Projects
At the heart of our lab’s mission is the integration of suicide prevention and psychotherapy research. Our work brings together the conceptual frameworks, research methods, and insights of both fields, leveraging their cross-fertilization to generate impactful and clinically meaningful findings.
Research on the suicide crisis syndrome
The Suicide Crisis Syndrome (SCS) is a cognitive and affective suicidal mental state proposed by Galynker and colleagues as a suicide-specific diagnosis (Galynker et al., 2017; 2024; 2025; Bloch-Elkouby et al., 2020; 2021; 2023; 2024; 2026; Cohen et al., 2023). Shown to be predictive of imminent risk for suicidal behaviors, the SCS represents the culmination of a cascade of inter- and intrapersonal processes involved in one’s progression from predisposing factors to acute suicidal crises described in the Narrative Crisis Model of Suicide (NCM; Galynker et al., 2017; Cohen et al., 2019; 2020; 2022; Bloch-Elkouby et al., 2020; 2023; 2024). The psychological markers featured in the SCS can be described along five dimensions: feeling entrapped, affective disturbances, loss of cognitive control, hyperarousal, and social withdrawal. To account for the well-documented difficulty individuals experience in sharing their suicidal thoughts, the Suicide Crisis Syndrome does not include self-reported suicidal ideation. In collaboration with the Galynker Suicide Prevention and Research Lab, the Bloch-Elkouby Lab is working on the validation and cultural adaptation of several self-report (SCI-2; Bloch-Elkouby et al., 2021; SCI-2SF, Sarli et al., 2024) and clinician-rated (SCS-C; Bloch-Elkouby et al., 2026) measures to further the field’s understanding of suicidal crises and to enhance risk detection across cultures (Bloch-Elkouby et al., 2026, under review).
Development of a new approach to suicide risk assessment and management
This project strives to combine evidence-based tools in suicide prevention and psychotherapy research to develop a new and integrative approach to suicide risk assessment and intervention. Based on the recently developed Narrative Crisis Model of Suicide (NCM; Galynker, 2017; Bloch-Elkouby et al., 2020; 2023;2024), and the principles of the empirically supported Alliance-Focused Training (AFT; Bloch-Elkouby & Barzilay, 2022; Eubanks et al., 2015; Muran & Eubanks, 2020), this approach promotes a collaborative and de-stigmatizing insight- and self-compassion-oriented framework to talk about suicide, where patients and clinicians work together to co-create an individualized model of patients’ Narrative-Crisis stages while addressing and resolving ruptures in the alliance in real-time.
Enhancing suicide risk assessment among diverse adolescents using virtual human interactions
In recent years, there has been a worrying increase in child and adolescent suicide rates, particularly among individuals with marginalized ethno-racial and gender identities. Funded by the American Foundation for Suicide Prevention Young Investigator grant, this project evaluates the effectiveness of a novel AI-powered clinician training tool, the Virtual Human Interactions (VHI), to enhance clinical training in the assessment of imminent suicidal risk among diverse adolescent populations.
American Foundation for Suicide Prevention Young Investigator grant info
Research on patients’ disclosure and concealment of suicidal ideation
Recent literature shows that a large proportion of patients who made suicide attempts or even died by suicide denied suicidal ideation when inquired by their mental health provider shortly before their attempt or death. In the absence of patient-disclosure, engaging a patient in a collaborative and effective suicide-specific intervention is impossible. Accordingly, this project strives to understand patient, therapist, and patient-therapist interactional factors that impact patients’ decision to disclose suicidal ideation to their providers or to conceal it from them.
Implementing measurement-based care in community mental health settings
Dr. Bloch-Elkouby and the lab have just launched a new routine process and outcome monitoring program at the Max and Celia Parnes Family Psychological and Psychoeducational Services Clinic in collaboration with the Parnes clinic leadership and Drs. Critchfield, Bekes, Schumpf, McGinn, and Zweig from the Clinical PsyD program at Ferkauf. Patients and therapists complete baseline, weekly, monthly, and semester-based measures designed to support their collaborative work and help patients achieve their desired outcomes.
Understanding treatment deterioration and patient-therapist interpersonal dynamics
To understand why some patients experience worsening symptoms or no improvement after undergoing therapy, our research delves into the interpersonal dynamics and the quality of the therapeutic alliance in therapy dyads using mixed-methods analyses. Aiming to uncover the underlying factors contributing to adverse therapy outcomes, this project is crucial for improving therapeutic techniques and strategies, ultimately enhancing their effectiveness and patient well-being.
Exploring alliance ruptures, resolutions, and microaggressions among cross-cultural and white dyads
Although recent research suggests that patients who self-identify as BIPOC underutilize treatment and terminate treatment prematurely, there is a paucity of research investigating the interpersonal dynamics within cross-cultural therapy dyads. This project strives to deepen the field’s understanding of these dynamics, identify obstacles to developing a strong therapeutic alliance, explore ethnoracial microaggressions, and assess their impact on therapy processes and outcomes. To further this aim, the Bloch-Elkouby Lab is developing an observer-based coding scheme to identify ethnoracial microaggressions enacted by patients or therapists during therapy.