Reducing suicide risk in parentally bereaved youth through promoting effective parenting: Testing a developmental cascade model.

Children who experience the death of a parent are at increased risk for suicidality. The Family Bereavement Program (FBP) is a preventive intervention for parentally bereaved families that was found to reduce suicidal thoughts or attempts in parentally bereaved youth up to 6 and 15 years later. In this study, we tested whether FBP-induced improvement in parenting led to changes in multiple factors that prior theory and research implicated in the pathway to suicide risk, namely, aversive self-views, caregiver and peer connectedness, grief, depressive symptoms and emotion suppression. The sample was 244 bereaved youth and their surviving caregiver from 156 families. Families were randomized into the FBP (twelve group-based sessions for parents, youth, and two joint sessions) or literature control condition. Caregivers and youth completed baseline, post-test, 6 years and 15 years follow-up assessments. Results showed that program-induced improved parenting at post-test was associated with reduced aversive self-views and increased caregiver connectedness at 6 years follow-up, and each was in turn associated with reduced suicide risk at 6 and 15 years follow-up. The mediated pathways via aversive self-views remained significant while controlling for the pathways via caregiver connectedness. We discussed the theoretical and clinical implications of the findings.