Time-Limited Cognitive-Behavioral Group Interventions with Suicidal Adolescents

Abstract

Suicide is the third leading cause of death in adolescents in the United States--following accidents and homicide. This paper reports on group based activities using a cognitive-behavioral therapy (CBT) framework targeted at variables most highly correlated with suicidal ideation and behaviors, including problems associated with self-esteem, cognitive rigidity, social skills deficits, and substance use. Instead of focusing exclusively on treatment of depressive symptoms, this paper presents a series of structured group activities applicable to time-limited groups and designed to increase self-esteem, reduce negative thinking, enhance coping abilities, delimit substance use, and reintroduce the ability to seek and enjoy pleasurable activities with peers. The activities are derived from experiences with adolescents in treatment and are devised to foster rapid group stage development for use in time-limited groups.

The Impact of Peer Death on Adolescent Girls: An Efficacy Study of the Adolescent Grief and Loss Group

“…Adolescent groups provide an environment which allows for the growth-enhancing impact of protective factors to occur as well as the creation of resiliency (Lee & Swenson, 2005;Malekoff, 2004). The group acts as a context for social reinforcement, which can improve adolescents' adaptive and social skills and reduce self-destructive behaviors (Masten, Best, & Garmezy, 1991;Rittner & Smyth, 1999). Self-examination and "cognitive restructuring occur with peer support and reinforcement which enables adolescents to cope more effectively with the emotional, familial, and social stressors in their lives" (Rittner & Smyth, 1999, p. 71).…”

Psychosocial Treatment of Youth Suicide: A Systematic Review of the Research

“…Group work has often been recommended to reduce youth suicidality (Aronson & Scheidlinger, 1995;Rittner & Smyth, 1999;Ross & Motto, 1984), but few studies have tested its efficacy. In a randomized clinical trial involving youth who had deliberately harmed themselves within the past year, group therapy and routine care (n = 32) were compared with routine care alone (n = 31) (Wood, Trainor, Rothwell, Moore, & Harrington, 2001).…”

“…Yet despite the data suggesting that youth suicide is a significant public health concern, comparably little research has been done on how to treat suicidality among youth. Although there are many review papers and descriptions of interventions and treatment strategies (e.g., Holman, 1997;Jobes, 1995;Lum, Smith, & Ferris, 2002;Morrison, 1987;Rittner & Smyth, 1999;Trautman, 1995;Wodarski & Harris, 1987), there are few experimental and quasi-experimental evaluations of suicide intervention strategies. More than a decade ago, the report of the Secretary's Task Force on Youth Suicide concluded that "there are no treatment studies-psychotherapeutic, behavioral, or psychopharmacologic-which show that a clearly defined treatment approach is superior to no treat-…”

The Practice of Functional Analytic Psychotherapy

“…Although a wide variety of cognitive behavioral and behavioral approaches have been applied to group psychotherapy for issues such as skills training, coping deficits, and changes in thinking (Fisher, Masia-Warner, & Klein, 2004;James, Thorn, & Williams, 1993;Rittner & Smyth, 2000;Rhode, Jorgensen, Seeley, & Mace, 2004;Wilson, Bouffard, & Mackenzie, 2005), behaviorally oriented groups are generally characterized by the use of behavior modification techniques (Vinagrov, Co, & Yalom, 2003) and do not focus on interpersonal process. Behavioral and cognitive behavioral therapies for process-oriented groups that focus on interpersonal interactions as they occur in group do not appear to be very common.…”