A person who is dealing with addiction or who is under the influence of alcohol or other drugs will have impaired judgment and is likely to be impulsive, greatly increasing the potential for suicide. In these cases, working to reduce the use of such substances is very important.
In the second part of treatment, individuals focus on solving problems that are most related to their suicidal crises. They also learn how to reduce potential future crises, especially by changing their distorted thinking and unhelpful behavior and learning new coping strategies. The therapist strongly reinforces their reasons for living and continues to work toward increasing hope.
Other typical strategies might include scheduling activities, especially ones that could lead to a sense of pleasure, increasing social connections and support, learning emotional regulation techniques, shifting attention when preoccupied with suicidal thoughts, modifying beliefs that their suffering is unbearable and reducing impulsivity.
In this stage of treatment, they also develop a Hope Kit, often a container or scrapbook with meaningful items such as photographs and letters, prayer cards (when relevant), and a list of significant events they want to attend (such as a graduation, wedding or reunion). This Hope Kit can be a powerful reminder of the reasons they want to live.
In the final phase of treatment, individuals consolidate their new skills and learn relapse prevention techniques. This phase allows individuals who are struggling with suicidal thoughts, as well as their family members, friends and health care providers, to feel less helpless.
Given the right kind of treatment, people can learn precisely what to do when they have thoughts of killing themselves and what to do to prevent future suicidal crises.
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources.
Judith S. Beck is president of the Beck Institute for Cognitive Behavior Therapy and a clinical professor of psychology in psychiatry at the University of Pennsylvania.