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NCT03653637: PLF

Group ("Project Life Force") vs. Individual Suicide Safety Planning RCT

Completed NA Results posted Last updated 10 November 2025
What this trial tests

NA trial testing Project Life Force in Suicide in 294 participants. Completed in 30 March 2024.

Timeline
15 October 2018
Primary endpoint
31 December 2023
30 March 2024

Quick facts

Lead sponsorVA Office of Research and Development
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment294
Start date15 October 2018
Primary completion31 December 2023
Estimated completion30 March 2024
Sites2 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

VA Office of Research and Development — full company profile →

Who can join

Adults 18 to 89, any sex, with Suicide. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Columbia Suicide Rating Scale (C-SSRS) Primary · Baseline, 3 Month, 6 Month, 12 Month

Columbia Suicide Rating Scale (C-SSRS) will be used to count prospective or treatment emergent suicidal behaviors. The CSSRS has been used in many treatment trials, and to measure treatment emergent suicidal events during pharmacotherapy. C-SSRS contains a subscale on suicidal ideation which is scored from 1-5; higher numbers indicate increased suicidal thinking. The definition of suicide attempt for the primary outcome will consist of any actual suicide attempt, aborted suicide attempt, or interrupted suicide attempt according to the CSSR-S.

GroupValue95% CI
Project Life Force22
Treatment-As-Usual30
Beck Depression Inventory-II Change Secondary · Baseline, 3 Month, 6 Month, 12 Month

The Beck Depression Inventory-II (BDI-II) measures depressive severity with 21 items on a Likert scale. It has high internal consistency, construct validity, and test-retest reliability. Each question has a set of at least four possible answer choices ranging in intensity. When the test is scored, a value of 0 to 3 is assigned for each answer, and items are summed for a total score (ranging from 0-63). Higher scores indicate worse depressive severity.

Baseline
GroupValue95% CI
Project Life Force32.03± 12.45
Treatment-As-Usual30.90± 15.08
3 month
GroupValue95% CI
Project Life Force23.54± 14.40
Treatment-As-Usual24.32± 16.04
6 month
GroupValue95% CI
Project Life Force23.82± 12.52
Treatment-As-Usual25.19± 17.41
12 month
GroupValue95% CI
Project Life Force23.87± 12.02
Treatment-As-Usual21.69± 17.28
Beck Hopelessness Scale Change Secondary · Baseline, 3 Month, 6 Month, 12 Month

The Beck Hopelessness Scale (BHS) measures hopelessness with 20 binary (true/false) items. Items are recoded so that optimistic beliefs equal 0 and pessimistic beliefs equal 1. Recoded items are summed for a total score (ranging from 0-20), and higher scores indicate more severe hopelessness. The BHS demonstrates excellent internal reliability and external validity.

Baseline
GroupValue95% CI
Project Life Force10.11± 6.35
Treatment-As-Usual9.40± 6.61
3-month
GroupValue95% CI
Project Life Force7.74± 6.67
Treatment-As-Usual8.21± 6.59
6-month
GroupValue95% CI
Project Life Force8.18± 6.38
Treatment-As-Usual7.67± 7.16
12-month
GroupValue95% CI
Project Life Force7.48± 6.26
Treatment-As-Usual7.57± 7.23
Suicide-related Coping Scale Change Secondary · Baseline, 3 Month, 6 Month, 12 Month

The Suicide-Related Coping Scale (SRCS) has 17 items assessing suicide-related coping (knowledge of, and perceived confidence in, using internal coping strategies and external supports to regulate suicidal thoughts and urges). Items are rated on a 5-point scale (Strongly disagree (0) - Strongly agree (4)). All items are summed for a total score (range 0-68), and the first 14 items can also be used for "external coping" and "internal coping" subscales (7 items each; total range 0-28). Higher scores show improved suicide-related coping. The SRCS has acceptable internal and external validity.

