The Evidence Base for CAMS

30 YEARS AGO Clinical research BY Dr. David Jobes LED to the Development of CAMS

Since that time, three Randomized Controlled Trials (RCT’s) have been published proving its effectiveness for treating suicidal risk. Additional supportive RCT data from two unpublished RCT’s in the US and abroad and three on-going RCT’s are presently being conducted in Seattle, Washington, San Diego, California and Germany with other RCT’s in the planning stages. Eight published correlational/open clinical trials of CAMS in real-world clinics and hospitals around the world provide further support for the efficacy of CAMS.

Replicated data across these various trials shows the following:

  • CAMS quickly reduces suicidal ideation in 6-8 sessions
  • CAMS reduces overall symptom distress, depression, and changes suicidal cognitions
  • CAMS increases hope and improves clinical retention to care
  • CAMS patients like the process of doing CAMS
  • CAMS may be optimal for suicidal ideators (the impact with borderline multiple attempter patients is mixed and needs further clarification)
  • CAMS decreases ED visits among certain subgroups
  • CAMS appears to have a promising impact on self-harm behavior and suicide attempts (but replication is needed)
  • CAMS is relatively easy to learn to use with adherence

Randomized Controlled Trials of CAMS

Principal Investigator Setting & Population Design & Method Sample Size Status Update

 Comtois

(Jobes)

Harborview/Seattle

CMH Patients 

CAMS vs TAU

Next Day Appts.

32

 

2011 Published

Article

Andreasson

(Nordentoft)

Danish Centers

CMH Patients

DBT vs CAMS

Superiority Trial

108

 

2016 Published

Article

Jobes

(Comtois et al)

Ft. Stewart, GA

U.S. Army Soldiers

CAMS vs E-CAU

 

148

 

2017 Published

Article

Pistorello

(Jobes)

Univ. Nevada (Reno)

College Students

SMART Design

TAU/CAMS/DBT

62

 

Manuscript in

preparation

Ryberg

(Fosse)

Norwegian Centers

CMH Patients

CAMS vs TAU

 

100

 

Manuscript in

preparation

Comtois

(Jobes)

Harborview/Seattle

CMH Patients

CAMS vs TAU

Post-Hospital D/C

200

 

Intent to Treat

Underway

Depp et al

 

San Diego VAMC

Walk In Veterans

CAMS vs Outreach

Same Day Services

176

 

Grant Awarded

(HSR&D)

Counseling Center Studies

There have been several studies with counseling center samples over the years. In replicated non-randomized clinical trials CAMS is associated with decreases in suicidal ideation and overall symptom distress. The intervention was originally developed for use in counseling center settings so it is well-suited to these settings and this population.

Relevant Citations:

 

  • Jobes, D. A., Jacoby, A. M., Cimbolic, P., & Hustead, L. A. T. (1997). The assessment and treatment of suicidal clients in a university counseling center. Journal of Counseling Psychology, 44, 368-377.
  • Jobes, D. A., Kahn-Greene, E., Greene, J., & Goeke-Morey, M. (2009). Clinical improvements suicidal outpatients: Examining suicide status form responses as predictors and moderators. Archives of Suicide Research,13, 147-159.
  • Jobes, D. A., & Mann, R. E. (1999). Reasons for living versus reasons for dying: Examining the internal debate of suicide. Suicide and Life-Threatening Behavior, 29, 97-104.
  • Jobes, D. A., Nelson, K. N., Peterson, E. M., Pentiuc, D., Downing, V., Francini, K., & Kiernan, A. (2004). Describing suicidality: An investigation of qualitative SSF responses. Suicide and Life-Threatening Behavior, 34, 99-112.
  • Jobes, D. A., & Jennings, K. W. (2011). The Collaborative Assessment and Management of Suicidality (CAMS) with College Students (pp 236-254). In D. Lamis and D. Lester (Eds.), Understanding and preventing college student suicide. Springfield, IL: Charles C. Thomas Press.
  • Brancu, M., Jobes, D.A., Wagner, B.A., Greene, J.A., & Fratto, T.A. (2015) Are there linguistic markers of suicidal writing that can predict the course of treatment? A repeated measures longitudinal analysis. Archives of Suicide Research, E-pub ahead of print, DOI: 10.1080/13811118.2015.1040935.
  • Pistorello, J., Jobes, D. A., Compton, S., Locey, N. S., Walloch, J. C., Gallop, R., Au, J., Noose, S. K., Young, M., Johnson, J., Dicken, Y., Chatham, P., Jeffcoat, T., Dalto, G., & Goswami, S. (2017). Developing adaptive treatment strategies to address suicidal risk in college students: A pilot Sequential Multiple Assignment Randomized Trial (SMART). Archives of Suicide Research. DOI: 10.1080/13811118.2017.1392915

