Psychotherapy with Suicidal People: The Commonalities

Abstract

This review article outlines the research basis for an effective approach to psychotherapy with suicidal people. It answers the question, "Is psychotherapy effective with suicidal people?" Based on the notable historical publications and the most recent (Lambert, 2004), it is shown that psychotherapy works, largely because there are commonalities (i.e., common factors) that may be the overriding important factor in all forms of psychotherapy. The therapeutic relationship is primary; this and other common factors are illustrated with suicidal people. Patient qualities, therapist qualities, and a multi-modal or multi-component approach are reviewed. On an empirical basis, it is concluded that one has to be person-centered (or patient centered): You have to know whom you are treating.

Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide

“…The study therapist integrated the participant's suicide risk and resiliency factors into interpersonally-informed individualized case conceptualizations, a process not explicitly described in standard IPT manuals [7,25]. Central to psychotherapeutic intervention with suicidal individuals is the amelioration of intense psychological pain [38,39]. Using core IPT techniques of interpersonal incident analysis and communication analysis, participants were helped to clarify factors contributing to their psychological pain and to improve the expression of their interpersonal needs and help alleviate despair.…”

The model of dynamic balance in therapists' experiences and views on working with suicidal clients: A qualitative study

“…Within the necessary knowledge, attitudes, skills, use of methods and techniques (Rudd, Joiner, & Rajab, 2001), it is relevant to explore professionals' attitudes and subjective experiences of working with suicidal clients, such as emotional responses (Barzilay et al, 2018), experienced difficulties (Rothes, Henriques, Leal, & Lemos, 2014) and therapeutic alliance with suicidal clients (Dunster-Page, Haddock, Wainwright, & Berry, 2017;Jobes & Ballard, 2011;Leenaars, 2006), as these are likely to influence their professional practice directly as well as indirectly, through personal well-being.…”

“Will you treat me? I'm suicidal!” The effect of patient gender, suicidal severity, and therapist characteristics on the therapist's likelihood to treat a hypothetical suicidal patient

“…Different methods of therapy, such as cognitive–behavioural therapy, problem‐solving therapy, and interpersonal psychotherapy, have been proved to be effective in treating suicide and reducing suicidal behaviour, ideation, and suicide attempts. Dialectical behaviour therapy was found to be the most well‐documented and efficient treatment (Leenaars, ; Linehan et al, ; Mann et al, ; Schwartz‐Lifshitz, Zalsman, Giner, & Oquendo, ). Researchers and clinicians emphasize the importance of the therapeutic alliance (Schechter, Goldblatt, & Maltsberger, ) and the clinician's empathy and emotional reaction as playing key roles in treating suicidal patients (Bar‐Sade, ; Gvion & Fachler, ;Leenaars, ; Orbach, ) as well as on treatment outcomes (Rossberg, Karterud, Pedersen, & Friis, ).…”