Combining Mindfulness-Based Cognitive Therapy with Safety Planning Intervention to Reduce Suicidal Behavior

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pan-lisa-2013Background
Mindfulness meditation is the practice of being more in touch with the present moment, bringing one’s attention inward without judgment of current thoughts or experiences. Mindfulness-Based Cognitive Therapy (MBCT) is an intervention that has been shown to reduce depression relapse in individuals who also have suicidal ideations and behaviors.

Mindfulness-Based Cognitive Therapy and Safety Planning Intervention (MBCT+SPI) is a mindfulness-based cognitive therapy tailored specifically for managing suicidal ideation and behavior. Both interventions have not been formally developed or used in a group format.

Dr. Megan Chesin’s research aims to explore the practice of mindfulness meditation and cognitive therapy practices in combination with Safety Planning Intervention MBCT+SPI in a group therapy environment for reducing suicidal ideation and behavior.

Question
Can Mindfulness Intervention and Safety Planning be combined using a group therapy environment to treat people with suicidal ideation and behaviors?

Study
Treatment is delivered in a group setting over about nine weeks. The first session is aimed at Safety Planning (SPI), a manualized, brief one-session intervention lasting 20-45 minutes. SPI helps individuals recognize their own warning signs of a suicidal crisis, and provides them with coping strategies, a ready-list of safety contacts, and a plan for limiting their access to lethal means.

Dr. Chesin’s study included outpatients who had suicidal ideation, a history of suicide attempt, and those with a method and plan of attempt within the past six months. Suicidal ideation was measured using the Scale for Suicidal Ideation (SSI), and depression with the Beck Depression Inventory-II. The study also assessed level of mindfulness, attention, and cognitive reactivity, i.e. negative patterns of thinking that can quickly be re-triggered.

Phase One consisted of a preliminary study with five participants, collecting feedback as to the  accessibility and feasibility of using mindfulness meditation as part of an intervention that targets suicidal ideation.

In Phase Two, 13 additional individuals received the manualized treatment of MBCT+SPI, measuring their level of mindfulness, attention, and cognitive reactivity.

Results
Treatments delivered in a group setting showed promise in increasing feelings of connectedness, due to the added peer support. MBCT+SPI was deemed safe, and depression, hopelessness and suicidal thinking were found to decrease over the course of treatment. Participants gave positive feedback on both the mindfulness training component and the safety planning.

Takeaway
Group Therapy treatments directed at suicidal ideations and behaviors is a novel approach to targeting suicidal ideation and behavior, particularly when there is a greater susceptibility to relapse and recurrence. Advantages of a group format are more cost effectiveness, stigma reduction and greater accessibility.

This study revealed the safe and positive effects of using Mindfulness-Based Cognitive Therapy and Safety Planning Intervention in a group therapy setting for individuals experiencing suicidal ideation and behavior.

Grant-related publications

  • Chesin, M., Interian, A., Kline, A., Benjamin-Phillips, C., Latorre, M., & Stanley, B. (2016). Reviewing mindfulness-based interventions for suicidal behavior. Archives of suicide research, 20(4), 507-527.
  • Chesin, Megan, and Barbara Stanley. “Risk assessment and psychosocial interventions for suicidal patients.” Bipolar disorders 15.5 (2013): 584-593.
  • Chesin, Megan S., and Elizabeth L. Jeglic. “Factors associated with recurrent suicidal ideation among racially and ethnically diverse college students with a history of suicide attempt: the role of mindfulness.” Archives of suicide research 20.1 (2016): 29-44.
  • Chesin, Megan S., et al. “Preliminary effectiveness of adjunct mindfulness-based cognitive therapy to prevent suicidal behavior in outpatients who are at elevated suicide risk.” Mindfulness 6.6 (2015): 1345-1355.
  • Chesin, Megan S., and Elizabeth L. Jeglic. “Suicidal behavior among Latina college students.” Hispanic Journal of Behavioral Sciences 34.3 (2012): 421-436.

Click here to read about Dr. Chesin’s Postdoctoral Fellowship.