Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART).

Journal Article (Journal Article)

This pilot study investigated the potential to utilize adaptive treatment strategies for treating moderate to severe suicidal risk among college students. This article will describe the unique study design and report on feasibility and acceptability findings. A 2-stage Sequential Multiple Assignment Randomized Trial (SMART) was conducted: In Stage 1, 62 suicidal college students were randomized to either a suicide-focused or a treatment-as-usual condition (4-8 weeks). Those deemed insufficient responders were re-randomized to one of two Stage 2 interventions-both suicide-focused but one comprehensive and multimodal and the other flexible and theoretically agnostic (4-16 additional weeks). Recruitment rates were high, treatment dropout levels were lower than expected for the setting, study dropouts were rare, and counselors were able to deliver suicide-focused approaches with fidelity. Treatment satisfaction was high among clients and moderately high among counselors. Findings from this pilot show that a SMART is highly feasible and acceptable to suicidal college students, counselors, and campuses.

Full Text

Duke Authors

Cited Authors

  • Pistorello, J; Jobes, DA; Compton, SN; Locey, NS; Walloch, JC; Gallop, R; Au, JS; Noose, SK; Young, M; Johnson, J; Dickens, Y; Chatham, P; Jeffcoat, T; Dalto, G; Goswami, S

Published Date

  • October 2017

Published In

Volume / Issue

  • 22 / 4

Start / End Page

  • 644 - 664

PubMed ID

  • 29220633

Pubmed Central ID

  • PMC6125229

Electronic International Standard Serial Number (EISSN)

  • 1543-6136

Digital Object Identifier (DOI)

  • 10.1080/13811118.2017.1392915


  • eng

Conference Location

  • England