International Studies

The cross-cultural utility of CAMS has been established through international studies. Particularly studied in Denmark, the SSF has been translated into many languages and CAMS is used around the world (e.g., Ireland, England Poland, Germany, Lithuania, China, Uruguay, and Australia). Across the various studies, CAMS decreases suicidal ideation and the SSF Core Assessment variables. There is promising evidence for CAMS also having an impact on self-harm and suicide attempts (in comparison to DBT).

Relevant Citations:

 

  • Arkov, K., Rosenbaum, B., Christiansen, L, Jonsson, H., Munchowm M. (2008). Treatment of suicidal patients: The collaborative assessment and management of suicidality. Ugeskr Laeger, 170, 149-153.
  • Corona, C. D., Jobes, D. A., Nielsen, A. C., Pedersen, C. M., Jennings, K. W., Lento, R. M., & Brazaitis, K. A. (2013). Assessing and treating different suicidal states in a Danish outpatient sample. Archives of Suicide Research, 17, 302-312.
  • Jobes, D. A. (2009). The CAMS approach to suicide risk: Philosophy and clinical procedures. Suicidologi, 14, 3-7.Nielsen, A. C., Alberdi, F., & Rosenbaum, B. (2011). Collaborative assessment and management of suicidality method shows effect. Danish Medical Bulletin, 58, A4300.
  • Andreasson, K., Krogh, K., Rosenbaum, B., Gluud, C., Jobes, D., & Nordentoft (2014). The DiaS trial: Dialectical behaviour therapy vs. collaborative assessment and management of suicidality on self-harm in patients with a recent suicide attempt and borderline personality disorder traits, study protocol for a randomized controlled trial. Trials Journal, 15, 194.
  • Andreasson, K., Krogh, J., Wenneberg, C., Jessen, H. K., Krakauer, K., Gluud, C.,  & Nordentoft, M. (2016). Effectiveness of dialectical behavior therapy versus collaborative assessment and management of suicidality treatment for reduction of self-harm in adults with borderline —A randomized observer-blinded clinical trial. Depression and Anxiety, 33, 520-530. doi:10.1002/da.22472
  • Wenche, R., Fosse, R., Zahl, P. H., Brorson, I. W., Moller, P., Landro, N. I., & Jobes, D. (2016). Collaborative assessment and management of suicidality (CAMS) compared to treatment as usual (TAU) for suicidal patients: Study protocol for a randomized controlled trial. Trials Journal.

Inpatient Studies

The SSF has been used extensively within inpatient settings. Most notably there has been research at the Mayo Clinic and the Menninger Clinic where a modified version of CAMS (called CAMS-M) has been used for many years. The SSF has been shown to have robust validity and reliability among inpatients; replicated inpatient data has shown the CAMS rapidly decreases suicidal ideation and changes suicidal cognitions over the course of care.

Relevant Citations:

 

