I've started reading Miller, Rathus & Linehan "DBT with suicidal adolescents" http://www.bookdepository.com/Diale...uicidal-Adolescents-Alec-Miller/9781593853839
I haven't experienced suicidality, but I have friends both on the board here and in meatspace who do, hence I'm sharing.
In one of the early chapters there is a review of clinical evidence for the effectiveness of different approaches for reducing suicidal ideation, behaviours and completions.
The authors break this into two basic approaches;
Bear two things in mind while you are reading what follows, The book was published in 2007, a lot could have changed in the academic literature in the 8 years since then, that I am not aware of (I'm an interested amateur, not a full time academic).
Also, bear in mind that absence of evidence does not constitute evidence of absence.
OK, The first approach of treating underlying "conditions" such as depression, using medications had only 2 studies! neither showed any statistically significant effect on suicidality. The raw results - and these are not statistically significant, they could be due to purely random factors, showed lower suicide rates with the placebo than with either SSRI or SNRI anti depressants. That said, the SSRIs are known to double the rate of suicide completions in depressed adolescents, and several of the clinical trials of SSRIs specifically excluded suicidal individuals.
Again, there do not seem to be studies showing an decrease in suicidality from treating depression with talk therapies such as CBT.
In terms of directly addressing suicidality, There are various codes of practice/ procedures / whatever in various places for dealing with people presenting with suicidal ideation, plans, actions etc. Again! there is an absence of studies demonstrating a positive effect.
One thing which did work for two years after presentation, were personal letters from the person who had received the suicidal person and dealt with them - wishing the suicidal person well. By five years, this effect was no longer demonstrable.
There was also no evidence that hospitalization or inpatient stays were any more effective than the person attending appointments and living at home.
Certainly, by the time the book went to press (2007) the only approach with multiple clinical studies showing reductions in suicidal and parasuicidal behaviours was Dialectical Behavioural Therapy. The early studies were with chronically suicidal women, diagnosed with "borderline personality disorder"
That is as far as I've got with my reading to date.
:hug:@
I haven't experienced suicidality, but I have friends both on the board here and in meatspace who do, hence I'm sharing.
In one of the early chapters there is a review of clinical evidence for the effectiveness of different approaches for reducing suicidal ideation, behaviours and completions.
The authors break this into two basic approaches;
- Addressing "conditions" such as depression which are associated with elevated risk of suicidal behaviours, in the hope that once the "condition" is gone, the suicidal behaviours will go too.
- Directly targetting suicidal and para suicidal ideations and behaviours, including non suicidal self injurious behaviour (NSIB).
Bear two things in mind while you are reading what follows, The book was published in 2007, a lot could have changed in the academic literature in the 8 years since then, that I am not aware of (I'm an interested amateur, not a full time academic).
Also, bear in mind that absence of evidence does not constitute evidence of absence.
OK, The first approach of treating underlying "conditions" such as depression, using medications had only 2 studies! neither showed any statistically significant effect on suicidality. The raw results - and these are not statistically significant, they could be due to purely random factors, showed lower suicide rates with the placebo than with either SSRI or SNRI anti depressants. That said, the SSRIs are known to double the rate of suicide completions in depressed adolescents, and several of the clinical trials of SSRIs specifically excluded suicidal individuals.
Again, there do not seem to be studies showing an decrease in suicidality from treating depression with talk therapies such as CBT.
In terms of directly addressing suicidality, There are various codes of practice/ procedures / whatever in various places for dealing with people presenting with suicidal ideation, plans, actions etc. Again! there is an absence of studies demonstrating a positive effect.
One thing which did work for two years after presentation, were personal letters from the person who had received the suicidal person and dealt with them - wishing the suicidal person well. By five years, this effect was no longer demonstrable.
There was also no evidence that hospitalization or inpatient stays were any more effective than the person attending appointments and living at home.
Certainly, by the time the book went to press (2007) the only approach with multiple clinical studies showing reductions in suicidal and parasuicidal behaviours was Dialectical Behavioural Therapy. The early studies were with chronically suicidal women, diagnosed with "borderline personality disorder"
That is as far as I've got with my reading to date.
:hug:@