Baseline
GroupValue95% CI
Project Life Force48.30± 10.79
Treatment-As-Usual49.17± 11.19
3-month
GroupValue95% CI
Project Life Force53.68± 10.67
Treatment-As-Usual50.09± 14.12
6-month
GroupValue95% CI
Project Life Force53.15± 10.84
Treatment-As-Usual49.22± 13.68
12-month
GroupValue95% CI
Project Life Force53.95± 10.19
Treatment-As-Usual52.88± 12.15
Outpatient Mental Health Treatment Utilization Secondary · 12 Month

Outpatient Mental Health Treatment Utilization was quantified using CPRS. The number of outpatient non-PLF mental health visits from the past three months was counted.

Baseline (3-months pre-treatment)
GroupValue95% CI
Project Life Force17.96± 21.50
Treatment-As-Usual17.53± 15.89
6-months post consent
GroupValue95% CI
Project Life Force45.28± 44.40
Treatment-As-Usual37.82± 30.98
Drug Abuse Screening Test 10 (DAST-10) Secondary · 12 Month

The DAST-10 measures drug use over the past twelve months to identify potential drug use disorder with 10 binary items (0/1). Total scores range from 0 to 10. Scores of 0 indicate no problems, 1-2 low-level, 3-5 moderate level, 6-8 substantial level, and 9-10 severe level.

GroupValue95% CI
Project Life Force4.0± 2.83
Treatment-As-Usual3.57± 3.15
Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) Secondary · 12 Month

The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) is a brief 3-item alcohol screening tool used to identify individuals who may be at risk for hazardous drinking or have an alcohol use disorder. Each item is rated from 0 to 4, and total scores range from 0 - 12. Higher scores indicated an increased likelihood that an individual's drinking is endangering his or her safety.

GroupValue95% CI
Project Life Force1.95± 2.99
Treatment-As-Usual1.62± 2.56
Interpersonal Needs Questionnaire Change Secondary · Baseline, 3 Month, 6 Month, 12 Month

The Interpersonal Needs Questionnaire-15 (INQ-15) consists of 15 items assessing thwarted interpersonal needs along two domains: Thwarted Belongingness (TB, nine items) and Perceived Burdensomeness (PB, six items). All items are rated from one (not at all true for me) to seven (very true for me). Six items from the TB subscale are reverse-keyed and reverse-scored. Items are summed for total scores (TB total score range: 9-63 and PB score range: 6-42). Higher scores indicate increased severity of TB and PB.

Baseline
GroupValue95% CI
Project Life Force38.64± 11.43
Treatment-As-Usual39.11± 12.36
3-month
GroupValue95% CI
Project Life Force33.98± 12.99
Treatment-As-Usual36.18± 13.85
6-month
GroupValue95% CI
Project Life Force33.7± 12.79
Treatment-As-Usual36.20± 13.67
12-month
GroupValue95% CI
Project Life Force32.29± 12.04
Treatment-As-Usual34.73± 14.57
Buss-Perry Aggression Questionnaire Change Secondary · Baseline, 3 Month, 6 Month, 12 Month

The Buss-Perry Aggression Questionnaire (BPAQ) assesses aggression in four domains (anger, hostility, physical aggression, and verbal aggression) with 29 items on a 4-point scale (Extremely uncharacteristic (0) - Extremely characteristic (3)). Items in each domain are summed for domain scores, and higher scores indicate more aggression severity in the respective domain. Total score ranges are: anger: 7-35, hostility: 8-40, physical aggression: 9-45, verbal aggression: 5-25.