  • Conrad, A. K., Jacoby, A. M., Jobes, D. A., Lineberry, T. Jobes, D., Shea, C., Fritsche, K., Schmid, P., Ellenbecker, S., Grenell, J., & Arnold-Ewing, T. (2009). A pychometric investigation of the suicide status form with suicidal inpatients. Suicide and Life-Threatening Behavior, 39, 307-320.
  • Ellis, T. E., Allen, J. G., Woodson, H., Frueh, B. C., & Jobes, D. A. (2010). Implementing an evidence-based approach to working with suicidal inpatients. Bulletin of the Menninger Clinic, 73, 339-354.
  • O’Connor, S., Jobes, D. A., Lineberry, T., & Bostwick, J. M. (2010). An investigation of emotional upset in suicidal inpatients. Archives of Suicide Research, 14, 35-43.
  • Kraft, T. L., Jobes, D. A., Lineberry, T. L., & Conrad, A. K. (2010). Brief report: Why suicide? Perceptions of suicidal inpatients and reflections of clinical researchers. Archives of Suicide Research, 14, 375-382.
  • O’Connor, S.S., Beebe, T.J., Jobes, D. A., Lineberry, T.W., & Conrad, A.K. (2012). The association between the K10 and suicidality: A cross-sectional analysis. Comprehensive Psychiatry, 53, 48-53.
  • Ellis, T. E., Green, K. L., Allen, J. G., Jobes, D. A., & Nadorff, M. R. (2012). Use of the collaborative assessment and management of suicidality in an inpatient setting: Results of a pilot study. Psychotherapy, 49, 72-80.
  • O’Connor, S. S., Jobes, D. A., Yeargin, M. K., Fitzgerald, M., Rodriguez, V., Conrad, A. K., & Lineberry, T. W. (2012). A cross sectional investigation of the suicidal spectrum: Typologies of suicidality based upon ambivalence about living and dying. Comprehensive Psychiatry, 53, 461-467
  • Lento, R. M., Ellis, T. E., Hinnant, B. J., & Jobes, D. A. (2013). Using the suicide index score to predict treatment outcomes among psychiatric inpatients. Suicide and Life-Threatening Behavior, 43, 547-561.
  • Ellis, T. E., Rufino, K. A., Allen, J. G., Fowler, J. C., & Jobes, D. A. (2015). Impact of a suicide-specific intervention within inpatient psychiatric Care: The collaborative assessment and management of suicidality (CAMS). Suicide and Life-Threatening Behavior. DOI: 10.1111/sltb.12151.
  • Ellis, T. E., Rufino, K. A., & Allen, J. G. (2017). A controlled comparison trial of the collaborative assessment and management of suicidality (CAMS) in an inpatient setting: Outcomes at discharge and six months follow up. Psychiatry Research, 249, 252-260.
  • Corona, C. D., Ellis, T. E., & Jobes, D. A. (in press). Word count as an indicator of suicide risk in an inpatient setting. Bulletin of the Menninger Clinic.

Non-randomized, Case-Controlled Studies

CAMS was used naturalistically in two US Air Force outpatient mental health clinics in a non-randomized case-control study of n=55 suicidal Air Force personnel. Within a correlational ex-post facto design, suicidal ideation was reduced significantly more quickly for patients treated by providers using an early version of CAMS in comparison to control group patients treated by providers using “treatment as usual” (TAU) care. Moreover, using an interrupted time-series analysis, CAMS was significantly correlated with reductions in primary care appointments and emergency department visits.

There are have been two clinical trials conducted at the Menninger Clinic that used “propensity score matching” to statistically create a viable comparison control group. Across these two studies CAMS was shown to significantly decrease suicidal ideation and change suicidal cognitions in comparison to the control group. These studies robustly replicated the impact of CAMS with high-risk suicidal inpatients.

Relevant Citations:

 

  • Jobes, D. A., Wong, S. A., Conrad, A., Drozd, J. F., & Neal-Walden, T. (2005). The collaborative assessment and management of suicidality vs. treatment as usual: A retrospective study with suicidal outpatients. Suicide and Life-Threatening Behavior, 35, 483-497.
  • Ellis, T. E., Rufino, K. A., Allen, J. G., Fowler, J. C., & Jobes, D. A. (2015). Impact of a suicide-specific intervention within inpatient psychiatric Care: The collaborative assessment and management of suicidality (CAMS). Suicide and Life-Threatening Behavior. DOI: 10.1111/sltb.12151.
  • Ellis, T. E., Rufino, K. A., & Allen, J. G. (2017). A controlled comparison trial of the collaborative assessment and management of suicidality (CAMS) in an inpatient setting: Outcomes at discharge and six months follow up. Psychiatry Research, 249, 252-260.

