Brief Cognitive-Behavioral Therapy to Mitigate Subacute Suicidal Ideation Among Youth

There is a critical need to develop brief, scalable interventions for youth that can facilitate accessible, cost-efficient, and least-restrictive support, while addressing key drivers of suicidal ideation (SI). We present an overview of a novel cognitive-behavioral therapy module which targets perceived burdensomeness toward others (PB), an established driver of SI. Empirical work indicates that PB precipitates SI and is modifiable in youth. Hence, the primary aims of the module are to decrease levels of PB and downstream SI in youth who present with subacute suicidal ideation (i.e., SI not requiring intensive, restrictive services). The four sections of the Give to Others (GO) module include (1) rapport-building and an introduction to the cognitive triangle, (2) identification of burden-related thoughts and cognitive restructuring strategies, (3) a social contribution (or "give to others") activity for teens, and (4) a parent message activity related to youth social contribution. This paper provides guidance to clinicians treating youth with subacute SI for whom there are limited brief evidence-based manualized protocols. The acceptability and feasibility of the module in the management of subacute SI is promising, with additional outcome data collected in an ongoing randomized controlled trial.