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Prevention of suicide
Counselling and psychotherapy for the prevention of suicide: a systematic review of the evidence
David Winter, Siobhan Bradshaw, Frances Bunn, David Wellsted
Publication date – November 2009
140 pages
ISBN number: 978-1-905114-32-0
£15.99 BACP members
£21.99 Non-members
“A very thorough and helpful review of the available evidence. I believe this publication has the potential to make a significant contribution to the literature base for counselling and psychotherapy interventions with suicidal clients, and as such it contains much that will be of benefit to practitioners within the field”.
Andrew Reeves, Editor, Counselling and Psychotherapy Research journal
Aims of the review
Suicide is the cause of death for nearly 900,000 people every year. Non-fatal acts of self-harm are also very frequent, occurring in about 300 of every 100,000 people per year. Although such acts may or may not involve suicidal intent, deliberate self-harm is a significant risk factor for eventual suicide. Accordingly, this review considers the research available for the use of counselling and psychotherapy in the prevention of suicide, as well as research which assesses the use of counselling and psychotherapy for deliberate self-harm.
The review is based on 113 publications within this arena, and aims to incorporate a broader evidence base than that considered by previous reviews. It considers randomised controlled trials and non-randomised trials, along with other quasi-experimental and non-experimental studies, including qualitative research. It considers not only the effectiveness but also the process of counselling and psychotherapy with people at risk of suicide.
What conclusions may be drawn from current reviews of the literature on psychotherapy and counselling in relation to the prevention of suicide, and how may any discrepancies between these reviews be explained?
What does the research evidence, both quantitative and qualitative, indicate concerning the effectiveness of counselling and psychotherapy with clients who are at risk of suicide?
What does the research evidence, both quantitative and qualitative, indicate concerning the process of counselling and psychotherapy with clients who are at risk of suicide?
How might the research evidence inform clinical practice and training programmes for counsellors and psychotherapists working with clients who are at risk of suicide? What are the implications of this review for further research?
Summary and conclusions
- Limitations were identified in several of the previous systematic reviews and meta-analyses in this area, but these provide a certain amount of evidence for the effectiveness of some, primarily cognitive-behavioral, therapies.
- Meta-analysis of quantitative studies provides evidence of the effectiveness of psychological interventions for clients at risk of suicide. Most studies concerned variants of cognitive-behavioral therapy.
- There are some promising findings concerning other forms of therapy and further research concerning these is a priority.