People who attempt suicide need a specific therapy

Attempted suicide is the main risk factor for repeated suicide attempts and death by suicide. So far there have only been very few therapy programs that have been successful in effectively reducing the suicide risk for suicide attempters. This article argues that the traditional medical model of suicide is not helpful for active treatment engagement of the patients, and that we need a different approach to the suicidal patient. Our research team developed and evaluated a novel, brief and very cost-effective therapy program (the Attempted Suicide Short Intervention Program ASSIP). In contrast to the medical model, which conceptualizes suicide as a consequence of a psychiatric illness, the ASSIP model is based on the concept of suicide as a personal action, which can be understood in a collaborative therapeutic approach. The action-theoretical approach is radically patient-centred, in that the patients are seen as the agents of their suicide actions. This approach fosters the patients’ active engagement in therapy. A central element is the patient’s self-narrative, which puts the suicide attempt in a biographical context. With the help of the therapist, the suicidal crisis can be understood, explained, and revised. ASSIP has been evaluated in a randomized controlled trial with 120 participants. At 24 months follow-up, the treatment group had a remarkable 80% reduced risk of reattempting suicide. The article explains the theoretical background and the development of ASSIP, followed by a summary of the ASSIP sessions and a discussion of the therapy process factors.