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Behavioural therapy of suicidality
1LVR-Klinik, Abteilung Abhängigkeitserkrankungen, Wilhelm-Griesinger-Str 23, 51109 Cologne, Germany. B.Schneider@lvr.de
Abstract:
Suicidal behaviour is a serious public health issue. Suicidal behaviour includes completed suicide, suicide attempts, suicidal intent and/or plans and suicide ideation. Two prominent mechanisms, behavioural deficits, in particular poor problem-solving skills, and a certain cognitive style with overgeneralization, distortion and lack of positive expectations, have been identified in suicidal patients so far. Besides general therapy strategies, including the diagnostic process and a collaborative, confident relationship and strengthening of protective factors, specific behavioural strategies should aim at the modification of the behavioural repertoire and of cognitive strategies. The modification of the behavioural repertoire includes the direct modification of the behaviour, acquiring techniques for stress reduction and learning problem-solving strategies. Applied cognitive techniques comprise such as thought-stopping, examining options and alternatives, fantasizing consequences, externalizing inner voices, and reattribution. Psychotherapy with suicidal patients has a specific feature: It requires high activity of the therapist in terms of motivation and guidance of the patient. Regular assessment of the suicide risk at every session is a must. Nevertheless, the therapist should always be aware that it is impossible to prevent all suicidal acts.
Insights
Suicidal behavior, a public health concern, involves deficits in problem-solving and negative cognitive styles. Therapy focuses on modifying behaviors and cognitive strategies to mitigate suicide risk.
Area of Science:
- Psychiatry
- Public Health
- Clinical Psychology
Background:
- Suicidal behavior is a significant public health issue encompassing suicide, attempts, intent, and ideation.
- Identified mechanisms include behavioral deficits, particularly poor problem-solving skills, and specific cognitive styles characterized by overgeneralization and negative expectations.
Purpose of the Study:
- To outline therapeutic strategies for suicidal patients.
- To detail specific behavioral and cognitive interventions for modifying maladaptive patterns.
Main Methods:
- General therapy strategies: diagnostic process, collaborative relationship, strengthening protective factors.
- Specific behavioral strategies: direct behavior modification, stress reduction techniques, problem-solving skills training.
- Applied cognitive techniques: thought-stopping, examining alternatives, consequence fantasizing, externalizing inner voices, reattribution.
Main Results:
- Therapy requires active therapist involvement in patient motivation and guidance.
- Regular assessment of suicide risk in every session is crucial.
- Despite interventions, complete prevention of all suicidal acts remains impossible.
Conclusions:
- Effective psychotherapy for suicidal patients necessitates a combination of general and specific behavioral and cognitive strategies.
- Active therapist engagement and consistent risk assessment are paramount.
- Acknowledging the limitations in preventing all suicidal acts is essential for realistic therapeutic goals.
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