Preliminary Evaluation of Implementation and Effectiveness of the Relational Suicide Intervention Pilot

Although primary interventions for suicidal ideation typically focus on individuals, couple-based clinical interventions for this population remain underdeveloped. Despite emerging evidence suggesting that relational interventions may improve suicidal ideation, currently only one couple-based intervention has preliminary evidence, and it was specifically designed for military couples. This gap highlights the need for systemic couple-based interventions in outpatient settings. We piloted the Relational Suicide Intervention (RSI), a four-session intervention grounded in Integrative Systemic Therapy and contemporary suicidology research, at a university clinic. Sixteen graduate student therapists consented to participate and received training in the intervention. Of four couples screened, three met eligibility criteria, consented, and completed the study. We used a mixed-methods approach to evaluate qualitative and quantitative data. Findings provided preliminary support for the safe and feasible implementation of RSI in this small pilot sample. Relationship satisfaction showed small average increases, particularly among partners with higher suicidal ideation, whereas suicidal ideation did not improve on average. Participants generally described the intervention as helpful, particularly regarding suicide safety planning, understanding relationship patterns, and learning mental health coping strategies. These preliminary findings suggest promise for RSI, with future research needed to replicate findings with larger samples, diverse clinical settings, and longer treatment durations comparable to traditional couple therapy.