Journal of the American Academy of Child & Adolescent Psychiatry
Volume 48, Issue 10 , Pages 1005-1013, October 2009

Cognitive-Behavioral Therapy for Suicide Prevention (CBT-SP): Treatment Model, Feasibility, and Acceptability

Drs. Stanley and Klomek are with Columbia University–New York State Psychiatric Institute; Dr. Brown is with the University of Pennsylvania; Drs. Brent and Goldstein and Ms. Poling are with the University of Pittsburgh and Western Psychiatric Institute & Clinic; Drs. Wells and Curry are with Duke University; Drs. Wagner and Vitiello are with the National Institute of Mental Health; Dr. Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Cwik and Barnett are with Johns Hopkins University; and Dr. Daniel is with the University of North Carolina at Greensboro

Accepted 11 June 2009.

Disclosure: Drs. Wells and Curry receive speaking fees from the REACH Institute. Dr. Wagner held stock in Johnson & Johnson in an amount deemed by government-wide regulations not to create a conflict of interest, and has since divested. The other authors report no conflicts of interest.

Abstract 

Objective

To describe the elements of a manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide.

Method

The CBT-SP was developed using a risk reduction and relapse prevention approach and theoretically grounded in principles of cognitive-behavioral therapy, dialectical behavioral therapy, and targeted therapies for suicidal youths with depression. The CBT-SP consists of acute and continuation phases, each lasting about 12 sessions, and includes a chain analysis of the suicidal event, safety plan development, skill building, psychoeducation, family intervention, and relapse prevention.

Results

The CBT-SP was administered to 110 recent suicide attempters with depression aged 13 to 19 years (mean 15.8 years, SD 1.6) across five academic sites. Twelve or more sessions were completed by 72.4% of the sample.

Conclusions

A specific intervention for adolescents at high risk for repeated suicide attempts has been developed and manual based, and further testing of its efficacy seems feasible. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(10):1005–1013.

Key Words:  suicide , psychotherapy , depression

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 This study was funded by the National Institute of Mental Health through cooperative agreement grants MH66750 (Duke University Medical Center), MH66769 (Johns Hopkins University), MH66762 (New York State Psychiatric Institute), MH66775 (University of Pittsburgh), and MH66778 (University of Texas Southwestern Medical Center).This article is the subject of an editorial by Dr. Garry Walter in this issue.Clinical trial registration information–Treatment of Adolescent Suicide Attempters (TASA). URL: http://clinicaltrials.gov. Unique identifier: NCT00080158.

PII: S0890-8567(09)60165-9

doi:10.1097/CHI.0b013e3181b5dbfe

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 48, Issue 10 , Pages 1005-1013, October 2009

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