Acute behavioral interventions and outpatient treatment strategies with suicidal adolescents.

Abstract

Despite the prevalence of suicidal thoughts and behaviors among adolescents, there is limited knowledge of effective interventions to use with this population. This paper reviews the findings of studies on behavioral interventions for adolescents who are at acute suicide risk, as well as outpatient treatment and risk management strategies with suicidal adolescents. The importance of addressing comorbid behaviors and enhancing protective factors are discussed. Cultural considerations in working with suicidal adolescents and strategies for conducting culturally competent treatment are explored. Suicide rates increase distinctly in adolescence and continue to rise until early adulthood (Bridge, Goldstein, & Brent, 2006). Suicide is the third leading cause of death for 10-to-24year-olds (National Center for Injury Prevention and Control [NCIPC], 2014) and the second for 15-24 year olds (McIntosh & Drapeau, 2014). The most recent findings from the Youth Risk Behavior Surveillance Survey estimated that of adolescents in grades 9-12, 16% reported seriously considering suicide, 13% reported creating a plan to kill themselves, and 8% reported trying to kill themselves in the 12 months preceding the survey (Kann et al., 2014). In a recent study of 6483 adolescents where face-to-face interviews were conducted, it was estimated that 12.1% of adolescents had contemplated suicide, 4.0% made a plan, and 4.1% made an attempt in their lifetime (Nock et al., 2013). Despite the prevalence of suicidal thoughts and behaviors among adolescents, there is limited knowledge of effective interventions to use with this population. Although there have been several large clinical trials conducted with suicidal adolescents over the past 20 years, we still lack the data to suggest an empirically validated treatment that prevents repeated suicidal behavior in adolescents (Brent et al., 2013