Baseline (verbal aggression subscale)
GroupValue95% CI
Project Life Force14.64± 4.87
Treatment-As-Usual15.45± 4.83
3-month (verbal aggression subscale)
GroupValue95% CI
Project Life Force13.56± 4.89
Treatment-As-Usual15.7± 4.83
6-month (verbal aggression subscale)
GroupValue95% CI
Project Life Force13.92± 4.56
Treatment-As-Usual15.41± 5.17
12-month (verbal aggression subscale)
GroupValue95% CI
Project Life Force14.56± 4.74
Treatment-As-Usual14.36± 4.77
Baseline (physical aggression subscale)
GroupValue95% CI
Project Life Force25.96± 8.91
Treatment-As-Usual27.0± 9.02
3-month(physical aggression subscale)
GroupValue95% CI
Project Life Force24.61± 8.93
Treatment-As-Usual27.51± 9.31
6-month(physical aggression subscale)
GroupValue95% CI
Project Life Force24.15± 7.73
Treatment-As-Usual26.93± 9.77
12-month(physical aggression subscale)
GroupValue95% CI
Project Life Force24.35± 9.19
Treatment-As-Usual25.72± 8.51
Insomnia Severity Index Change Secondary · Baseline, 3 Month, 6 Month, 12 Month

The Insomnia Severity Index (ISI) is a 7-item brief screening measure of insomnia. Items include insomnia severity (falling asleep, staying asleep, and waking too early), satisfaction with sleep, the extent to which sleep difficulties impair daily functioning, how noticeable low quality of life due to sleep difficulties is to others, and distress about sleep difficulties. Item responses range from 0 - 4 and are summed for total scores (range 0-28). Higher scores indicate more severe insomnia. The ISI has good internal consistency and validity for treatment research.

Baseline
GroupValue95% CI
Project Life Force18.17± 7.26
Treatment-As-Usual16.98± 7.81
3-month
GroupValue95% CI
Project Life Force14.59± 8.46
Treatment-As-Usual14.88± 8.15
6-month
GroupValue95% CI
Project Life Force13.63± 8.08
Treatment-As-Usual15.15± 8.36
12-month
GroupValue95% CI
Project Life Force13.94± 6.60
Treatment-As-Usual13.63± 8.81
Beck Lethality Scale Change Secondary · 12 Month

The Beck Lethality Scale (BLS) is an interview-administered measure of medical lethality of a suicide attempt for eight possible methods (i.e., coma-producing drugs, non-coma-producing drugs, shooting, burning, drowning, cutting, jumping, and hanging). The BLS was used following suicidal behavior over the full study duration. Each item (i.e., each method) is rated from "0" (none or minimal damage) to "10" (death) based on an examination of the patient's physical condition on admission, review of the medical charts, and consultation with the attending physician. Higher scores on each method ind

GroupValue95% CI
Project Life Force4.41± 4.10
Treatment-As-Usual3.36± 4.45
Beck Suicide Intent Scale Change Secondary · Baseline, 3 Month, 6 Month, 12 Month

The Suicide Intent Scale (SIS) measures the retrospective intensity of the wish to die at the time of a suicide attempt with 20 items. Each item is graded in intensity from 0 to 2, and the first 15 items are summed for a total score (ranging from 0 to 30). Higher scores indicate higher suicide intent. The SIS has high inter-rater reliability and internal consistency.

Baseline
GroupValue95% CI
Project Life Force16.74± 4.55
Treatment-As-Usual16.06± 3.94
3-month
GroupValue95% CI
Project Life Force16.71± 4.42
Treatment-As-Usual16.00± 3.57
6-month
GroupValue95% CI
Project Life Force15.25± 7.27
Treatment-As-Usual15.14± 4.67
12-month
GroupValue95% CI
Project Life Force3.23± 2.41
Treatment-As-Usual17.30± 16.14

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse event data were collected from participant consent date through study completion, average of one year.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Project Life Force
Serious: 31/101 (31%)
Deaths: 1/101
Treatment-As-Usual
Serious: 29/106 (27%)
Deaths: 3/106

Serious adverse events (17 terms)

