Two models of suicide treatment: evaluation and recommendations

Treating suicidal patients is one of the most stressful aspects of psychotherapeutic work. This paper describes and evaluates two models of therapy with suicidal patients. The crisis-intervention model, which assumes suicidal feelings are acute and suicide is preventable; and the continuing-therapy model, which emphasizes chronic suicidal feelings and posits that suicide is not preventable. Ethical and legal issues as well as treatment strategies from each model are described. Both therapy models stress the importance of assessing, understanding, and validating the patient's feelings as well as establishing a good therapeutic relationship. The crisis intervention model recommends an active, directive intervention while the continuing therapy model emphasizes ongoing therapy principles. After reviewing the different models, this article concludes that the assumptions of the crisis-intervention model are not supported while those of the continuing-therapy model are. In addition, it is concluded that there are more therapeutic advantages to employing the continuing-therapy model. These include taking short-term risks to acquire long-term gain, treating the patient as a responsible adult and seeing the suicidal behavior in the context of the total personality.