In a new study, brief cognitive behavioral therapy (BCBT)—with an emphasis on emotion regulation and crisis response planning—led to fewer suicide attempts in veterans and military personnel.
Veterans and military personnel are at a higher risk of suicide. Yet increased screening and drug treatment have led to worsening outcomes, not better. Despite some researchers’ insistence on lithium as the only worthwhile psychiatric drug, a major attempt to reduce suicide in veterans using lithium had to be stopped early because it simply didn’t work.
The lack of support for existing treatment goes for the general population too: analysis after analysis has found that suicide rates have increased alongside increasing antidepressant drug use (and actually decreased when antidepressant prescribing took a dip, too).
Other studies have supported the notion that antidepressants increase suicide. While this increased risk is particularly strong for children and teens, it has also been found for adults.
Yet researchers are finding that psychotherapy could result in improved outcomes. And the current study supports this, with more specific findings about which elements of therapy have an outsized protective effect.
The current study compared BCBT against an existing psychotherapy (present-centered therapy, or PCT) which has already been shown to reduce suicidal ideation. The result—that BCBT was better at reducing suicide attempts—shows that there is something about this therapy that could lead to better results than existing therapies.
“Our results are noteworthy when considering our comparator (PCT) included recommended clinical practices like suicidal ideation screening and safety planning,” the researchers write.
The study was led by Craig J. Bryan and published in JAMA Psychiatry. Bryan, a veteran who is involved with the VA’s Center for Excellence in Suicide Prevention (CoE), has researched and written extensively about the need to rethink existing suicide prevention programs.
“This RCT found that BCBT reduced the risk of suicide attempts among military personnel and veterans with recent suicidal ideation and/or suicidal behaviors and was more effective than an active psychotherapy that has been shown to reduce suicidal ideation,” Bryan writes.
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It’s good to know that studies support a no-drug approach to this problem.
But it’s obvious that they are still grasping at straws regarding what makes people want to kill themselves (besides psych drugs).
I haven’t studied this subject that much, but I am sure that the more workable therapies (that seldom get reported here or anywhere else, and are seldom tested by academic researchers) work the best with this problem, too.
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“As a final note, all participants also continued treatment as usual, probably including antidepressant drugs, so it is not possible to judge whether these therapies would have been effective alone.
Still, even for severe depression, multiple studies have found that adding antidepressants to cognitive behavioral therapy does not result in better outcomes—psychotherapy alone is just as good. In fact, therapy alone beats the drugs when it comes to long-term outcomes. In terms of other “treatments” for depression, a recent large study found that exercise alone is also just as good as antidepressants.”
And then this, all in the SAME article:
“The lack of support for existing treatment goes for the general population too: analysis after analysis has found that suicide rates have increased alongside increasing antidepressant drug use (and actually decreased when antidepressant prescribing took a dip, too).
Other studies have supported the notion that antidepressants increase suicide. While this increased risk is particularly strong for children and teens, it has also been found for adults.”
For one thing, one can conclude that exercise works as well as what has proven to increase suicide, which of course isn’t the case. Exercise does help.
The title also made me cringe, actually. When someone is suicidal, to tell them “emotional regulation may help.” sounds rather like a put off. Being so distressed that suicidal thoughts emerged, somehow being told that regulating one’s emotions (the ones one wasn’t supposed to have), this isn’t more suppression? There is a difference between regulating and having an outlet for emotions.
When someone is in the trenches for days, being shot at, they have shown the signs of “psychosis,” then being taken out of such a situation, they get better after a few days. That’s how the story of the “scientific” research goes. That they ever ended up in a trench being shot at, that the war they were in is a means of solving problems, that in this day the militaries of various countries can destroy all human life multiple times over (last I heard years ago this was 20 times, but this was 2008), and this all for promoting “safety” from some “enemy” this isn’t considered perhaps as being symptoms of a disease!? Or even questioned at all in regards what’s looked at, for the most part. What does this really say about what’s called “psychosis” or “depression!?”
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They didn’t say how long the therapy was or the follow up period. A total of 108 patients and 10 suicides and they think that’s good.
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