How Is Therapy for Suicidal Patients Different?

CBT and other common types of therapy work for a lot of mental health issues. However, it was found that it does not work nearly as well for suicidal ideation/behaviour, leading researchers to look for other kinds of therapies that could decrease the risk of suicide.

In this article, you will find how they arrived at collaborative therapy and how it works specifically for suicidal patients.

Usual logic for reducing the risk of suicide is by treating the underlying psychiatric illness, due to the idea that it is the cause for suicidality. However, research shows that risk of suicide does not lower with the lowering of symptoms of the psychiatric illness.

David A Jobes has introduced person-centred collaborative therapy that lets the client collaborate with the psychologist to understand the cause of their suicide risk instead of having the client in a passive role with the therapist being the expert as it has been done previously.

Out of this idea a structured 3 session treatment plan was created called and Attempted Suicide Short Intervention Program (ASSIP). When researched, this program helped reduce suicide risk by 80% in a 2 year follow up.

Another research by Michel and colleagues (also written as et al.) looked into therapeutic alliance between the therapist and the client has shown that the more the client-centred the therapy was, the more positive the outcome of the therapy became.

Later studies such as Gysin-Maillart et al.  and Bryan et al. also found that collaboration helped decrease suicidal ideation following brief therapies.

Lohani looked at specific collaboration techniques between the patient and the clinician like narrative assessment and found that in the 82 participants that he studied who had history of suicide ideation and/or attempts, that these techniques helped to significantly reduce suicidal thoughts.

Fluid Vulnerability Theory has been constructed to understand the concept that long term-based line risk of suicide varies from individual to individual and short term risk is highly determined by aggravating factors. Meanwhile in December of 2009, Rudd and colleagues found that it helps to provide a simple explanations for such models of suicidality to help engage them with treatment.

A more unique way that helped address suicidal thoughts directly was having a play back session where the client and the clinician reflect on the patient’s suicidality. Meerwijk et al. found that this way of directly address suicidal thoughts and behaviour has proven to effectively decrease suicidality within clients.

Through more research several specific elements were identified that helped decrease the risk of suicide, including providing understandable model of suicidality, introducing the concept of the suicidal model and the Fluid Vulnerability Theory that helps understand the variability between individuals and the idea of short-term risks that can aggravate the risk of suicide. The ASSIP uses the suicidal person’s life goals, vulnerabilities and suicide triggers to help understand and directly address the suicidal thoughts.

Conclusion

The most effective way to really decrease the suicide risk of a person is to help them gain personal insight into their personal warning signs and triggers to develop safety strategies to keep safe in the future, which can be done through the person focused interview style therapy that is collaborative.

To do this, modern-day therapists must adapt to practicing collaborative style therapy to create a truly patient-centred approach.