Brief modular approach to target perceived burdensomeness in clinic-referred youth

Introduction
Existing CBT protocols for internalizing disorders target thoughts and behaviors related to anxiety and/or depression, but do not explicitly target other identified risk factors for suicide ideation, including perceived burdensomeness toward others. The aims of the current study were to (1) develop a novel, brief module (the “Give program”) targeting perceived burdensomeness toward others that can be embedded within existing CBT protocols for youth internalizing disorders, (2) evaluate the acceptability and feasibility of the module with an eye toward intervention refinement, and (3) examine reductions in perceived burdensomeness.
Methods
Participants were 18 clinic-referred youths with anxiety or depressive disorders who endorsed burdensomeness. We used a quasi-experimental interrupted time-series design to evaluate changes in burdensomeness scores following the administration of the module.
Results
The module was clinically feasible and well-accepted. Youth burdensomeness scores increased in the first half of the CBT protocol and decreased immediately following the administration of the Give program module. Burdensomeness scores were significantly associated with suicide ideation.
Conclusion
The current study is the first to develop and evaluate a module targeting burdensomeness in at-risk youth in an outpatient setting, demonstrating that burdensomeness can be efficiently and effectively targeted within existing evidence-based treatment protocols for internalizing disorders in youth.