Published Randomized Controlled Trials of CAMS

Because causality is a central goal in treatment development scientific research, current CAMS research is heavily focused on randomized controlled trial (RCT) designs. To date, there are three published RCT’s of CAMS with several other RCT’s in various stages of completion.

1) CAMS-Next Day Appointment (NDA) Study:

The CAMS-NDA RCT was funded by the American Foundation for Suicide Prevention (AFSP). This was a small feasibility-oriented RCT comparing CAMS to Enhanced Care as Usual (E-CAU) with community-based sample of suicidal outpatients. In this study, 32 suicidal outpatients were randomly assigned to the respective treatment arms in an outpatient mental health treatment clinic housed within a large urban medical center. Despite limited statistical power given the small sample, there were statistically significant experimental findings on all our primary and secondary measures including between-group differences in suicidal ideation, overall symptom distress, and optimism/hope. Importantly, the experimental between-group differences were most robust at the most distal assessment time point (12 months after the index treatment assessment) showing the possible enduring causal impact of CAMS long after the treatment ended (on average around eight sessions). Finally, CAMS patient satisfaction ratings were significantly higher than control patient ratings and the patients receiving CAMS care demonstrated superior treatment retention in comparison to control patients. Click this link for a copy of the journal article:  Comtois, Jobes, O’Connor et al 2011

2) DBT vs. CAMS RCT (the DIAS RCT):

Researchers in Copenhagen Denmark conducted a well-powered RCT using a parallel group superiority design in which 108 suicide attempters with Borderline Personality Disorder traits were randomly assigned to either Dialectical Behavior Therapy (DBT) or “CAMS-Informed Supportive Psychotherapy.” Data from this study showed no significant differences between DBT and CAMS for the treatment of self-harm and suicide attempts. As DBT is a proven and highly effective treatment for self-harm and suicide attempts this finding was encouraging particularly because patients received significantly less clinical contact (1X/week of CAMS for an average of 10 sessions vs. 2Xweek of DBT for 16 weeks). Click this link for a copy of the journal article: Andreasson, Krogh, Wenneberg et al 2016

3) Operation Worth Living (OWL) Study:

The “Operation Worth Living” (OWL) study funded by the US Department of Defense was a well-powered RCT of CAMS vs. Enhanced Care as Usual with an “intent-to-treat” sample of 148 suicidal U.S. Army Soldiers at an outpatient military treatment facility. In this study, CAMS significantly eliminated suicidal ideation in 6-8 sessions significantly more quickly that control care at 3 months follow up and this reduction in ideation was maintained at 6 and 12 months. There are “moderator” data showing that CAMS was significantly better than control care for 6 of 8 significant findings showing that subgroups of CAMS patients had decreased visits to the emergency department, decreases in overall symptom distress, and increases in resilience.Click this link for a copy of the journal article: Jobes, Comtois, Gutierrez, Brenner et al 2017

Unpublished RCT’s of CAMS

A NIMH R-34 grant has funded a small randomized controlled trial at the University of Nevada-Reno Counseling Center comparing CAMS vs. TAU vs. DBT using a sequential multiple assignment randomized trial (a “SMART” design) research methodology where 63 suicidal college students were randomized to 8 sessions of CAMS vs. TAU in Stage 1; for those who do not respond, there is a second randomization to Stage 2 which is 16 weeks of CAMS or 16 weeks of DBT. Within the SMART design there is the potential to investigate possible dosing effects of different treatments with the prospect of effectively matching different treatments to different suicidal states.

Researchers in Oslo Norway have conducted a rigorous RCT comparing CAMS to TAU for 80 suicidal patients across 4 different treatment settings demonstrating a significant impact for CAMS on suicidal ideation and overall symptom distress. Another RCT is underway in Germany on an inpatient unit; treatment and data collection are currently underway. Several RCT’s of CAMS with children and teenagers are currently being developed for funding.

