Suicidal IdeationWRITE-SAFENCT07479823
A Text-Based Expressive Writing Program for Adolescents at Risk of Suicide
A study testing Structured Expressive Writing Intervention and Treatment as Usual (TAU) in people with Suicidal Ideation and Suicide Risk, run by Hallym University Medical Center.
Trial summary
The goal of this clinical trial is to learn if a structured expressive writing program can help reduce suicidal thoughts in adolescents and young adults who have experienced suicidal thoughts, suicide attempts, or self-harm. Read more about this study
- Who is it for?
- Ages 13 to 24 years
- Conditions the study is for
- Suicidal Ideation, Suicide Risk, Self-Injurious Behavior
- What is being tested?
- Structured Expressive Writing Intervention and Treatment as Usual (TAU)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 160 participants
- Where
- No sites listed yet
- Study dates
- 1 Apr 2026to Mar 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 13 to 24 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Adolescents or young adults aged 13 to 24 years.
- Individuals with a history of suicidal ideation, suicide attempts, or non-suicidal self-injury.
- Individuals currently receiving mental health services or who have been evaluated as having suicide risk within the past 6 months.
- Ability to read and write in Korean.
- For participants under 19 years of age, both participant assent and parental consent are required.
Who cannot join
- Individuals requiring immediate psychiatric hospitalization.
- Severe intellectual disability or neurodevelopmental disorder that prevents participation in writing activities.
- Acute psychosis or manic episode that would interfere with participation in the study.
- Participation in another suicide prevention clinical trial during the study period.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Effectiveness of a Text-Based Expressive Writing Intervention for Suicidal Adolescents and Young Adults: A Randomized Controlled Trial
The goal of this clinical trial is to learn if a structured expressive writing program can help reduce suicidal thoughts in adolescents and young adults who have experienced suicidal thoughts, suicide attempts, or self-harm. The study will include participants aged 13 to 24 years who are receiving mental health care or have recently been identified as being at risk for suicide.
The main questions the study aims to answer are:
Read more
- Does a structured expressive writing program lower suicidal thoughts compared with usual care alone?
- Does the program improve depression, impulsivity, and self-esteem?
Researchers will compare participants who receive the expressive writing program together with treatment as usual to participants who receive treatment as usual alone.
Participants will:
- Be randomly assigned to one of two groups: a writing program group or a usual care group
- Complete questionnaires about mood, suicidal thoughts, and well-being at the start of the study, after 4 weeks, and after 8 weeks
- If assigned to the writing program group, complete guided writing activities several times per week for 4 weeks. Each writing session will take about 15 to 20 minutes and will focus on understanding emotions, personal experiences, relationships, and meaning in difficult experiences.
Researchers will study whether this writing program is a helpful and practical way to support young people who are experiencing suicidal thoughts or emotional distress.
Read the detailed description
Suicide represents a major public health concern among adolescents and young adults. In South Korea, suicide has consistently ranked as the leading cause of death among individuals aged 10-29 years. Preventive interventions targeting suicidal ideation and early stages of suicide risk are therefore urgently needed.
Existing evidence-based interventions for suicidal behaviors, including dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT), have demonstrated clinical effectiveness but require intensive therapist involvement and specialized training. These characteristics limit their scalability and accessibility in many community and school-based settings.
Expressive writing is a brief psychological intervention originally developed by Pennebaker and colleagues, in which individuals write about emotionally significant experiences. The intervention is believed to promote emotional labeling, cognitive processing, and narrative integration of stressful experiences. Neuropsychological research suggests that labeling emotions may reduce amygdala activation and facilitate regulation through prefrontal cortical mechanisms. Meta-analytic studies have also reported improvements in psychological outcomes among adolescents who engage in expressive writing.
However, randomized controlled trials evaluating expressive writing interventions specifically for adolescents and young adults at risk of suicide remain limited. In addition, most existing interventions are unstructured, which may limit their suitability for high-risk populations.
The present study aims to develop and evaluate a structured text-based expressive writing program designed for adolescents and young adults with suicide risk. The intervention is designed to promote emotional awareness, self-understanding, relational awareness, and meaning reconstruction through guided writing prompts delivered over four weeks.
