A CBT-Based Psychoeducational Intervention for Suicide Survivors: A Cluster Randomized Controlled Study
Abstract
Background: Bereavement following suicide is associated with an increased vulnerability for depression, complicated grief, suicidal ideation, and suicide. There is, however, a paucity of studies of the effects of interventions in suicide survivors. Aims: This study therefore examined the effects of a cognitive behavioral therapy (CBT)-based psychoeducational intervention on depression, complicated grief, and suicide risk factors in suicide survivors. Method: In total, 83 suicide survivors were randomized to the intervention or the control condition in a cluster randomized controlled trial. Primary outcome measures included maladaptive grief reactions, depression, suicidal ideation, and hopelessness. Secondary outcome measures included grief-related cognitions and coping styles. Results: There was no significant effect of the intervention on the outcome measures. However, the intensity of symptoms of grief, depressive symptoms, and passive coping styles decreased significantly in the intervention group but not in the control group. Conclusion: The CBT-based psychoeducational intervention has no significant effect on the development of complicated grief reactions, depression, and suicide risk factors among suicide survivors. The intervention may, however, serve as supportive counseling for suicide survivors.
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The other three studies were conducted in the Netherlands, Australia, and Belgium.
“The other three were conducted in the Netherlands [41, 42], Australia [43], and Belgium [44].”
Five studies had a passive control group (no intervention).
“Five studies had a passive control group (i.e., no intervention) [36, 38, 39, 43, 44].”
Three studies evaluated family-oriented interventions, and two examined individual interventions.
“Three studies evaluated family-oriented interventions [38, 41, 42, 44], and two examined individual interventions [37, 40].”
A study assessing the effects of an intervention based on CBT and psycho-education on complicated grief found reduced depression and passive coping styles in the intervention group, although no differences were found regarding depression at eight-month follow-up.
“A study assessing the effects of an intervention based on CBT and psycho-education on complicated grief found reduced depression and passive coping styles in the intervention group, although no differences were found regarding depression at eight-month follow-up [44].”
Wittouck et al. found that grief reduced in the intervention group, but no differences were found on the development of complicated grief eight months after the intervention.
“Although grief reduced in the intervention group, no differences were found on the development of complicated grief eight months after the intervention.”
Wittouck et al. found no statistically significant differences between study groups regarding suicidal ideation either immediately after completion of therapy or eight months post intervention.
“Wittouck et al. [44] found no statistically significant differences between study groups regarding suicidal ideation either immediately after completion of therapy or eight months post intervention.”
Two studies that tested CBT-based interventions targeting complicated grief yielded some positive short-term results.
“Two studies that tested CBT-based interventions targeting complicated grief, such as an intervention with psycho-education [44] and targeted complicated grief therapy [40], yielded some positive short-term results.”
Particular interventions were related to particular positive outcomes, e.g., a group therapy for children, CBT-based psycho-educational intervention, and group psychotherapy for widows, found significant reductions in depression.
“Particular interventions were related to particular positive outcomes, e.g., a group therapy for children [38], CBT-based psycho-educational intervention [44], and group psychotherapy for widows [34], found significant reductions in depression.”
These three studies were relatively recent RCTs and evaluated effectiveness of a CBT-based psychotherapy intervention.
“Of interest, these three studies were relatively recent RCTs and evaluated effectiveness of a CBT-based psychotherapy intervention [40, 41, 44].”
The ineffective interventions with a passive comparator comprised shorter interventions (one and four sessions, respectively), and focused on complicated grief.
“The ineffective interventions with a passive comparator [43, 44] comprised shorter interventions (one and four sessions, respectively), and focused on complicated grief [44].”
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- Authors
- Wittouck, C., Van Autreve, S., Portzky, G., & van Heeringen, K.
- Affiliations
- Ghent University (BE)
- Unit for Suicide Research, Department of Psychiatry and Medical Psychology, Ghent University, Belgium
- Venue
- Crisis
- Publisher
- Hogrefe Publishing Group
- Published
- 2014-05-01
- Volume
- 35
- Issue
- 3
- Pages
- 193-201
- ISSN
- 0227-5910 (ISSN-L)
- 2151-2396
- OpenAlex
- W1792813837
- Cited by
- 49
- References
- 37
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 3 · 2019: 7 · 2018: 1 · 2017: 5 · 2016: 5 · 2015: 2
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Crisis (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Keywords
- suicide survivors, complicated grief, depression, suicidal ideation, suicide risk factors, hopelessness, cognitive behavioral therapy, psychoeducational intervention, supportive counseling
- MeSH terms
- Suicide Prevention, Female, Humans, Male, Middle Aged, Patient Education as Topic, Risk Factors, Suicide, Suicide, Attempted, Cognitive Behavioral Therapy, Survivors, Suicidal Ideation
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