SuicideTHRIVENCT07784634
THRIVE: A Recovery-Focused Suicide Prevention Intervention in Crisis Stabilization Centers
A study testing Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE) and Center Care as Usual in people with Suicide, run by University of Alabama at Birmingham at 3 sites in United States.
Trial summary
Suicide is a major public health concern in the United States, with more than 1.4 million adults attempting suicide and nearly 50,000 adults dying by suicide each year. The launch of the national 3-digit 988 Suicide \& Crisis Lifeline in 2022 has strengthened the crisis care system by emphasizing the need for people… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Suicide
- What is being tested?
- Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE) and Center Care as Usual
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 552 participants
- Where
- 3 sitesUnited States
- Study dates
- 15 Dec 2026to Oct 2031
- Phase
- Interventional
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
- Admission to CSC with suicidal crisis, as defined by active suicide ideation ascertained by the Columbia Suicide-Severity Rating scale (C-SSRS), which the sites already routinely administer
- Ability and willingness to provide information and permission to contact at least one person in case of emergency or inability to reach the participant for follow-up.
Who cannot join
- Under age 18.
- Inability to communicate with the researcher in English.
- Acute psychiatric instability (e.g., psychotic symptoms) prohibiting participation in psychotherapy.
Trial locations and contacts
3 sites in 1 country. Contact the study team or a site near you to ask about taking part.
United States3 sites
Wellstone
Huntsville, Alabama, 35802
Paula Steele, M.S., (256) 533-1970, paula.steele@wellstone.com
Paula Steele, M.S.
Mental Health Cooperative
Nashville, Tennessee, 35756
Lindsay Hamilton, M.S., 855-274-7471, lindsay.hamilton@mhc-tn.org
Lindsay Hamilton, M.S.
Connections Health Solutions
Phoenix, Arizona, 85007
Margie Balfour, MD, (602) 416-7600, Margie.Balfour@connectionshs.com
Margie Balfour, MD
About this study
Official title: THRIVE: Hybrid Randomized Effectiveness-Implementation Trial of a Recovery-Focused Suicide Prevention Intervention for Crisis Stabilization Centers
Suicide is a major public health concern in the United States, with more than 1.4 million adults attempting suicide and nearly 50,000 adults dying by suicide each year. The launch of the national 3-digit 988 Suicide \& Crisis Lifeline in 2022 has strengthened the crisis care system by emphasizing the need for people in crisis to have someone to call, someone to respond, and somewhere to go. Community-based Crisis Stabilization Centers (CSCs) are an important part of the crisis care system, providing short-term crisis stabilization services and an alternative to Emergency Department care. However, suicide risk can remain high after discharge from CSCs, and no brief, effective, recovery-focused interventions are currently available for this setting.
This study will evaluate the effectiveness of THRIVE (Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement) in CSCs. THRIVE is a recovery-focused intervention designed for adults receiving care for suicide risk . THRIVE includes one 60-minute psychotherapy group (focused on belonging, giving, meaningful living, and recovery) delivered during the CSC stay and up to six peer-led recovery coaching calls during the weeks following discharge.
This multi-site Hybrid Type 1 randomized effectiveness-implementation trial will enroll 552 participants and compare care as usual (CAU) in CSCs to CAU plus THRIVE (CAU + THRIVE). The primary purpose of this study is to determine whether THRIVE reduces suicide risk events (SREs) following CSC discharge, including crisis care re-admissions, escalation to higher levels of care, suicide attempts, and suicide deaths. The study will also examine barriers and facilitators that may influence the adoption and implementation of THRIVE in community-based crisis settings.
Read the detailed description
The study is designed to determine whether Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE), a brief, recovery-focused group psychotherapy intervention initiated during a Crisis Stabilization Center (CSC) stay and continued by peer-support specialists during the six-week transition back to the community can reduce post-discharge suicide risk events (SREs) while improving treatment engagement and recovery. Findings will also provide information about the ways THRIVE may work and the factors that may support or hinder its implementation in community-based crisis care settings.
Effectiveness. The primary aim of this study is to determine whether THRIVE reduces SREs during the 12 months following CSC discharge. A total of 552 CSC participants will be randomized to receive either Care as Usual (CAU) or CAU plus THRIVE. CAU includes routine CSC services, including medication management, safety planning, referral to outpatient treatment, and a post-discharge follow-up contact. Participants assigned to CAU plus THRIVE will receive these services in addition to the THRIVE psychotherapy group and six post-discharge peer recovery coaching calls. Participants will complete assessments at baseline and discharge, weekly during the first 6 weeks after discharge, and at 3, 6, and 12 months. The primary outcome is SREs post discharge, the total aggregated occurrences of crisis care events including re-admissions, escalation to higher levels of care, suicide attempts, and suicide deaths.