Participants aged 13-24 years with a history of suicidal ideation, suicide attempts, or non-suicidal self-injury will be recruited from clinical and community settings. After screening and baseline assessment, participants will be randomly assigned to one of two groups:
- Experimental group: 4-week structured expressive writing intervention plus treatment as usual (TAU)
- Control group: TAU alone
Participants in the intervention group will complete guided writing exercises multiple times per week. Each writing session will take approximately 15-20 minutes and will be supported by structured prompts designed to facilitate emotional expression and cognitive processing.
Primary and secondary outcomes will be assessed at baseline, 4 weeks (post-intervention), and 8 weeks (follow-up). The primary outcome is change in suicidal ideation measured using the Beck Scale for Suicide Ideation (BSSI). Secondary outcomes include depressive symptoms, impulsivity, self-esteem, and help-seeking behavior.
The study is designed as a randomized controlled trial with parallel assignment. A total of 160 participants will be enrolled. The findings of this study may contribute to the development of accessible and scalable suicide prevention interventions for adolescents and young adults.
- Being tested
- Structured Expressive Writing Intervention, Treatment as Usual (TAU)
- Keywords
- Expressive Writing, Suicide Prevention, Adolescent Suicide, Self-Harm, Youth Mental Health
- Medical subject headings
- Suicidal Ideation, Self-Injurious Behavior, Suicide Prevention
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Structured Expressive Writing InterventionBehavioural
A structured expressive writing program in which participants complete guided writing sessions several times per week for four weeks. Each session lasts approximately 15 to 20 minutes and focuses on emotional awareness and personal reflection.
Treatment as Usual (TAU)Behavioural
Participants receive the standard mental health care or support services that are normally available during the study period.
| Study group | Role | What they receive |
|---|---|---|
| Expressive Writing Intervention plus Treatment as Usual | Experimental | Participants in this group receive a structured expressive writing intervention in addition to treatment as usual. Receives: Behavioral: Structured Expressive Writing Intervention |
| Treatment as Usual | Active comparator | Participants receive treatment as usual, which may include standard mental health care or counseling services. Receives: Behavioral: Treatment as Usual (TAU) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Suicidal Ideation
Suicidal ideation will be measured using the Beck Scale for Suicide Ideation (BSSI). The outcome measure is the change in BSSI score between baseline and follow-up assessments.
Measured: Baseline, 4 weeks, and 8 weeks
Secondary outcomes (5)
Change in Depressive Symptoms
Depressive symptoms will be measured using the Beck Depression Inventory (BDI). The outcome measure is the change in BDI score between baseline and follow-up assessments.
Measured: Baseline, 4 weeks, and 8 weeks
Change in Impulsivity
Impulsivity will be measured using the Barratt Impulsiveness Scale (BIS-11). The outcome measure is the change in BIS-11 score between baseline and follow-up assessments.
Measured: Baseline, 4 weeks, and 8 weeks
Change in Self-Esteem
Self-esteem will be measured using the Rosenberg Self-Esteem Scale. The outcome measure is the change in self-esteem score between baseline and follow-up assessments.
Measured: Baseline, 4 weeks, and 8 weeks
Change in Alexithymia
Alexithymia will be assessed using the Toronto Alexithymia Scale (TAS-20). The outcome measure is the change in TAS-20 score between baseline and follow-up assessments.
Measured: Baseline, 4 weeks, and 8 weeks
Program Acceptability
Acceptability of the intervention will be assessed using the Acceptability of Intervention Measure (AIM). The measure evaluates participants' perceived acceptability and satisfaction with the intervention.
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Mar 2026
- Study start1 Apr 2026 (estimated)
- Primary completionDec 2027 (estimated)
- Study completionMar 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Suicidal IdeationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two groups: (1) a structured expressive writing intervention plus treatment as usual (TAU), or (2) treatment as usual (TAU) alone. The intervention group will complete guided expressive writing sessions for 4 weeks, while the control group will receive usual care during the study period.
- Masking
- None (open label)
- Enrolment
- 160 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hallym University Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07479823
- Sponsor's protocol ID
- HSHH-2026-EW-RCT
- Acronym
- WRITE-SAFE
- Status last verified
- Mar 2026
- First submitted
- 13 Mar 2026
- Last updated
- 18 Mar 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared due to the sensitive nature of the data and the need to protect participant confidentiality, particularly because the study involves adolescents and suicide-related mental health information.