Relevant Citations:

 

  • Comtois, K. A., Jobes, D. A., O’Connor, S., Atkins, D. C., Janis, K., Chessen, C., Landes, S. J., Holen, A., & Yuodelis Flores, C. (2011). Collaborative assessment and management of suicidality (CAMS): Feasibility trial for next-day appointment services. Depression and Anxiety, 28, 963-972.
  • Andreasson, K, Krogh, J., Wenneberg, C., Jessen, H. L. K., Krakauer, K., Gluud, C., Thomsen, R. R., Randers, L., & Nordentoft, M. (2016). Effectiveness of Dialectical Behavior Therapy Versus Collaborative Assessment and Management of Suicidality Treatment for Reduction of Self-Harm in Adults with Borderline Personality Traits and Disorder–A Randomized Observer-Blinded Clinical Trial. Depression and Anxiety, DOI 10.1002/da.22472.
  • Wenche, R., Fosse, R., Zahl, P. H., Brorson, I. W., Moller, P., Landro, N. I., & Jobes, D. (2016). Collaborative assessment and management of suicidality (CAMS) compared to treatment as usual (TAU) for suicidal patients: Study protocol for a randomized controlled trial. Trials Journal.
  • Jobes, D. A., Comtois, K.A., Gutierrez, P. M., Brenner, L. A., Huh, D., Chalker, S. A., Ruhe, G., Kerbrat, A. H., Atkins, D. C., Jennings, K., Crumlish, J., Corona, C. D., O’Connor, S., Hendricks, K. E., Schembari, B., Singer, B., & Crow, B. (2017). A randomized controlled trial of the collaborative assessment and management of suicidality versus enhanced care as usual with suicidal soldiers. Psychiatry: Interpersonal and Biological Processes, 80, 339–356. DOI: https://doi.org/10.1080/00332747.2017.1354607
  • Pistorello, J., Jobes, D. A., Compton, S., Locey, N. S., Walloch, J. C., Gallop, R., Au, J., Noose, S. K., Young, M., Johnson, J., Dicken, Y., Chatham, P., Jeffcoat, T., Dalto, G., & Goswami, S. (2017). Developing adaptive treatment strategies to address suicidal risk in college students: A pilot Sequential Multiple Assignment Randomized Trial (SMART). Archives of Suicide Research. DOI: 10.1080/13811118.2017.1392915

Research on CAMS Training

Training in CAMS has been recognized as one of only a handful of national-level suicide-specific professional training approaches. There is compelling unpublished evidence that CAMS training can be effective in changing clinician’s knowledge and attitudes about working with suicidal risk. In an unpublished study conducted by Schuberg et al (2009) of a range of CAMS-trained Veterans Affairs mental health providers (n=165), the investigators observed significant pre-post training differences related to decreasing clinician anxiety about working with suicidal risk in general, while specifically increasing clinician confidence in assessing and treating suicidal risk. There were further significant pre-post positive training findings related to clinicians’ perceptions about forming an alliance with a suicidal patient, increasing patient motivation, and conducting safety-planning. Importantly, most of these significant CAMS-training pre-post effects were sustained in a 3-month follow up assessment with a subset of the original sample (n=36).

In an on-line survey of 120 mental health practitioners self-reported adherence to the CAMS therapeutic philosophy was found to be moderate to high, which was comparable to other studies gauging the impact of suicide-focused training (Crowley et al., 2014). Participants further reported relatively high adherence to CAMS practice which was higher than findings on adherence to interventions for other psychiatric issues. Overall adherence to CAMS philosophy and practice did not vary consistently as a function of any contextual variable. For example, a range of clinicians in a range of different settings receiving different training modalities can successfully subscribe to the CAMS therapeutic philosophy and implement CAMS-specific practices.

Data on the positive impact of CAMS training delivered within an e-learning training modality has also been published (Marshall et al., 2014). In this study, a total of n=215 Veterans Affairs mental health providers across five sites were randomized to three conditions: n=69 to CAMS e-learning, n=70 to in-person CAMS training, and n=76 to the control no-training group. We observed in this study that both the CAMS live training and e-learning training were favorably received and no major significant differences between clinician ratings between the live training and e-learning training showing the potential value of an accessible broad-based e-learning training in CAMS to a wide range of mental health providers.
While these studies have some limitations (e.g., their self-report nature), it does seem that clinicians can quickly learn key CAMS concepts and with support and guidance can become CAMS-adherent often with their first case. Further training research is underway going beyond the limits of clinician self-report to more specifically investigate training that results in actual clinician behavior-change by becoming a competent CAMS-adherent clinical provider. A major research project on CAMS Integrated Training (CAMS-IT) offered by CAMS-care is now being developed.

