Utilizing the couple relationship to prevent suicide: A preliminary examination of Treatment for Relationships and Safety Together

Abstract

Objective: To evaluate the feasibility, preliminary effects, and acceptability of the first comprehensive couple-based treatment for suicide, called Treatment for Relationships and Safety Together (TR&ST). Method: In a preliminary examination, five couples (N = 10) participated in 10 weekly sessions of TR&ST. All couples included a veteran who reported active suicidal ideation at baseline and their partner. Couples completed measures of relationship functioning, perceived burdensomeness, thwarted belonging, and suicidal ideation at baseline, midtreatment, and posttreatment. Results: TR&ST was feasible to deliver. Veteran and partner relationship functioning improved and veteran perceived burdensomeness, thwarted belonging, and suicidal ideation decreased. There were no suicide related behaviors, hospitalizations, or crisis line calls during the study. TR&ST seemed acceptable to couples (100% retention and high satisfaction ratings). Conclusion: Couple-based suicide prevention may provide an additional avenue for suicide prevention in veterans.

Characteristics of Seekers of Couple Therapy for Alcohol Use or Gambling Disorder

“…The factors of thwarted belongingness and perceived burdensomeness have been posited to be causes of suicidality, 43 hence couple therapy to rebuild connection and mutual understanding in couples should be researched as a viable intervention to prevent and reduce suicidality. In a recent purportedly first comprehensive couple‐based suicide‐specific intervention study with 5 veterans and their partners, results showed improved couple relationship and decreased perceived burdensomeness, thwarted belonging, and suicidal ideation, suggesting the feasibility and acceptability of a couple-based suicide prevention as an additional avenue for suicide prevention in veterans 46 . The potential of using couple-based interventions in suicide prevention warrants further examination and research.…”

“…In a recent purportedly first comprehensive couple-based suicide-specific intervention study with 5 veterans and their partners, results showed improved couple relationship and decreased perceived burdensomeness, thwarted belonging, and suicidal ideation, suggesting the feasibility and acceptability of a couple-based suicide prevention as an additional avenue for suicide prevention in veterans. 46 The potential of using couple-based interventions in suicide prevention warrants further examination and research.…”

Experiences and needs of adult informal carers of adults at risk of suicide: A systematic review with mixed methods analysis

“…These interventions should be tailored to context and needs, with family interventions being flexible enough to attend to the various roles within the family, the adult–adult dynamic, and differing experiences and perspectives. Research aiming to develop effective couple interventions which incorporate these elements is beginning to emerge (Khalifian et al., 2022), however current family‐based interventions are predominantly tailored to families where the suicidal individual is an adolescent (Ougrin et al., 2015).…”

Brief relationship support as a selective suicide prevention intervention: Piloting the Relationship Checkup in veteran couples with relationship and mental health concerns

“…Fortunately, recent years have seen growing attention to adult relationships through “indicated prevention”—treatments designed for families of individuals with recent ideation or attempts. Studies include a 6‐session conjoint safety planning protocol (Goodman et al, 2022), a 10‐session behavioral couple therapy program (Khalifian et al, 2022), a 15‐week intensive outpatient program (Anastasia et al, 2015), and a 6‐month post‐discharge telephone protocol (Miller et al, 2016). However, it can be difficult to engage supportive family members in times of crisis, with the largest study of a family approach after suicide‐related emergency department visits finding only 20% of patients had a family member engage in the treatment (Miller et al, 2017).…”