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6: Cognitive Behavioral Therapy for Suicide Prevention

Risk Management and Treatment » Non-pharmacologic Treatments
6: Cognitive Behavioral Therapy for Suicide Prevention

We recommend using cognitive behavioral therapy-based interventions focused on suicide prevention for patients with a recent history of self-directed violence to reduce incidents of future self-directed violence.

Strength:

Strong for

Category:

ReviewedNew-added

Grades and Definitions

Strong for
or "We recommend offering this option …"
Weak for
or "We suggest offering this option …"
No recommendation
or "There is insufficient evidence …"
Weak against
or "We suggest not offering this option …"
Strong against
or "We recommend against offering this option …"

Categories and Definitions

Evidence Reviewed* Recommendation Category* Definition*
Reviewed New-added New recommendation following review of the evidence
New-replaced Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence
Not changed Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed based on review of the evidence
Not reviewed Not changed Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG
*Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72.

Recommendation Resources

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. All studies reviewed for this recommendation used CBT to directly address suicide risk. Key components of this approach include the identification of thoughts, images and beliefs 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.

Webinars

This section includes links to 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
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Videos

This section includes links to 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 links to 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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Articles

This section includes links to 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
Gøtzsche, P. C., & Gøtzsche, P. K. (2017). Cognitive behavioural therapy halves the risk of repeated suicide attempts: systematic review. Journal of the Royal Society of Medicine, 110(10). 404-410. https://doi.org/10.1177/0141076817731904
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 adultss. 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
Slee, N., Garnefski, N., van der Leeden, R., Arensman, E., & Spinhoven, P. (2008). Cognitive-behavioural intervention for self-harm: randomised controlled trial. The British journal of psychiatry : the journal of mental science, 192(3). 202-211. https://doi.org/10.1192/bjp.bp.107.037564
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