title: Engagement and retention of suicide attempters in clinical research: challenges and solutions.
abstract: BACKGROUND
  High attrition rates in longitudinal research can limit study generalizability, threaten internal validity, and decrease statistical power. Research has demonstrated that there can be significant differences between participants who complete a research study and those who drop out prematurely, and that treatment outcomes may be dependent on retention in a treatment protocol.
  
  
  OBJECTIVE
  The current paper describes the challenges encountered when implementing a randomized controlled trial of cognitive therapy for the prevention of suicide attempts and the solutions developed to overcome these problems.
  
  
  METHODS
  Problems unique to suicide attempters are discussed, and strategies successfully implemented to boost retention rates are provided.
  
  
  RESULTS
  The methods implemented appeared to increase retention rates in the randomized controlled trial.
  
  
  CONCLUSIONS
  Many steps can be taken to work with this difficult population, and researchers are encouraged to be as involved and flexible with participants as possible.
authors.affiliation: Yale University School of Medicine, Department of Psychiatry and VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Carly J
authors.initials: CJ
authors.lastname: Gibbons
authors.forename: Shannon Wiltsey
authors.initials: SW
authors.lastname: Stirman
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Brown
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Beck
mesh_terms: D000223:Adaptation, Psychological; D001071:Appointments and Schedules; D019090:Case Management; D015928:Cognitive Behavioral Therapy; D003219:Confidentiality; D004636:Emergency Service, Hospital; D006297:Health Services Accessibility; D006785:Hospitals, University; D006801:Humans; D008137:Longitudinal Studies; D010352:Patient Dropouts / Q000523:psychology*; D018579:Patient Selection; D010865:Pilot Projects; D011340:Problem Solving; D016032:Randomized Controlled Trials as Topic; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology*