Optimizing family intervention in the treatment of suicidal youth

There is growing appreciation of the role of family interventions in preventing youth suicide and treating youth struggling with suicidal thoughts and behaviors. Increasingly, clinical investigators include parent (e.g., caregivers) in treatments in order to target family processes associated with risk and protection from suicide. On a continuum, these models range from individual treatments augmented with family psycho-education to family therapies that focus explicitly on the quality of intra-familial relationships as the central mechanisms of change. In this chapter, we review the clinical assumptions and structure of some of these models and offer a conceptual framework to help clarify the theoretical and methodological approaches to including parents in treatments. We discuss how and when families are included in the treatment and the goals of caregiver involvement. We encourage future work to report more fully on the dose and nature of family involvement and include more rigorous examination of family variables as potential mediators and moderators of treatment effects.