Relevant Citations:

 

  • Crowley, K. J., Arnkoff, D. B., Glass, C. R., & Jobes, D. A. (2014, April). Collaborative assessment and management of suicidality (CAMS): Adherence to a flexible clinical framework. In J. Crumlish (Chair), The collaborative assessment and management of suicidality: Perspectives from the Catholic University suicide prevention lab. American Association of Suicidology, Los Angeles, CA.
  • Pisani, A. R., Cross, W. F., Gould, M. S., (2011). The assessment and management of suicide risk: State of workshop education. Suicide and Life-Threatening Behavior, 41, 255-276.
  • Schuberg, K., Jobes, D. A., Ballard, E., Kraft, T. L., Kerr, N. A., Hyland, C. A., Freimuth, J.Seaman, K., & Guidry, E. (2009, April). Pre/post/post evaluations of CAMS-trained VA clinicians. Poster presented at the annual meeting of the American Association of Suicidology, San Francisco, CA.
  • Marshall, E., York, J., Magruder, K., Yeager, D., Knapp, R., De Santis, M., Burriss, L., Mauldin, M., Sulkowski , S., Pope, C., & Jobes, D. (2014). Implementation of online suicide-specific training for VA providers. Academic Psychiatry.

CAMS Research and Work with Suicidal Service Members and Veterans

CAMS has been used across all US military service branches and throughout VA mental health care across the country. Dr. Jobes and CAMS-care consultants routinely provide expert consultation, process improvement, and on-going research with both the US Department of Defense and Veterans Affairs. This work has led to various professional publications and on-going as well as future research projects with these significantly at-risk populations.

Relevant Citations:

 

  • Oordt, M., Jobes, D., Rudd, M., Fonseca, V., Russ, C., Stea, J., Campise, R., & Talcott, W. (2005). Development of a clinical guide to enhance care for suicidal patients. Professional Psychology: Research and Practice. 36, 208-218.
  • Jobes, D. A., Wong, S. A., Conrad, A., Drozd, J. F., & Neal-Walden, T. (2005). The Collaborative assessment and management of suicidality vs. treatment as usual: A retrospective study with suicidal outpatients. Suicide and Life-Threatening Behavior, 35, 483-497.
  • Nademin, E., Jobes, D. A., Pflanz, S. E., Jacoby, A. M., Ghahramanlou-Holloway, M., Campise, R., Joiner, T. E., Wagner, B, M, & Johnson, L. (2008). An investigation of interpersonal-psychological variables in air force suicides: A controlled-comparison study. Archives of Suicide Research, 12, 309-326.
  • Oordt, M. S., Jobes, D. A., Fonseca, V. P., & Schmidt, S. M. (2009). Training mental health professionals to assess and manage suicidal behavior: Can provider confidence and practice behaviors be altered? Suicide and Life-Threatening Behavior, 39, 21-37.
  • Jobes, D. A., Bryan, C. J., & Neal-Walden, T. A. (2009). Conducting suicide research in naturalistic clinical settings. Journal of Clinical Psychology, 65, 382-395.
  • Cox, D.W., Ghahramanlou-Holloway, M., Greene, F. N., Bakalar, J. L., Schendel, C. L., Nademin, E., Jobes, D., Englert, D., & Kindt, M. (2011). Suicide in the United States Air Force: Risk factors communicated before and at death. Journal of Affective Disorders, 133, 398-405.
  • Bryan, C. J., Jennings, K. W., Jobes, D. A., & Bradley, J. C. (2012). Understanding and preventing military suicide. Archives of Suicide Research, 16, 95-110.
  • Jobes, D. A., Lento, R., & Brazaitis, K. (2012). An evidence-based clinical approach to suicide prevention in the department of defense: The collaborative assessment and management of suicidality (CAMS). Military Psychology, 24, 604-623.
    Martin, J.S., Ghahramanlou-Holloway, M., Englert, D., Bakalar, J.L., Olsen, C., Nademin, E., Jobes, D., & Branlund, S. (2013). Marital status, life stressor precipitants, and communications of distress and suicide intent in a sample of United States Air Force suicide decedents. Archives of Suicide Research, 17(2).
  • Jobes, D. A. (2013). Reflections on suicide among soldiers. Psychiatry, 76, 126-131.
  • Marshall, E., York, J., Magruder, K., Yeager, D., Knapp, R., De Santis, M., Burriss, L., Mauldin, M., Sulkowski , S., Pope, C., & Jobes, D. (2014). Implementation of online suicide-specific training for VA providers. Academic Psychiatry.
  • Johnson, L. L., O’Connor, S. S., Kaminer, B., Jobes, D. A., & Gutierrez, P. M. (2014). Suicide-focused group therapy for veterans. Military Behavioral Health, 2, 327–336.
  • Archuleta, D., Jobes, D. A., Pujol, L., Jennings, K., Crumlish, J., Lento, R. M., Brazaitis, K., Moore, B. A., & Crow, B. (2014). Raising the Clinical Standard of Care for Suicidal Soldiers: An Army Process Improvement Initiative. Army Medical Department Journal, Oct-Dec, 55-66.
    O’Connor, S. S., Carney, E., Jennings, K. W., Johnson, L. L. Gutierrez, P. M., & Jobes, D. A. (2016). Relative impact of risk factors, thwarted belongingness, and perceived burdensomeness on suicidal ideation in veteran service members. Journal of Clinical Psychology. [Epub ahead of print]
  • Jobes, D. A., Comtois, K.A., Gutierrez, P. M., Brenner, L. A., Huh, D., Chalker, S. A., Ruhe, G., Kerbrat, A. H., Atkins, D. C., Jennings, K., Crumlish, J., Corona, C. D., O’Connor, S., Hendricks, K. E., Schembari, B., Singer, B., & Crow, B. (2017). A randomized controlled trial of the collaborative assessment and management of suicidality versus enhanced care as usual with suicidal soldiers. Psychiatry: Interpersonal and Biological Processes, 80, 339–356. DOI: https://doi.org/10.1080/00332747.2017.1354607
  • Johnson, L.L., O’Connor, S.S., Kaminer, B., Gutierrez, P.M., Carney, E., Groh, B., & Jobes, D.A. (in press). Evaluation of structured assessment and mediating factors of suicide focused group therapy for Veterans recently discharged from inpatient psychiatry. Archives of Suicide Research.

FREQUENTLY ASKED QUESTIONS

Why is CAMS the best choice for suicide prevention?
CAMS stands for the “Collaborative Assessment and Management of Suicidality” (CAMS). CAMS is first and foremost a clinical philosophy of care. It is a therapeutic framework for suicide-specific assessment and treatment of a patient’s suicidal risk. It is a flexible approach that can be used across theoretical orientations and disciplines for a wide range of suicidal patients across treatment settings and different treatment modalities.

Our organization already uses a screening risk assessment measure for suicide. I understand that CAMS is used for risk assessment so why would we need to add another screening tool?
While CAMS emphasizes a therapeutic assessment of suicidal risk, it is much more than a screening or risk assessment tool. Guided by a multi-purpose clinical tool called the “Suicide Status Form” (SSF), CAMS guides the patient’s treatment through a suicide-specific assessment, a suicide-specific treatment plan focusing on patient-defined “drivers” of suicide (i.e., those problems that lead to suicidality), tracks the on-going risk, and facilitates clinical outcomes and dispositions.

So CAMS is not just a screening or risk assessment tool, so what else does it do?
Beyond merely assessing suicidal risk, CAMS is a proven clinical intervention that reliably and effectively treats patient-defined suicidal drivers leading to rapid reductions in suicidal ideation, overall symptom distress, depression, and hopelessness. In addition, there are promising data for decreasing suicide attempts and self-harm behaviors. These results are based on 8 published clinical trials, 3 published randomized controlled trials (RCTs), and one unpublished randomized controlled trial (RCT).

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