"Life doesn't make any sense without interdependence. We need each other, and the sooner we learn that, the better for us all."
-Erik Erikson
How Can
We Help
As Physical and Mental Health Treatment and Rehabilitation Providers?
There are best practices and multiple evidence-based interventions we can use when working with chronically suicidal clients. Below is a list of commonly used treatments and reasons why they can be effective with chronic suicidality.
EARLY INTERVENTION
If a client comes to the agency and displays any of the symptoms or risk factors of suicidality, it is important to direct the client to their counselor or medication management provider for a full risk assessment. They should be treated with compassion and patience. Everyone has a life worth living.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is based on the premise that the schemas or mental representations we develop as children and into our adulthood influence how we see the world, as well as our mental health. The theory behind CBT posits that when individuals have distorted thoughts- such as in the form of all-or-nothing thinking, catastrophizing, jumping to conclusions, or overgeneralization- this can negatively impact one's mental health, leading to symptoms of depression, anxiety, and more. For individuals who think about suicide regularly, it is a response to excessive mental and emotional suffering that can be fueled by negative thought patterns and the belief that the pain cannot be tolerated. Cognitive Behavioral Therapy- Suicide Prevention (CBT-SP) is a rendition of CBT specifically designed for adolescents who experience chronic and acute suicidality. Main goals include reducing risk factors, improving coping, and prevention of suicide-related behaviors (Stanley et al., 2009).
Dialectical Behavior Therapy
Dialectical behavior therapy (DBT), developed by psychologist Marsha Linehan, is a therapy founded on the principle of the dialectic, or the idea that two seemingly opposing forces or truths can exist at the same time. It challenges the notion that one cannot feel positive emotions and cope well while also having mental or emotional distress at the same time. Dr. Linehan encourages clients to develop a life worth living and recover a sense of purpose. This type of intervention was essentially created for people with borderline personality disorder but has been found to be effective for a range of other mental health symptoms. It was also intended for treating chronic suicidality. This therapy is implemented through the use of a manual with four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The emotion regulation and distress tolerance skills are especially efficacious for tolerating difficult emotions and experiences.
Collaborative Assessment and Management of Suicidality
Collaborative Assessment and Management of Suicidality (CAMS) is a theoretical framework that entails risk assessment and treatment for suicidality. It is a versatile style of treatment that can be used in combination with any other theoretical framework. With this style of therapy, the client has a significant role in their own plan of treatment and the risk assessment process. Directness, respect, empathy, and non-judgment from the the counselor is crucial in their philosophy. CAMS has been shown to be effective and reliable for decreasing suicidal ideation, hopelessness, depression, and overall distress (CAMS-care, 2021).
Other Therapies
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Mentalization-Based Treatment
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Problem-Solving Therapy
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Psychodynamic Interpersonal Therapy
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Transference-Focused Psychotherapy (Yager & Feinstein, 2017)
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Minfulness-Based Cognitive Therapy
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Cognitive Behavioral Analysis System of Psychotherapy (Forkmann et al., 2016)