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The case against no-suicide contracts: the commitment to treatment statement as a practice alternative
M David Rudd1, Michael Mandrusiak, Thomas E Joiner
1Department of Psychology & Neuroscience, Baylor University, TX 97334, USA. M_Rud@baylor.edu
Journal of Clinical Psychology
|December 13, 2005
Summary
No-suicide contracts lack empirical support and present significant conceptual and practical issues in clinical settings. Researchers suggest commitment to treatment statements as a viable alternative for patient care.
Area of Science:
- Clinical Psychology
- Psychiatry
- Healthcare Policy
Background:
- No-suicide contracts are frequently used in clinical practice despite limited evidence.
- Previous literature includes conceptual debates, surveys, and some empirical studies on their utility.
Purpose of the Study:
- To critically review the existing literature on no-suicide contracts.
- To evaluate the conceptual, practical, and empirical basis for their use.
- To propose an alternative clinical intervention.
Main Methods:
- Comprehensive literature review of conceptual discussions, patient and clinician surveys, and empirical studies.
- Analysis of the evidence regarding the effectiveness and limitations of no-suicide contracts.
Main Results:
- No-suicide contracts exhibit numerous conceptual, practical, and empirical deficiencies.
- There is a significant lack of empirical evidence supporting the effectiveness of no-suicide contracts in clinical practice.
Conclusions:
- No-suicide contracts are not empirically supported and pose significant problems for clinical utility.
- The commitment to treatment statement is presented as a recommended, evidence-informed alternative practice.