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Empowering Lives: Therapeutic Approaches to Combat Suicidal Ideation


Suicide is a complex and personal experience, often driven by overwhelming emotional pain. Many people seek therapy to help deal with difficult stressors and emotions. Individuals experiencing suicidal ideation may worry that the societal stigma means traditional therapy is hopeless. On the contrary, there are proven therapeutic strategies that can help individuals navigate these crises and find hope. In this blog, we'll explore three essential approaches in suicide prevention: Safety Planning, Cognitive Behavioral Therapy (CBT), and Dialectical Behavior Therapy (DBT). These approaches provide clients with practical strategies to cope with distress, confront unhelpful thinking patterns, and strengthen their emotional resilience. Through collaboration between clients and mental health professionals, these methods pave the way for healing and long-term recovery.



Safety Planning



What is a Suicide Safety Plan?


A Suicide Safety Plan is a simple, personalized list of coping strategies and support resources designed for individuals at high risk of suicide. When the body enters fight-or-flight mode in response to stress, it can be challenging to engage the brain's problem-solving abilities. Having a plan in place before a crisis arises helps individuals overcome this instinctive reaction, providing them with clear steps to manage the situation. The plan should be concise, easy to read, and written in the individual's own words. In session, the therapist can help guide the client through the safety planning process.


Components of a Safety Plan


  • Warning Signs: As discussed in an earlier post, there are many warning signs that could indicate suicidal ideation is occurring. The presentation of warning signs differs for each person. Through exploration and collaboration, you and the counselor can identify precursors that are unique to you.


  • Coping Strategies: Coping mechanisms here should be easy to access and complete in times of crisis and aimed at self-soothing. These often include deep breathing and grounding exercises.


  • Social Support: You can create a list of supportive people in your life that may be available to help you in moments of crisis. This can include friends, family, and professionals.


  • Professional Resources: Your safety plan should include contact details for mental health professionals, crisis hotlines, and emergency services. A list of resources has been made available in our previous blog post.


  • Safe Environment: This section is aimed at either seeking out a safe environment or altering your existing environment by removing access to harmful objects, weapons, or substances.


  • Reasons for Living: Here, you can take note of individual protective factors and personal motivations for staying alive as a reminder during tough times.



Cognitive Behavioral Therapy (CBT)



Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that targets the connection between thoughts, feelings, and behaviors, making it especially effective for individuals at risk of suicide. The primary goal of CBT is to prevent future suicidal crises by helping individuals identify and challenge negative thought patterns that lead to emotional distress.  

Through the assessment process, clients learn about this thought-behavior-mood connection and learn to recognize distorted thoughts that have become automatic and seemingly innate in nature. In this therapy, you will learn to examine these thoughts, question their validity, and explore healthier alternatives. Ultimately, CBT empowers individuals to break the cycle of negative thought patterns and eventually rewire the brain.


The main objectives of Cognitive Behavioral Therapy (CBT) are as follows:


  1. Identifying Thoughts: Clients learn to recognize and monitor negative or distorted thoughts and automatic thoughts. Cognitive distortions are beliefs that are at their core faulty or inaccurate, based off our thinking, perception, or belief. Automatic thoughts are typically instant, habitual, and outside of our conscious mind.


  2. Challenging Beliefs: Many of our thoughts are based on faulty assumptions or cognitive distortions. Clients learn to evaluate these beliefs critically through the process of cognitive restructuring. By exploring alternative perspectives and looking at situations from an objective stance, they can begin to replace distorted thinking with more balanced, rational views.


  3. Behavioral Experiments: Behavioral experiments allow clients to test the accuracy of their thoughts and beliefs. For example, if a client believes they will always fail at a task, a behavioral experiment might involve attempting a task and observing the actual outcome. This process allows clients to challenge assumptions in real-world situations, allowing them to see whether their beliefs hold true or if alternative, more positive outcomes are possible.


  4. Coping Strategies: CBT emphasizes the development of practical coping strategies to manage emotional distress. These strategies may include relaxation techniques and problem solving skills to address challenges more effectively and combat the mental and physical tension that stress brings. Strategies can include progressive muscle relaxation, deep breathing, and mindfulness practices. 

 

 

Dialectical Behavioral Therapy (DBT)



Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan, is a highly effective treatment for individuals struggling with suicidal ideation. DBT focuses on the balance between emotion regulation and behavioral control. At its core, DBT addresses the idea of dialectics (opposites) and the natural tension between competing emotions or viewpoints. For example, the desire to solve a problem versus accepting it, or striving for self-improvement while embracing self-acceptance. This approach can help integrate these opposing views, allowing for better emotional regulation and less impulsive reactions. DBT can be conducted in individual or group therapy, with both modalities being incorporated into a true DBT program. However, these skills can be learned and applied through the process of individual therapy.

 

DBT is broken up into four sequential modules with specific topics and goals for each.


  1. Mindfulness: This module teaches clients to focus on the present moment, enhancing awareness of thoughts, feelings, and sensations without judgment. By cultivating mindfulness, clients can better observe their emotional responses and reduce reactivity.


  2. Distress Tolerance:  The focus here is on developing skills to cope with and endure difficult emotions and situations without resorting to harmful behaviors. It equips individuals with techniques to acknowledge reality and manage crises effectively- especially when the problem can’t be solved in the immediate moment.


  3. Emotion Regulation: Often it is difficult for people to put a name to the emotion they are experiencing. In this module, clients learn to identify and understand their emotions, as well as strategies to modulate their emotional responses. The goal is to decrease the impact of overwhelming feelings and increase emotional stability.


  4. Interpersonal Effectiveness: The goal of this module is to develop skills for effective communication and relationship management. Clients learn to assert their needs, maintain self-respect, and navigate social interactions while fostering healthy connections with others.


If you or someone you know is in immediate danger or at imminent risk of suicide, it’s crucial to seek help right away. In such emergencies, calling 911 or going to the nearest emergency room is the best course of action. Once stabilized, seeking support through these therapy modalities can help work towards long term growth and healing.

 


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