Study at a glance
From the registry record, last updated by the sponsor on 18 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness of a Text-Based Expressive Writing Intervention for Suicidal Adolescents and Young Adults: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07479823
- Acronym / sponsor ID
- WRITE-SAFE / HSHH-2026-EW-RCT
- Keywords
- Expressive Writing, Suicide Prevention, Adolescent Suicide, Self-Harm, Youth Mental Health
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 160 participants (estimated)
- Lead sponsor
- Hallym University Medical CenterUniversity, hospital or other
- Study start
- 1 Apr 2026 (estimated)
- Primary completion
- Dec 2027 (estimated)
- Study completion
- Mar 2028 (estimated)
- First posted
- 18 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to learn if a structured expressive writing program can help reduce suicidal thoughts in adolescents and young adults who have experienced suicidal thoughts, suicide attempts, or self-harm. The study will include participants aged 13 to 24 years who are receiving mental health care or have recently been identified as being at risk for suicide.
The main questions the study aims to answer are:
- Does a structured expressive writing program lower suicidal thoughts compared with usual care alone?
- Does the program improve depression, impulsivity, and self-esteem?
Researchers will compare participants who receive the expressive writing program together with treatment as usual to participants who receive treatment as usual alone.
Participants will:
- Be randomly assigned to one of two groups: a writing program group or a usual care group
- Complete questionnaires about mood, suicidal thoughts, and well-being at the start of the study, after 4 weeks, and after 8 weeks
- If assigned to the writing program group, complete guided writing activities several times per week for 4 weeks. Each writing session will take about 15 to 20 minutes and will focus on understanding emotions, personal experiences, relationships, and meaning in difficult experiences.
Researchers will study whether this writing program is a helpful and practical way to support young people who are experiencing suicidal thoughts or emotional distress.
Detailed description
Suicide represents a major public health concern among adolescents and young adults. In South Korea, suicide has consistently ranked as the leading cause of death among individuals aged 10-29 years. Preventive interventions targeting suicidal ideation and early stages of suicide risk are therefore urgently needed.
Existing evidence-based interventions for suicidal behaviors, including dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT), have demonstrated clinical effectiveness but require intensive therapist involvement and specialized training. These characteristics limit their scalability and accessibility in many community and school-based settings.
Expressive writing is a brief psychological intervention originally developed by Pennebaker and colleagues, in which individuals write about emotionally significant experiences. The intervention is believed to promote emotional labeling, cognitive processing, and narrative integration of stressful experiences. Neuropsychological research suggests that labeling emotions may reduce amygdala activation and facilitate regulation through prefrontal cortical mechanisms. Meta-analytic studies have also reported improvements in psychological outcomes among adolescents who engage in expressive writing.
However, randomized controlled trials evaluating expressive writing interventions specifically for adolescents and young adults at risk of suicide remain limited. In addition, most existing interventions are unstructured, which may limit their suitability for high-risk populations.
The present study aims to develop and evaluate a structured text-based expressive writing program designed for adolescents and young adults with suicide risk. The intervention is designed to promote emotional awareness, self-understanding, relational awareness, and meaning reconstruction through guided writing prompts delivered over four weeks.
Participants aged 13-24 years with a history of suicidal ideation, suicide attempts, or non-suicidal self-injury will be recruited from clinical and community settings. After screening and baseline assessment, participants will be randomly assigned to one of two groups:
- Experimental group: 4-week structured expressive writing intervention plus treatment as usual (TAU)
- Control group: TAU alone
Participants in the intervention group will complete guided writing exercises multiple times per week. Each writing session will take approximately 15-20 minutes and will be supported by structured prompts designed to facilitate emotional expression and cognitive processing.
Primary and secondary outcomes will be assessed at baseline, 4 weeks (post-intervention), and 8 weeks (follow-up). The primary outcome is change in suicidal ideation measured using the Beck Scale for Suicide Ideation (BSSI). Secondary outcomes include depressive symptoms, impulsivity, self-esteem, and help-seeking behavior.
