Cognitive behavioral therapy for suicide prevention (CBT‐SP): Implications for meeting standard of care expectations with suicidal patients

Bryan, Craig J.

doi:10.1002/bsl.2411

Cited by 40 publications

(24 citation statements)

References 43 publications

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“…The efficacy of CT on this independent phenomenon (suicidality) was not completely unexpected (Miller et al, 2017; Rudd et al, 2015; Stanley et al, 2018) given the existence of effective brief variants of CT or CBT for suicide prevention and procedures (Bryan, 2019; Wenzel et al, 2009). Potentially, CT identifies and changes maladaptive cognitions, beliefs such as hopelessness, entrapment, defeat and self‐hatred, and self‐statements that contribute to suicidal behaviors (Bryan, 2019).…”

Section: Discussionmentioning

confidence: 99%

Cognitive therapy and interpersonal psychotherapy reduce suicidal ideation independent from their effect on depression

Bentum

Bronswijk

Sijbrandij

et al. 2021

Depression and Anxiety

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Background Clinical guidelines suggest that psychological interventions specifically aimed at reducing suicidality may be beneficial. We examined the impact of two depression treatments, cognitive therapy (CT) and interpersonal psychotherapy (IPT) on suicidal ideation (SI) and explored the temporal associations between depression and SI over the course of therapy. Methods Ninety‐one adult (18–65) depressed outpatients from a large randomized controlled trial who were treated with CT (n = 37) and IPT (n = 54) and scored at least ≥1 on the Beck Depression Inventory II (BDI‐II) suicide item were included. Linear (two‐level) mixed effects models were used to evaluate the impact of depression treatments on SI. Mixed‐effects time‐lagged models were applied to examine temporal relations between the change in depressive symptoms and the change in SI. Results SI decreased significantly during treatment and there were no differential effects between the two intervention groups (B = −0.007, p = .35). Depressive symptoms at the previous session did not predict higher levels of SI at the current session (B = 0.016, p = .16). However, SI measured at the previous session significantly predicted depressive symptoms at the current session (B = 2.06, p < .001). Conclusions Both depression treatments seemed to have a direct association with SI. The temporal association between SI and depression was unidirectional with SI predicting future depressive symptoms during treatment. Our findings suggest that it may be most beneficial to treat SI first.

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Section: Discussionmentioning

confidence: 99%

Cognitive therapy and interpersonal psychotherapy reduce suicidal ideation independent from their effect on depression

Bentum

Bronswijk

Sijbrandij

et al. 2021

Depression and Anxiety

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“…Generally, mental health specialty providers in all systems were responsible for treatment of patients at risk of suicide, but the specific treatments providers were using were unknown in some health care systems and difficult to discern in others (e.g., differentiating CBT from CBT-SP, and DBT groups from other group-based therapies). Moreover, it was not possible to know exactly what parts of specific therapies patients were receiving (e.g., specific DBT/CBT skills/strategies) (Bryan, 2019;Koerner, 2013). support patients with severe and persistent mental illnesses in outpatient settings (Dieterich et al, 2017).…”

Section: Cognitive Participation and Collective Actionmentioning

confidence: 99%

An implementation evaluation of “Zero Suicide” using normalization process theory to support high-quality care for patients at risk of suicide

Richards

Simon

Boggs

et al. 2021

Implementation Research and Practice

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Background: Suicide rates continue to rise across the United States, galvanizing the need for increased suicide prevention and intervention efforts. The Zero Suicide (ZS) model was developed in response to this need and highlights four key clinical functions of high-quality health care for patients at risk of suicide. The goal of this quality improvement study was to understand how six large health care systems operationalized practices to support these functions—identification, engagement, treatment and care transitions. Methods: Using a key informant interview guide and data collection template, researchers who were embedded in each health care system cataloged and summarized current and future practices supporting ZS, including, (1) the function addressed; (2) a description of practice intent and mechanism of intervention; (3) the target patient population and service setting; (4) when/how the practice was (or will be) implemented; and (5) whether/how the practice was documented and/or measured. Normalization process theory (NPT), an implementation evaluation framework, was applied to help understand how ZS had been operationalized in routine clinical practices and, specifically, what ZS practices were described by key informants ( coherence), the current state of norms/conventions supporting these practices ( cognitive participation), how health care teams performed these practices ( collective action), and whether/how practices were measured when they occurred ( reflexive monitoring). Results: The most well-defined and consistently measured ZS practices (current and future) focused on the identification of patients at high risk of suicide. Stakeholders also described numerous engagement and treatment practices, and some practices intended to support care transitions. However, few engagement and transition practices were systematically measured, and few treatment practices were designed specifically for patients at risk of suicide. Conclusions: The findings from this study will support large-scale evaluation of the effectiveness of ZS implementation and inform recommendations for implementation of high-quality suicide-related care in health care systems nationwide. Plain Language Summary Many individuals see a health care provider prior to death by suicide, therefore health care organizations have an important role to play in suicide prevention. The Zero Suicide model is designed to address four key functions of high-quality care for patients at risk of suicide: (1) identification of suicide risk via routine screening/assessment practices, (2) engagement of patients at risk in care, (3) effective treatment, and (4) care transition support, particularly after hospitalizations for suicide attempts. Researchers embedded in six large health care systems, together caring for nearly 11.5 million patients, are evaluating the effectiveness of the Zero Suicide model for suicide prevention. This evaluation focused on understanding how these systems had implemented clinical practices supporting Zero Suicide. Researchers collected qualitative data from providers, administrators, and support staff in each system who were responsible for implementation of practices supporting Zero Suicide. Normalization process theory, an implementation evaluation framework, was applied following data collection to: (A) help researchers catalog all Zero Suicide practices described, (B) describe the norms/conventions supporting these practices, (C) describe how health care teams were performing these practices, and (D) describe how practices were being measured. The findings from this evaluation will be vital for measuring the effectiveness of different Zero Suicide practices. This work will also provide a blueprint to help health care leaders, providers, and other stakeholders “normalize” new and existing suicide prevention practices in their own organizations.

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“…Awareness programs for warning signs can also assist in the prevention of SH. Integrating cognitive behavioural therapy (CBT) can be facilitative in the prevention of SH, particularly in the youth (44). Likewise, incorporating social skills building in the curriculum, and initiating school health and peer support programs could be bene cial.…”

Section: Conclusion and Recommendationsmentioning

confidence: 99%

Characteristics of Individuals with Self-Harm: A Retrospective Descriptive Study from Karachi, Pakistan

Tharani

Farooq

Ali

et al. 2021

Preprint

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Background: Self-Harm (SH) is a major global public health problem which is under-researched in Pakistan. A prior act of self-harm is one of the strongest predictors of future suicide.Method: This retrospective descriptive study describes the characteristics of SH cases (n=350) that presented to a tertiary care teaching hospital in Karachi, Pakistan, from January 2013 to December 2017. Details related to demography, history, associated factors, access to methods used, and intent to die were collected on a structured proforma and analysed using STATA version 14. Results: It was found that self-harm acts were twice as more common in females than in males. More than half of the reported cases were in the age group 20-39 years. Drug overdose and use of insecticides were the two most common methods used in both genders. Depression was identified in nearly half of the reported SH cases. Intention to die was found to be 3 times greater among patients with psychiatric illness as compared to those with no history of psychiatric illness. Conclusion: This study suggests that limiting access to lethal means, regulating over-the-counter sale of medications, and safe storage of pesticides can possibly serve as effective measures to minimize self-harm incidences. Moreover, integration of suicide assessment and prevention programmes for the general population is also suggested.

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Cognitive behavioral therapy for suicide prevention (CBT‐SP): Implications for meeting standard of care expectations with suicidal patients

Cited by 40 publications

References 43 publications

Cognitive therapy and interpersonal psychotherapy reduce suicidal ideation independent from their effect on depression

Cognitive therapy and interpersonal psychotherapy reduce suicidal ideation independent from their effect on depression

An implementation evaluation of “Zero Suicide” using normalization process theory to support high-quality care for patients at risk of suicide

Characteristics of Individuals with Self-Harm: A Retrospective Descriptive Study from Karachi, Pakistan

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