Family-focused suicide risk management service on reducing suicide behavior repetitions among adolescents: protocol for a randomized controlled trial

Abstract Background Suicidal behavior in adolescents is a major global public health challenge, yet evidence-based, scalable interventions remain limited, particularly in low- and middle-income countries. Methods This is a single-center, randomized, parallel-group controlled trial with a 1:1 allocation ratio. A total of 824 adolescents with suicide behavior and their family caregivers will be randomly allocated to either a brief family-based cognitive behavioral therapy intervention (three sessions) or an enhanced usual care control condition (supportive contact and psychoeducation). The primary outcome is time from randomization to first suicidal behavior within 90 days, assessed using the Columbia-Suicide Severity Rating Scale. Secondary outcomes include suicide attempt occurrence, self-harm frequency, self-efficacy to coping self-harm, perceived family function, retention rate and adherence to medical treatment. Follow-up assessments are conducted at day 30, day 60, day 90, and month 6. Data analysis will follow the intention-to-treat principle using Cox proportional hazards models. Discussion This trial will provide evidence on the effectiveness of a brief family-based intervention for adolescent in suicide crisis. If successful, the intervention has the potential to be scaled in resource-limited settings. Protocol version 2024-12-27, 1.0. Trial registration This study was registered with the Chinese Clinical Trial Registry on February 24, 2025 (registration number: ChiCTR2500097699). It can be accessed at https://www.chictr.org.cn/showproj.html?proj=261988 ).