A Pilot Randomized Control Trial of a Dyadic Safety Planning Intervention: Safe Actions for Families to Encourage Recovery

A recent systematic review on family and suicide prevention efforts identified a lack of family-based interventions for adults. To address this gap, Safe Actions for Families to Encourage Recovery (SAFER) intervention was created. SAFER is a novel, manualized, four-session, family-based treatment intervention that provides the tools and structure to support family involvement in Safety Planning Intervention (SPI). The SAFER intervention includes the development of a Veteran, and a complementary supporting partner, SPI. This Stage II (2aii) randomized clinical trial evaluated preliminary efficacy of this innovative approach. Thirty-nine Veterans and an associated supporting partner were randomized to receive SAFER or currently mandated individual SPI (I-SPI). Veterans in SAFER, compared to I-SPI, exhibited significant monthly decrements in suicide ideation (B = −0.37; p =.032). Moreover, a treatment-by-time interaction emerged when predicting improvements in Veteran suicide-related coping (B = 0.08; p =.028) and partner support of Veteran’s coping (B = 0.17; p =.032). However, the treatment effect for Veteran coping was not significant in dyadic analyses (B = 0.07; p =.151) after controlling for the partner’s support (B = 0.16; p =.009). Self-reported appraisals of relational factors and self-efficacy were not impacted by condition for either Veterans or partners. This initial efficacy pilot trial suggests SAFER has the potential to improve Veteran suicide symptoms and family members’ support of coping. More intensive work may be required for changes in burdensomeness and belongingness.