhancing coping skills, and preventing the activation or escalation of suicidal crises.
This study is a single-arm feasibility study designed to evaluate the acceptability and feasibility of BCBT among adult psychiatric inpatients in Sweden. A total of 20 participants aged 18 years or older will be recruited from inpatient psychiatric units at Psykiatri Sydväst and Psykosvård Stockholm.
Participants will receive four individual BCBT sessions delivered by trained clinical psychologists during the participants' inpatient stay. Each session lasts approximately 60-90 minutes and focuses on specific therapeutic components. The first session includes psychoeducation, a narrative of the suicide attempt, and development of an individualised case conceptualisation and safety plan. The second session focuses on cognitive flexibility and identifying reasons for living, including the creation of a "hope box". The third session addresses restriction of access to lethal means and development of coping strategies, including coping cards. The fourth session focuses on consolidation of skills and relapse prevention, including guided imagery exercises to prepare for future crises. If discharge occurs before completion, sessions may be continued after discharge. All participants will continue to receive treatment as usual in accordance with standard inpatient care.
In addition, semi-structured qualitative interviews will be conducted with patients, focusing on the acceptability, perceived effects, and satisfaction with the treatment. The investigators will also conduct semi-structured qualitative interviews with treating psychologists, clinical staff, and managers (approximately 8-12 participants). These interviews aim to explore feasibility, and barriers and facilitators to implementation of BCBT in routine inpatient psychiatric care.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| BCBT | Experimental | Behavioral: Brief Cognitive Behaviour TherapyParticipants will receive four individual BCBT sessions delivered by trained clinical psychologists during their inpatient stay. Each session lasts approximately 60-90 minutes and focuses on specific therapeutic components. The first session includes psychoeducation, a narrative of the suicide attempt, and development of an individualised case conceptualisation and safety plan. The second session focuses on cognitive flexibility and identifying reasons for living, including the creation of a "hope box". The third session addresses restriction of access to lethal means and development of coping strategies, including coping cards. The fourth session focuses on consolidation of skills and relapse prevention, including guided imagery exercises to prepare for future crises. If discharge occurs before completion, sessions may be continued after discharge. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- admitted following a suicide attempt within one week of admission or presenting with suicidal ideation with a plan and a prior suicide attempt within the last two years
- 18 years or older
Key exclusion criteria (4 listed)
- current mania, current acute psychosis, or cognitive impairment
- expected inpatient stay shorter than four working days
- ongoing or planned electroconvulsive therapy
- psychiatric or somatic conditions leading to inability to provide informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Brief Cognitive Behaviour TherapyBrief Cognitive Behaviour Therapy to prevent suicide reattempts | Behavioural | BCBT |
Primary outcome
Treatment completion
Time frame: Posttreatment assessment performed within two working days after the final treatment session.
Proportion of participants completing 3 or more BCBT sessions
Treatment satisfaction
Time frame: Posttreatment assessment performed within two working days after the final treatment session.
Patient-reported treatment satisfaction assessed using the Client Satisfaction Questionnaire (CSQ-8). The CSQ-8 is an 8-item scale, with each item rated on a four-point Likert scale (1-4), giving a total score ranging from 8 to 32, with higher scores indicating greater treatment satisfaction.
Retention
Time frame: 1- and 3-month follow-up after the final treatment session
Proportion of participants completing follow-up assessments at 1 and 3 months
9 secondary outcomes
Decline rate
Time frame: From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Recruitment pace
Time frame: From first potentially eligible participant approached until recruitment of 20 patients is completed (anticipated duration: 6 months)
Likelihood of treatment component use
Time frame: During the 4-session treatment period (planned for 4 consecutive days), assessed at each session
Use and perceived helpfulness of treatment components
Time frame: 1- and 3-month follow-up after the final treatment session
Adverse events and negative effects of treatment
Time frame: During the 4-session treatment period (planned for 4 consecutive days), assessed at each session; posttreatment assessment (performed within 2 working days after the final treatment session); and 1- and 3-month follow-up after the final treatment session
Semi-structured interviews with personnel
Time frame: Interviews will be conducted within 1 month after recruitment of the final patient (n=20) is completed (anticipated recruitment duration: approximately 6 months)
Semi-structured interviews with patients
Time frame: Interviews will be conducted on the same day, directly following the 1-month follow-up assessment (i.e., one month after the final treatment session).
Suicidal ideation
Time frame: Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.
Suicide attempts
Time frame: Assessed at screening (baseline), posttreatment (within 2 working days after the final treatment session), and at 1-month and 3-month follow-up after the final treatment session. Primary endpoint: 3-month follow-up after the final treatment session.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Aug 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Brief Cognitive Behaviour Therapy in people with Suicide Attempt, run by Karolinska Institutet at 1 site in Sweden.
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 2 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 17 Aug 2026. 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 Sweden. 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 Christian Rück, Professor (+46704843392, christian.ruck@ki.se), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Treatment completion (time frame: Posttreatment assessment performed within two working days after the final treatment session.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 17 Aug 2026.