New Approach to the Management of the Suicidal Patient

A new study suggests that an adjunctive acceptance and commitment therapy (ACT) group program could be effective in treating suicidal behaviors.

Researchers at Academic Hospital of Montpellier (France) and Lapeyronie Hospital (Montpellier, France) conducted a study involving 35 outpatients suffering from a current suicidal behavior disorder (SBD), which is defined (according to DSM-5) as a history of suicidal attempt in the past year. The patients were included in an ACT program, and were assessed at inclusion, after one week, and three months after program completion. Exclusion criteria were current mania or depressive episodes, or schizophrenia.

The results showed that between inclusion and the one week follow-up, there was a significant reduction in the intensity of suicidal ideations during the last 15 days. There was also a significant reduction in depression symptoms, anxiety state, hopelessness, and psychological pain, and a significant improvement in global functioning and quality of life. All the differences remained significant at three month follow up, and dosages of benzodiazepines were reduced for 65% of the patients. Notably, there was no suicide reattempt during the follow-up period. The study was published on December 9, 2014, in the Journal of Psychotherapy and Psychosomatics.

“ACT, a ‘third-wave' behavioral therapy, specifically focuses on experiential avoidance, that is the tendency to avoid unwanted thoughts or emotions, at the core of psychiatric disorders,” concluded lead author Deborah Ducasse, MD, of the department of psychiatric emergency and acute crisis at Lapeyronie Hospital. “This may be a key aspect in suicidal subjects who often report intrusive mental images of suicide that they try to suppress, increasing in their intensity and frequency, independently from depressive symptoms.”

ACT is a is an empirically based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways with commitment and behavior-change strategies to increase psychological flexibility. Rather than trying to teach people to better control their thoughts, feelings, sensations, and memories as in traditional cognitive behavioral therapy (CBT), ACT teaches them to observe, accept, and embrace their private events, especially previously unwanted ones. The method was developed in the late 1980s.

Related Links:
Academic Hospital of Montpellier
Lapeyronie Hospital