ReactionSystemProject Life ForceTreatment-As-Usual
Hospitalized inpatient psych unitPsychiatric disorders
Inpatient Psychiatric HospitalizationPsychiatric disorders
Suicide attempt without medical interventionPsychiatric disorders
Heart FailureCardiac disorders
Emergency Department visit for rib painMusculoskeletal and connective tissue disorders
Emergency Department visit for orthopedic concernsMusculoskeletal and connective tissue disorders
Medical hospitalization (unspecified)General disorders
Hospitalized following motor vehicle accidentGeneral disorders
Hospitalized for shoulder surgeryMusculoskeletal and connective tissue disorders
Hospitalized for attempted overdosePsychiatric disorders
Hospitalized for pulmonary embolismRespiratory, thoracic and mediastinal disorders
Emergency Department visit for chest painCardiac disorders
Hospitalized for COVID-19Respiratory, thoracic and mediastinal disorders
Emergency Department visit for tremors and headachePsychiatric disorders
Emergency Department visit for high blood pressureCardiac disorders
Hospitalized for broken hipMusculoskeletal and connective tissue disorders
Hospitalized for knee replacementMusculoskeletal and connective tissue disorders
Other adverse events (13 terms — click to expand)

ReactionSystemProject Life ForceTreatment-As-Usual
Loss of employmentSocial circumstances
Emergency Department visit for back painMusculoskeletal and connective tissue disorders
Emergency Department visit for jaw painMusculoskeletal and connective tissue disorders
Emergency Department visit for cough, headache, chills, feverRespiratory, thoracic and mediastinal disorders
Emergency Department visit for rashSkin and subcutaneous tissue disorders
Increase in suicidal ideation/depressionPsychiatric disorders
Challenges transferring inpatient programsSocial circumstances
Emergency Department visit for blood clot post surgical operationCardiac disorders
Emergency Department visit for COPDRespiratory, thoracic and mediastinal disorders
Emergency Department visit for substance withdrawlPsychiatric disorders
Emergency Department visit for leg painMusculoskeletal and connective tissue disorders
Emergency Department visit for trouble breathing due to air qualityRespiratory, thoracic and mediastinal disorders
Financial hardship and housing insecuritySocial circumstances

Most-reported serious reactions: Hospitalized inpatient psych unit, Inpatient Psychiatric Hospitalization, Suicide attempt without medical intervention, Heart Failure, Emergency Department visit for rib pain, Emergency Department visit for orthopedic concerns, Medical hospitalization (unspecified), Hospitalized following motor vehicle accident.

Data from ClinicalTrials.gov NCT03653637 adverse events section.

Sponsor's own description

The management of suicide risk is a pressing national public health issue especially among Veterans. This grant consists of two arms: the novel treatment and treatment-as-usual. "Project Life Force" (PLF), a novel suicide safety planning group intervention has been developed to provide a mechanism to develop and enhance the Suicide Safety Plan (SSP) over time. PLF, a 10-session, group intervention, combines cognitive behavior therapy (CBT)/dialectical behavior therapy (DBT) skill based, and psychoeducational approaches, to maximize suicide safety planning development and implementation. Veterans revise their plans over several weeks while learning coping, emotion regulation, and interpersonal skills to incorporate into their safety plans.

Publications & conference data

4 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Group-Based Suicide Safety Planning and Skills Training for Veterans With High Suicide Risk: A Randomized Clinical Trial.
    Goodman M, Jager-Hyman S, Monahan M, Glatt S, et al · · 2026 · PMID 42213437 · DOI 10.1001/jamanetworkopen.2026.15029
  2. Do the Beck Depression Inventory-II and Beck Hopelessness Scale reliably capture systematic change and within-person variation? Evidence from generalizability theory.
    Glatt S, Greene AL, Chan CC, Brown GK, et al · · 2026 · PMID 41801754 · DOI 10.1037/pas0001457
  3. The association between aggression and suicidal behaviors in veterans at risk for suicide.
    Krauss A, McCloskey MS, Kurz AS, Ilgen MA, et al · · 2025 · PMID 40483847 · DOI 10.1016/j.jpsychires.2025.06.001
  4. Open Clinical Trials for Veterans With Suicidal Ideation.
    · 2019 · PMID 31772493

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing