Protecting Adolescents from Suicide

A renowned clinical psychologist has developed groundbreaking screening and family therapy techniques to reduce risk.

by Carolyn Shea

Thunderstorms in New York City on May 22, 2014 could not dampen the spirit of hopefulness and community that prevailed at the American Foundation for Suicide Prevention (AFSP) 26th Annual Lifesavers Dinner. Held at Jazz at Lincoln Center in midtown Manhattan, the gala was attended by people in politics, science, media, entertainment, and business who have dedicated themselves to raising greater public awareness about suicide. It also recognized outstanding contributions made by researchers, corporations, suicide survivors, and humanitarians.

Guy Diamond ’81 was among the distinguished honorees that evening. He received the 2014 AFSP Research Award for the important work he’s done to treat high-risk adolescents by expanding and improving family therapy so that it more successfully addresses suicide prevention for youth and LGBT populations. Recipients of this award, said the AFSP, “symbolize hope, courage and commitment to suicide prevention.”

Guy Diamond

Guy Diamond in his office at Drexel University

According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death in young people between the ages of 15 and 24. A significant public health problem among all age groups, suicide exacts a lasting toll on individuals, families, and communities. Although its causes are complex and affected by many factors, the goal of suicide prevention is simple, states the CDC: “Reduce factors that increase the risk (i.e., risk factors) and increase factors that promote resilience (i.e., protective factors).”

Diamond is a child and adolescent psychologist who has made major headway on both of these fronts. A professor emeritus at the University of Pennsylvania School of Medicine, where he worked for 22 years, he’s currently an associate professor at Drexel University’s College of Nursing and Health Professions and director of Drexel’s doctoral program in Couple and Family Therapy, as well as his own Center for Family Intervention Science, which he founded in 1996.

When Diamond moved to Drexel as a full-time faculty member in March 2014, the university issued a statement saying, “A renowned expert in adolescent suicide screening and depression treatment, he joins us at the pinnacle of a career filled with important publications, accolades, ground-breaking research, and an outstanding grant funding history.”

Included in the groundbreaking research is the treatment recognized by the AFSP, Diamond’s Attachment-Based Family Therapy (ABFT). This leading-edge approach is specifically designed to address family and individual practices associated with adolescent suicide and depression. Diamond spent over a decade developing and testing ABFT, which aims to strengthen or repair parent-adolescent bonds and improve family communication.

In clinical trials, it has been successful in reducing suicidal thoughts, hopelessness, depression, anxiety, and family conflict, and now has the distinction of being an empirically supported treatment on the National Registry of Evidence-based Programs and Practices (NREPP), administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). Diamond co-authored the definitive text on the approach, Attachment-Based Family Therapy for Depressed Adolescents, published by the American Psychological Association. He said the essence of ABFT, which has been used by more than 500 families, is providing the support that makes “kids feel more comfortable and capable of sharing their distress and parents more effective listeners.” Following treatment, “Lots of parents tell us we helped them get through a difficult time.”

Diamond also developed an innovative Web-based suicide-screening tool to get adolescents to open up with their doctors about deeply personal feelings, experiences, and behaviors. The tool, called Behavioral Health Works, employs a seven-minute standardized questionnaire that teens answer in private on a computer as they wait for their visit with their healthcare provider. Once completed, it is automatically scored and a report is added to the patient’s record. The provider reviews the report with the patient and makes any necessary referrals.

With the screening tool, we hear mostly from doctors who say, ‘I never thought these kids had these problems. They’re doing so well in school and have lots of friends. I had no idea about their risk behaviors.’

—Guy Diamond

Before he decided on his career path, Diamond spent several years “dabbling with the idea of becoming a psychologist or a rabbi.” He attended New York’s Jewish Theological Seminary for a year until he realized the rabbinical life wasn’t for him. He then enrolled in a master’s program at the New School of California, and “became smitten with family therapy.” He continued on that track, earning his doctorate in clinical psychology and doing postdoctoral work in Philadelphia, where he’s spent his entire professional career. He lives outside Philly with his wife, four children, and dog.

In light of recent guidelines from the American Academy of Pediatrics recommending depression screening for adolescents during their annual physicals, Diamond’s tool is valuable not just for depression, but for many other factors that could contribute to the risk of suicide in teens, including trauma, substance use, sexuality, bullying, and exposure to violence. Diamond said, “With the screening tool, we hear mostly from doctors who say, ‘I never thought these kids had these problems. They’re doing so well in school and have lots of friends. I had no idea about their risk behaviors.’”

In use for 10 years, Behavioral Health Works screens more than 1,000 youths a month. It is currently employed in scores of primary care and mental health settings, emergency rooms, schools, and college health centers across Pennsylvania, New York, Delaware, and Maryland—and interest in using it is growing in other states and abroad. “It has a lot of legs to it,” said Diamond. “It was built for primary care, but it doesn’t have to exist only there.”

Before coming to Evergreen, he took a couple of years off after finishing high school to try making it as a drummer in a Los Angeles rock and roll band called Fuschia. For another year, he hitchhiked through Europe and the Middle East and lived on a kibbutz in Israel. It was from Israel that he sent in his application for admission to the college.

This gap in his formal education enriched his learning not only because he had been to all the places he studied in his interdisciplinary first-year history program, but also because, he said, “it helped me better engage in the learning.”

At Evergreen, faculty member Mark Levensky was a major influence on him. “He was a fabulous philosophy teacher who spent one entire quarter devoted to Plato’s Republic and a second quarter to Dante’s Inferno. Mark taught me how to think.”

As for his professional success, Diamond said, “I’ve had a satisfying career that’s been meaningful and allowed me to pursue things that interest me. I think Evergreen should take a little credit for me.”