Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Nonmonetary and nonreciprocal freecycling: Motivations for participating in online alternative giving communities

This research examines consumers' participation in a nonmonetary, nonreciprocal form of online consumer exchange wherein consumers may decide to give only, receive only, or both give and receive. Given the lack of financial incentives or relational norms that would traditionally drive participation in this societally beneficial consumption activity for which we advance the term alternative giving, this research examines consumers' participation motivations. Are consumers, as prior research suggests, motivated to participate in alternative giving activities on the basis of prosocial motives or for other reasons? Through a content analysis of the online Freecycle Network, we found that participation is driven primarily by fundamental consumer needs and wants, though other prosocial, less materialistic factors are also drivers. Our findings also identify an inconsistency in product categories between what givers offer and what receivers seek, suggesting that supply–demand imbalances can emerge within alternative giving communities.