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Brief therapy program improves suicidal outcomes in individuals with suicidal behavior

A brief therapy program for individuals who have recently attempted suicide significantly reduced risk for another suicide attempt over 2 years, according to recent findings.

“Therapeutic alliance is a consistent predictor of outcome across psychotherapies. Based on guidelines for clinicians formulated by an international working group, we developed a brief therapy program for patients who have recently attempted suicide, the Attempted Suicide Short Intervention Program (ASSIP),” Anja Gysin-Maillart, PhD, of University Hospital of Psychiatry, University of Bern, Switzerland, and colleagues wrote. “A major focus of ASSIP lies in the development of an early therapeutic alliance, combined with psychoeducation, a cognitive case conceptualization, safety planning and continued long-term outreach contact.”

To assess efficacy of ASSIP for suicidal behavior, researchers conducted a randomized controlled study among individuals who recently attempted suicide. Study participants received treatment as usual (n = 60) or treatment as usual plus ASSIP (n = 60) for 24 months. ASSIP participants received three therapy sessions followed by regular contact through personal letters. Sixty-three percent of participants had an affective disorder and 50% had a history of prior suicide attempts.

During the study, five repeat suicide attempts occurred among the ASSIP group, compared with 41 attempts in the control group.

Rates for attempting suicide at least once were 8.3% (n = 5) in the ASSIP group and 26.7% (n = 16) in the control group.

ASSIP was associated with an estimated 80% reduced risk for at least one suicide attempt and those who received ASSIP spent 72% fewer days in the hospital.

Prior suicide attempts, depression and a diagnosis of personality disorder at baseline did not significantly affect outcome, though participants with borderline personality disorder (n = 20) had more previous suicide attempts and more reattempts.

“ASSIP, a manual-based brief therapy for patients who have attempted suicide, administered in a real-world clinical setting, was efficacious in reducing suicidal behavior over 24 months. ASSIP thus fulfills the need for a brief, easy-to-implement and low-cost intervention. We believe that ASSIP has the potential for dissemination in various treatment settings and for reducing of the costs of health care for patients attempting suicide. Large pragmatic trials will be needed to conclusively establish the efficacy of ASSIP and to replicate our findings in other clinical settings,” the researchers concluded. – by Amanda Oldt

Disclosure: Gysin-Maillart reports receiving royalties from Hogrefe Publishing for ASSIP — Attempted Suicide Short Intervention Program: A Manual for Clinicians. Please see the full study for a list of all authors’ relevant financial disclosures.