Skip to main content
OpenTrials
Not yet recruiting

NCT Number: NCT07784634

THRIVE: A Recovery-Focused Suicide Prevention Intervention in 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.

Not yet recruiting

Trial opening soon.

Get Notified

Key information

Conditions

Suicide Behavior Behavioral Symptoms Self-Injurious Behavior Suicide Prevention Suicide, Attempted

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Wellstone, Huntsville, Alabama, United States

Loading trial locations.

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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.

Exclusion criteria

  • Under age 18.
  • Inability to communicate with the researcher in English.
  • Acute psychiatric instability (e.g., psychotic symptoms) prohibiting participation in psychotherapy.

Treatment and study plan

Toward Hope, Recovery, Interpersonal Growth, Values, and Engagement (THRIVE)

Behavioral

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 Usual

Behavioral

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.

Primary outcomes

  1. Total Suicide Risk Events (SREs) per Arm

    Time frame: 12 Months

    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.

Study contacts

Contact information is provided by the study sponsor or research team.

Fallan Lloyd, B.S.

CONTACT

[email protected]

615-593-6728

Jennifer D. Lockman, PhD

CONTACT

[email protected]

205-934-7008

Sponsors and collaborators

Lead sponsor

University of Alabama at Birmingham

Other

Collaborators

  • National Institute of Mental Health (NIMH)

Registry information

Official study title

THRIVE: Hybrid Randomized Effectiveness-Implementation Trial of a Recovery-Focused Suicide Prevention Intervention for Crisis Stabilization Centers

Acronym: THRIVE

Important dates

Study start
2026
Primary completion
2030
Study completion
2031
First posted
Aug 25, 2026
Registry last updated
Sep 3, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.