Strategies in Treatment of Suicidality: Identification of Common and Treatment-Specific Interventions in Empirically Supported Treatment Manuals
Abstract
OBJECTIVE: Many reports of treatments for suicidal patients claim effectiveness in reducing suicidal behavior but fail to demonstrate which treatment interventions, or combinations thereof, diminish suicidality. In this study, treatment manuals for empirically supported psychological treatments for suicidal patients were examined to identify which interventions they had in common and which interventions were treatment-specific. METHOD: Empirically supported treatments for suicidality were identified through a literature search of PsychLit and MEDLINE for the years 1970-2007, employing the following search strategy: [suicide OR parasuicide] AND [therapy OR psychotherapy OR treatment] AND [random OR randomized]. After identifying the reports on randomized controlled studies that tested effectiveness of different treatments, the reference list of each report was searched for further studies. Only reports published in English were included. To ensure that rated manuals actually correspond to the delivered and tested treatments, we included only treatment interventions with explicit adherence rating and scoring and with adequate adherence ratings in the published studies. Five manualized treatments demonstrating efficacy in reducing suicide risk were identified and were independently evaluated by raters using a list of treatment interventions. RESULTS: The common interventions included a clear treatment framework; a defined strategy for managing suicide crises; close attention to affect; an active, participatory therapist style; and use of exploratory and change-oriented interventions. Some treatments encouraged a multimodal approach and identification of suicidality as an explicit target behavior, and some concentrated on the patient-therapist relationship. Emphasis on interpretation and supportive interventions varied. Not all methods encouraged systematic support for therapists. CONCLUSION: This study identified candidate interventions for possible effectiveness in reducing suicidality. These interventions seem to address central characteristics of suicidal patients. Further studies are needed to confirm which interventions and which combinations thereof are most effective.
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Shame, stigma, the need to maintain esteem within the community, cost, service availability and service suitability are major barriers to help-seeking among Indigenous populations.
“Shame, stigma and the need to maintain esteem within the community are major barriers to help-seeking, as are cost (service or transport), service availability and service suitability [4].”
From The effectiveness of a suicide prevention app for indigenous Australian youths: study protocol for a randomized controlled trial. (2013) · cites this paper as [4]
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- Authors
- Weinberg, I., Ronningstam, E., Goldblatt, M. J., Schechter, M., Wheelis, J., & Maltsberger, J. T.
- Affiliations
- Harvard University (US)
- Corresponding author
- Weinberg, Igor
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2010-06-15
- Volume
- 71
- Issue
- 06
- Pages
- 699-706
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2000877373
- Cited by
- 55
- References
- 54
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 4 · 2016: 5 · 2015: 6 · 2014: 1 · 2013: 5 · 2012: 4
- FWCI
- 6.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- suicidality, suicide prevention, empirically supported treatments, treatment manual, medication adherence, therapeutic relationship, therapist support, emotional attention, multimodal therapy, parasuicide
- MeSH terms
- Suicide Prevention, Behavior Therapy, Mental Disorders, Clinical Protocols, Combined Modality Therapy, Crisis Intervention, Humans, Manuals as Topic, Patient Care Team, Professional-Patient Relations, Psychotherapy, Suicide, Suicide, Attempted, Randomized Controlled Trials as Topic, Treatment Outcome, Outcome Assessment, Health Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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