Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability.
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.


METHODS
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.
Stanley
Barbara
B
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. Electronic address: bhs2@columbia.edu.
Brown
Gregory
G
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.
Brent
David A
DA
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.
Wells
Karen
K
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.
Poling
Kim
K
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.
Curry
John
J
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.
Kennard
Betsy D
BD
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.
Wagner
Ann
A
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.
Cwik
Mary F
MF
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.
Klomek
Anat Brunstein
AB
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.
Goldstein
Tina
T
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.
Vitiello
Benedetto
B
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.
Barnett
Shannon
S
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.
Daniel
Stephanie
S
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.
Hughes
Jennifer
J
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.
D000223:Adaptation, Psychological; D000293:Adolescent; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005196:Family Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D019018:Imagery, Psychotherapy; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010555:Personality Inventory; D055502:Secondary Prevention; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology; D000092864:Suicide Prevention