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Risk Management and Treatment » Non-pharmacologic Interventions
5: Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP)

We suggest cognitive behavioral therapy-based psychotherapy focused on suicide prevention to reduce the risk of suicide attempts in patients with a history of suicidal behavior within the past six months.

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Cognitive behavioral therapy for suicide prevention (CBT-SP) refers to a group of therapies using a cognitive behavior therapy (CBT) approach to reduce risk of future suicidal behaviors. The majority of studies reviewed for this recommendation used a psychotherapy intervention grounded in CBT to explicitly address suicide risk. Key components of this approach include teaching patients to identify and modify problematic thinking and behavioral patterns that precede suicidal behaviors and the use of both cognitive and behavioral strategies to help patients learn adaptive ways of coping with suicide-related stressors. Although there may be some variation with respect to CBT's alignment with patient values and preferences, most patients typically report high satisfaction with CBT focused on suicide prevention.

Videos

This section includes recommended videos about CBT-SP.

CBT for SP — an informational video created in partnership with MIRECC and EDC/Brad Karlin:
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Books

The section includes recommended books about CBT-SP.

Book cover thumbnail image Cognitive Therapy for Suicidal Patients; Scientific and Clinical Applications by Wenzel, Brown & Beck Describes the authors' cognitive model of suicide, the instruments they developed to assess theoretically and clinically relevant suicide constructs, and their cognitive intervention for suicidal individuals.
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Webinars

This section includes recommended webinars about CBT-SP.

CPG Webinar Cognitive Behavioral Therapy for Suicide Prevention Presented by Dr. Gregory K. Brown
CPG Webinar Suicide Prevention 2.0 Clinical Telehealth Program Presented by Dr. Jessica A Walker
CPG Webinar Suicide Prevention 2.0 Clinical Telehealth: Implementation of an evidence-based psychotherapy program to reduce suicide behavior in U.S. Veterans Presented by Dr. Jessica A Walker
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Articles

This section includes recommended articles about CBT-SP.

Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial. JAMA, 294(5). 563-570. https://doi.org/10.1001/jama.294.5.563
Ecker, A. H., Johnson, A. L., Sansgiry, S., Fletcher, T. L., Hundt, N., Petersen, N. J., Sweeney, A. C., Chaison, A. D., York-Ward, K. M., Kauth, M. R., Kunik, M. E., & Cully, J. A. (2019). Brief cognitive behavioral therapy reduces suicidal ideation in veterans with chronic illnesses. General hospital psychiatry, 58. 27–32. https://doi.org/10.1016/j.genhosppsych.2019.02.002
Hawton, K., Witt, K. G., Taylor Salisbury, T. L., Arensman, E., Gunnell, D., Hazell, P., Townsend, E., & van Heeringen, K. (2016). Psychosocial interventions for self-harm in adults. The Cochrane database of systematic reviews, (5). CD012189. https://doi.org/10.1002/14651858.CD012189
Leavey, K., & Hawkins, R. (2017). Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis. Cognitive behaviour therapy, 46(5). 353-374. https://doi.org/10.1080/16506073.2017.1332095
Riblet, N., Shiner, B., Young-Xu, Y., & Watts, B. V. (2017). Strategies to prevent death by suicide: meta-analysis of randomised controlled trials. The British journal of psychiatry : the journal of mental science, 210(6). 396-402. https://doi.org/10.1192/bjp.bp.116.187799
Rudd, M. D., Bryan, C. J., Wertenberger, E. G., Peterson, A. L., Young-McCaughan, S., Mintz, J., Williams, S. R., Arne, K. A., Breitbach, J., Delano, K., Wilkinson, E., & Bruce, T. O. (2015). Brief cognitive-behavioral therapy effects on post-treatment suicide attempts in a military sample: results of a randomized clinical trial with 2-year follow-up. The American journal of psychiatry, 172(5). 441–449. https://doi.org/10.1176/appi.ajp.2014.14070843
Sobanski, T., Josfeld, S., Peikert, G., & Wagner, G. (2021). Psychotherapeutic interventions for the prevention of suicide re-attempts: a systematic review. Psychological medicine, 51(15). 2525–2540. https://doi.org/10.1017/S0033291721003081
Witt, K. G., Hetrick, S. E., Rajaram, G., Hazell, P., Taylor Salisbury, T. L., Townsend, E., & Hawton, K. (2021). Psychosocial interventions for self-harm in adults. The Cochrane database of systematic reviews, 4(4). CD013668. https://doi.org/10.1002/14651858.CD013668.pub2
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