Are there Common Components in Effective Psychotherapies for Suicidal Behavior? Implications for Professional Practice

Abstract

The scientific literature in recent years and the new research paradigms for suicidal behavior indicate that clinical treatment should focus on the reasons a person is considering suicide and why they would prefer to die rather than live. Suffering, desperation, and an inability to find meaning in life transcend diagnostic categories and are linked to the presence of any manifestation of suicidal behavior. This calls for a perspective that understands the need for specific approaches, beyond particular diagnoses or what is required for other possible psychological problems. In the adult population, the psychotherapies with the most empirical support for their efficacy are cognitive behavioral therapy and dialectical behavioral therapy for people diagnosed with borderline personality disorder, particularly women. In adolescents, dialectical behavioral therapy has the highest level of recommendation. The short intervention with the best empirical support in response to suicidal crises is safety planning. We indicate the common components needed for effective psychotherapies, such as the importance of comprehensive evaluations, the therapeutic alliance, the family component, and emotional regulation skills, among others. We consider the professional implications and reflect on the need for specific training for therapists.