Dynamic deconstructive therapy effectively reduces suicide ideation among adolescents
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Key takeaways:
- Treatment with DDP led to a 47% decrease in suicide ideation among suicidal adolescents.
- Treatment also led to significant improvements in other related outcomes.
NEW YORK — Dynamic deconstructive psychotherapy appeared effective at reducing suicide ideation among suicidal adolescents, according to a poster presented at the American Psychiatric Association Annual Meeting.
“A lot of the current management of suicidality [involves] going to the ED, crisis calls and doing safety planning; a lot of it is really crisis management,” Rebecca J. Shields, DO, child and adolescent psychiatry specialist at Upstate Medical University, told Healio. “What dynamic deconstructive psychotherapy aims to do is heal from the inside out and build resiliency so that people can continue the healing process even once therapy is over.
“We’re trying to repair the emotion processing system itself so that they don’t become as overwhelmed, and they know who they are, what they want and what their value is,” she added.
Shields and colleagues examined the naturalistic outcomes of dynamic deconstructive psychotherapy (DDP) among 65 suicidal adolescents aged 13 to 17 years who were admitted to their institution’s Psychiatry High Risk Program.
The participants underwent weekly DDP treatment, which focused on repairing the emotion processing system by labeling interactions and emotions; improving identity through the integration of opposing emotions and beliefs; using the therapist-patient relationship to improve the capacity to form relationships; and building self-compassion by grieving limitations.
The primary outcome was suicide ideation, which researchers assessed using the Columbia-Suicide Severity Rating Scale, from baseline to 6 months of weekly DDP therapy. Secondary outcomes included suicide attempts, self-harm behaviors, depression, anxiety, disability, self-compassion and health care utilization.
The researchers used Wilcoxon Signed-Ranks test to examine differences in suicide ideation and all secondary measures between baseline and 6 months of DDP treatment.
Overall, there was a 47% decrease in suicide ideation and an 81% decrease in suicide attempts from baseline to 6 months of DDP treatment (P < .001 for both).
All of the secondary endpoints measured, including depression, self-harm behaviors, anxiety, disability and self-compassion also showed significant improvements (P < .001 for all).
Additionally, there was a reduction in the number of ED visits for patients in the intent-to-treat sample who completed 6 months of DDP treatment.
Shields noted that although people sometimes say suicidality decreases naturally over time in the population, the researchers found that the adolescents who stayed in the program for at least 6 months had fewer hospital days, “while the adolescents who dropped out actually had an initial decrease while they were in the program but then it actually went back up.”
The researchers concluded that DDP appears to be a promising treatment for adolescent suicide prevention. However, further research directly comparing DDP with other treatments for suicidal adolescents is needed.
“I really believe in DDP and it’s nice to have another approach to helping suicidal adolescents,” Shields said.