The study is designed as a randomized controlled trial with parallel assignment. A total of 160 participants will be enrolled. The findings of this study may contribute to the development of accessible and scalable suicide prevention interventions for adolescents and young adults.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two groups: (1) a structured expressive writing intervention plus treatment as usual (TAU), or (2) treatment as usual (TAU) alone. The intervention group will complete guided expressive writing sessions for 4 weeks, while the control group will receive usual care during the study period.
| Arm | Type | Receives |
|---|---|---|
| Expressive Writing Intervention plus Treatment as Usual | Experimental | Behavioral: Structured Expressive Writing InterventionParticipants in this group receive a structured expressive writing intervention in addition to treatment as usual. |
| Treatment as Usual | Active comparator | Behavioral: Treatment as Usual (TAU)Participants receive treatment as usual, which may include standard mental health care or counseling services. |
Who may qualify
- Ages
- 13 to 24 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (5 listed)
- Adolescents or young adults aged 13 to 24 years.
- Individuals with a history of suicidal ideation, suicide attempts, or non-suicidal self-injury.
- Individuals currently receiving mental health services or who have been evaluated as having suicide risk within the past 6 months.
- Ability to read and write in Korean.
- For participants under 19 years of age, both participant assent and parental consent are required.
Key exclusion criteria (4 listed)
- Individuals requiring immediate psychiatric hospitalization.
- Severe intellectual disability or neurodevelopmental disorder that prevents participation in writing activities.
- Acute psychosis or manic episode that would interfere with participation in the study.
- Participation in another suicide prevention clinical trial during the study period.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Structured Expressive Writing InterventionA structured expressive writing program in which participants complete guided writing sessions several times per week for four weeks. Each session lasts approximately 15 to 20 minutes and focuses on emotional awareness and personal reflection. | Behavioural | Expressive Writing Intervention plus Treatment as Usual |
| Treatment as Usual (TAU)Participants receive the standard mental health care or support services that are normally available during the study period. | Behavioural | Treatment as Usual |
Primary outcome
Change in Suicidal Ideation
Time frame: Baseline, 4 weeks, and 8 weeks
Suicidal ideation will be measured using the Beck Scale for Suicide Ideation (BSSI). The outcome measure is the change in BSSI score between baseline and follow-up assessments.
5 secondary outcomes
Change in Depressive Symptoms
Time frame: Baseline, 4 weeks, and 8 weeks
Change in Impulsivity
Time frame: Baseline, 4 weeks, and 8 weeks
Change in Self-Esteem
Time frame: Baseline, 4 weeks, and 8 weeks
Change in Alexithymia
Time frame: Baseline, 4 weeks, and 8 weeks
Program Acceptability
Time frame: 4 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Mar 2026.
- Individual participant dataSharing planned: No. Individual participant data will not be shared due to the sensitive nature of the data and the need to protect participant confidentiality, particularly because the study involves adolescents and suicide-related mental health information.
Related trials for Suicidal Ideation
Recruiting
Effects of Transcranial Direct Current Stimulation (tDCS) in the Management of Suicidal Ideation
Depression and Suicide
Not yet recruitingPhase 2
Intravenous Ketamine for Acute Suicidal Crisis and Psychiatric Hospital Length of Stay
Suicidal Ideation, Suicidal Behavior
Recruiting
Developing a Recovery-Oriented Suicide Prevention Program for Young People at Clinical High Risk for Psychosis
Clinical High Risk for Psychosis (CHR), Suicidal Ideation
Enrolling by invitationObservational study
Cannabis, Neuroinflammation, and Suicidal Ideation: A Supplemental Brain Imaging Study
PTSD, Suicidal Thoughts and Behaviors
Recruiting
Evaluation of a Multi-Layered Digital Phenotyping, Digital Safety Plan, and Pharmacogenomic Intervention for Suicide Prevention in Adults With Depression
Depressive Disorder, Major Depressive Disorder, Suicidal Ideation
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing Structured Expressive Writing Intervention and Treatment as Usual (TAU) in people with Suicidal Ideation and Suicide Risk, run by Hallym University Medical Center.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 18 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Hyun Ju Hong, MD, PhD (82+031-380-1500, honghj88@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Suicidal Ideation (time frame: Baseline, 4 weeks, and 8 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Mar 2026.