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Working With the Suicidal Client Who Also Abuses Substances.

Christianne Esposito-Smythers1, Adam Walsh, Anthony Spirito

  • 1George Mason University and Brown University Center for Alcohol & Addiction Studies.

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Summary

Integrated cognitive behavioral treatment (CBT) shows promise for co-occurring substance use disorders and suicidal behaviors in adults and adolescents. This approach offers a framework for effective case conceptualization and treatment planning.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Science

Background:

  • Substance use disorders (SUDs) and suicidal thoughts/behaviors frequently co-occur in psychiatric populations.
  • Evidence for treating this dual diagnosis is limited, but integrated approaches show promise.

Purpose of the Study:

  • To review evidence-based interventions for co-occurring SUDs and suicidality in adults and adolescents.
  • To present a conceptual framework (S-O-R-C) for case conceptualization and treatment planning.
  • To illustrate integrated cognitive behavioral treatment (CBT) application through a case example.

Main Methods:

  • Literature review of interventions for co-occurring SUDs and suicidal behaviors.
  • Development of the S-O-R-C conceptual framework.
  • Detailed case example applying integrated CBT.

Main Results:

  • Integrated CBT protocols, or those heavily utilizing CBT techniques, demonstrate potential efficacy.
  • The S-O-R-C framework can guide clinical decision-making for complex cases.
  • A case example highlights the practical application of integrated CBT for co-occurring alcohol use disorder and suicidal behavior.

Conclusions:

  • Integrated CBT protocols offer a promising avenue for treating individuals with co-occurring suicidality and SUDs.
  • Prioritizing treatment targets and skill selection is crucial for individualized care.
  • Further research is recommended to expand the evidence base for these integrated treatments.