Review Of Efficacy Research

In a recent study (Brown et al., 2005), adults evaluated at the University of Pennsylvania's Hospital Emergency Department within 48 hours of a suicide attempt were randomized either to receive CT (N = 60) or not to receive CT (N = 60). Both groups received enhanced usual care that included the assessment and referral services of a study case manager. Follow-up assessments were performed at 1, 3, 6, 12, and 18 months. The primary outcome measure was the incidence of repeat suicide attempts. Secondary outcome measures included suicide ideation, hopelessness, and depression. From baseline to the 18-month assessment, 24.1% of the participants in the CT group, compared to the 41.6% of the participants in the usual care group, made at least one subsequent suicide attempt. Although there were no significant between-group differences on rates of suicide ideation at any assessment point, the severity of depression was significantly lower for the CT group at 6, 12, and 18 months. Significantly reduced levels of hopelessness were observed for the CT group at 6 months. Overall, the results of this randomized clinical trial indicated that a relatively brief cognitive protocol, as presented here, effectively reduced the rate of repeated attempts by 50% in adults who had recently attempted suicide.

Over the years, only a limited number of studies have examined the effectiveness of various psychosocial interventions with suicidal persons. Unfortunately, there is also a paucity of research for specific at-risk populations, such as older adults (Pearson & Brown, 2000) and individuals with substance dependence. Successful interventions with suicide attempters include intensive follow-up treatment or case management (e.g., Van Heeringen et al., 1995), interpersonal psychotherapy (e.g., Guthrie et al., 2001), dialectical behavior therapy (Linehan et al., 2006), and CT (e.g., Brown et al., 2005). Further research that examines the effectiveness of psychosocial interventions for suicide attempters with co-occurring psychiatric and substance use disorders is warranted.

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