Evidence Based Suicide Prevention Psychotherapy

If you were seeking a therapist to provide treatment to your loved one, when they were suicidal, would you want to know that they were following evidence based care? Would you want to know that the intervention was indicated as having the greatest potential for preventing suicide? The truth is, that not all psychotherapies have the same evidence behind them. This can be a confusing topic for many clinicians (and clients alike). It has been a common misperception that if you treat symptoms of depression, the thoughts of suicide will resolve – but how often have you heard stories that someone was ‘getting better’ when they took their life?

Research has demonstrated that ‘direct’ treatment approaches – those that specifically focus on a person’s suicidality – achieve better clinical outcomes for clients by way of reduced suicide related outcomes, over ‘indirect’ treatment approaches, which may improve symptoms of a psychological disorder, but not behaviours such as suicidality.

‘Direct’ psychotherapeutic treatment should be undertaken by appropriately trained and qualified clinicians, who may be Psychologists, Psychiatrists or other mental health clinicians with endorsement in counselling therapies. Of the ‘direct’ therapies that have undergone Randomised Clinical Trials, there are only three that have demonstrated clinically significant improvments for clients reporting suicidality;

• Dialectical Behaviour Therapy (DBT)
• Suicide Prevention – Cognitive Behavioural Therapy
• Collaborative Assessment and Management of Suicidality (CAMS)

These treatments focuses on a person’s desire for death, their suicidal ideation and suicidal behaviours, working with them to learn strategies to cope with those thoughts and behaviours. Although ‘indirect’ treatment may achieve reductions in distress that may co-exist with suicidality, it has not consistently demonstrated reductions in suicidality of the power described by the direct psychotherapies. Evidence has demonstrated that safety from suicide is only reliably achieved in the immediate term, when suicidality was directly targeted (Meerwijk, et al., 2016).  Indirect therapies were found to offer benefit only in the longer term, with 1.5 times greater potential for death by suicide in the immediate term when compared with those receiving ‘direct’ treatment methodologies. We are pleased that there is ongoing research into interventions such as Acceptance and Commitment Therapy, however, at present there is insufficient research of sound methodological rigour to demonstrate it is as effective as DBT, SP-CBT or CAMS (Calati & Courtet, 2016).

Join Our Register!

If you are a therapist that has been trained in either DBT, SP-CBT or CAMS, and you would like to join our Suicide Prevention Psychotherapist Register, please download the SP Register EOI form and send it to admin@suicideriskasessment.com.au. To join our register is free, whereby we aim to support practitioners and families across Australia in accessing practitioners skilled and knowledgeable in responding to suicidality.