Cognitive-Behavioral Therapy for Suicide Prevention (CBT-SP): Treatment Model, Feasibility, and Acceptability

• NCJ Number: 228677
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 48 Issue: 10 Dated: October 2009 Pages: 1005-1013
• Author(s): Barbara Stanley, Ph.D.; Gregory Brown, Ph.D.; David A. Brent, M.D.; Karen Wells, Ph.D.; Kim Poling, L.C.S.W.; John Curry, Ph.D.; Betsy D. Kennard, Psy.D.; Ann Wagner, Ph.D.; Mary F. Cwik, Ph.D.; Anat Brunstein Klomek, Ph.D.; Tina Goldstein, Ph.D.; Benedetto Vitiello, M.D.; Shannon Barnett, M.D.; Stephanie Daniel, Ph.D.; Jennifer Hughes, B.A.
• Date Published: October 2009
• Length: 9 pages
• Grant Number(s): MH66750; MH66769; MH66762; MH66775; MH66778
• Sponsoring Agency: National Institute of Mental Health
• Publication Format: Article
• Publication Type: Program/Project Evaluation
• Language: English
• Country: United States of America

Annotation

This article describes the components of a manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) and assesses its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide.

Abstract

The CBT-SP focuses on developing skills (cognitive behavioral, and interactional skills) that enable the adolescent to refrain from further suicidal behavior. CBT-SP anticipates that the adolescent will use a more effective means of coping when faced with stressors and problems that trigger suicidal crises. Parents meet with the therapist for family sessions that focus on suicide risk-reduction strategies. The CBT-SP is based on a stress-diathesis model of suicidal behavior. The diathesis for suicidal behavior includes a combination of factors, such as sex, religion, familial and genetic components, childhood experiences, and psychosocial support system. In this model, stressors trigger suicidal behavior in the context of an individual who possesses the diathesis. Stressors include a variety of psychosocial events, such as interpersonal conflict and work-related or school-related stressors. The CBT-SP acts to modify reactions to stressors both acutely and chronically in the context of vulnerability. This article provides detailed descriptions of the features of CBT-SP in the initial phase of acute treatment, the middle phase of acute treatment, and the end of acute treatment and continuation phase. The treatment involves a 12-week acute phase and a continuation phase over a 6-month period of contact. The results of the treatment show that CBT-SP is a feasible treatment that is acceptable to patients. The retention of patients, despite the difficult conditions of the patient population, was high. The majority of patients remained in therapy long enough to receive the essential components of the treatment; however, many patients terminated during the continuation phase. The tapering of treatment in the continuation phase seemed to contribute to patients' decision to leave treatment. 4 tables and 35 references