Cognitive Behavior Therapy - Suicide Prevention : CBT-SP

CBT-SP focuses on skills training designed to strengthen self-regulation and alter decision-making style, although one slight difference between DBT and CBT-SP is the latter’s central focus on teaching skills designed to directly influence and change the patient’s belief systems, assumptions, and thought processes that contribute to suicidal behaviors. These include hopelessness (e.g., Things will never change), self-hatred (e.g., I deserve to be punished), perceived burdensomeness (e.g., People would be better off without me), entrapment (e.g., There’s no way out), and unbearability (e.g., I can’t take this any longer).

Cognitive reappraisal skills are intended to help patients learn how to identify negative and maladaptive thoughts and beliefs that contribute to and sustain suicidal thoughts and behaviors and to help them learn how to replace these thoughts with more balanced and life-affirming beliefs (e.g., It’ll be okay; Just because I make a mistake doesn’t mean I’m a failure; This may be difficult but it’s not impossible; I can handle it). These life-affirming beliefs serve to weaken the perceived value of suicidal behavior by strengthening the perceived value of life.

You may not know what’s going to happen in the future and you may not always get what you want, for instance, but sometimes we do get what we want and things end up going better than expected, so it may be better to make a decision based on that possibility rather than making a decision based on the assumption that things won’t work out. In this way, CBT-SP teaches the person to slow down and collect more information before acting.