Engaging suicidal youth in outpatient treatment: theoretical and empirical underpinnings

Suicidal and non-suicidal self-injurious behaviors are pernicious and highly prevalent among youth worldwide. Studies confirm that engaging suicidal youth in outpatient treatment is a challenge for most therapists and that a substantial number of suicidal youth never follow through with treatment referrals received in emergency departments and eventually re-attempt suicide. The treatment engagement literature for suicidal youth has largely focused on identifying empirical correlates of attendance and testing interventions to increase compliance. In an effort to promote the use of theory in this field, this article employs Staudt's (2007) conceptual model of the treatment engagement process to both organize the empirical literature and to explain specific treatment engagement and retention strategies used in dialectical behavior therapy for suicidal adolescents. Recommendations for future research are offered.