Mechanisms. A secondary aim is to examine the psychological and behavioral processes through which THRIVE may reduce SREs post-discharge. Consistent with the Interpersonal Theory of Suicide, the study will examine whether THRIVE improves perceived burdensomeness and thwarted belongingness, and whether it increases treatment initiation and engagement following CSC discharge. Our study will evaluate whether changes in these factors help explain the relationship between THRIVE participation and subsequent suicide risk events.
Implementation. The study will also evaluate barriers and facilitators to implementing THRIVE in routine CSC practice. A mixed-methods implementation evaluation guided by the Consolidated Framework for Implementation Research (CFIR) will examine factors associated with intervention adoption and delivery across the three participating CSCs.
- Conditions
- Suicide
- Being tested
- Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE), Center Care as Usual
- Keywords
- THRIVE, Suicide Prevention, Suicide Recovery, Peer Support, Suicide, Suicide Attempts, Treatment Engagement, Treatment Initiatoin, Suicide Risk Events, Meaningful Living, Perceived Burdensomeness, Thwarted Belonging
- Medical subject headings
- Suicide, Suicide Prevention, Suicide, Attempted
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE)Behavioural
Toward Hope, Recovery, Interpersonal Growth, Values and Engagement (THRIVE), is a brief, suicide-specific, narrative, recovery-focused, 60 minute group psychotherapy intervention followed by up to 6 peer-led recovery coaching phone calls. THRIVE includes five components: 1) Creating a Safe Space for Disclosure; 2) Psychoeducation on Suicide Recovery; 3) Sharing the Suicide narrative; 4) Completing the Meaningful Living Plan; 5) Taking Action on the Meaningful Living Plan in the Community.
Center Care as UsualBehavioural
Care as Usual in the Crisis Stabilization Centers includes medication management, the safety planning Intervention, individual counseling, group psychoeducation, discharge planning, and community referral linkages.
| Study group | Role | What they receive |
|---|---|---|
| Care as Usual + THRIVE | Experimental | Behavioral: THRIVE Toward Hope, Recovery, Interpersonal Growth, Values and Engagement (THRIVE), is a brief, suicide-specific, narrative, recovery-focused, 60 minute group psychotherapy intervention followed by up to 6 peer-led recovery coaching phone calls. THRIVE includes five components: 1) Creating a Safe Space for Disclosure; 2) Psychoeducation on Suicide Recovery; 3) Sharing the Suicide Narrative; 4) Completing the Meaningful Living Plan; 5) Taking Action on the Meaningful Living Plan in the Community.
Behavioral: Usual Care Care as Usual in Crisis Stabilization Centers includes medication management, the safety planning Intervention, group psychoeducation, individual counseling, discharge planning, and community referral linkages Receives: Behavioral: Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE); Behavioral: Center Care as Usual |
| Care as Usual | Active comparator | Care as Usual in the Crisis Stabilization Centers includes medication management, the safety planning Intervention, individual counseling, group psychoeducation, discharge planning, and community referral linkages. Receives: Behavioral: Center Care as Usual |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total Suicide Risk Events (SREs) per Arm
The primary outcome, total Suicide Risk Events (SREs), is a participant's aggregate number of crisis care contacts and events for suicide risk (e.g., crisis re-admissions, escalations, suicidal behaviors including suicide attempts, suicide deaths) in the 12-months post-discharge. The investigative team will discover post-discharge events via: 1) Participant follow-up surveys, including the Columbia Suicide Severity Rating Scale; 2) Electronic Health Record data; 3) Claims data. Blinded, trained, reviewers will apply a pre-set codebook with adjudication rules to determine whether post-discharge events are suicide-related or non-suicide related. Afterward, the unduplicated SREs from all sources up to 12 months post-discharge will be summed to calculate the total SREs for a participant, a count outcome measure.
Measured: 12 Months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Aug 2026
- Study start15 Dec 2026 (estimated)
- Primary completionOct 2030 (estimated)
- Study completionOct 2031 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for SuicideStudies of the same condition, open and under way.
- More trials run by University of Alabama at BirminghamThe 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
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 552 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Alabama at Birmingham
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute of Mental Health (NIMH)
- Responsible party
- Principal investigator, Jennifer Lockman, University of Alabama at Birmingham
- Investigators
- Jennifer D Lockman, PhD, Principal investigator, University of Alabama at Birmingham
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07784634
- Sponsor's protocol ID
- IRB-300016866
- Other IDs
- 1R01MH145192-01
- Acronym
- THRIVE
- Status last verified
- Oct 2026
- First submitted
- 14 Aug 2026
- Last updated
- 20 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: We will share de-identified IPD according to our comprehensive NIMH Data Management and Sharing Plan