Hostname: page-component-7dd5485656-npwhs Total loading time: 0 Render date: 2025-10-31T18:31:27.717Z Has data issue: false hasContentIssue false
  • English
  • Français

Does cognitive behavioural therapy have a role in improving problem solving and coping in adolescents with suicidal ideation?

Published online by Cambridge University Press:  07 August 2014

Sarah Hetrick ,
Hok Pan Yuen ,
Georgina Cox ,
Sarah Bendall ,
Alison Yung ,
Jane Pirkis  and
Jo Robinson
Sarah Hetrick*
Affiliation:
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
Hok Pan Yuen
Affiliation:
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
Georgina Cox
Affiliation:
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
Sarah Bendall
Affiliation:
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
Alison Yung
Affiliation:
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia Centre for Psychosis and Mood Disorders, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
Jane Pirkis
Affiliation:
Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
Jo Robinson
Affiliation:
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
*
*Author for correspondence: Dr S. Hetrick, Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne Locked Bag 10, Parkville, Vic 3052, Australia (email: shetrick@unimelb.edu.au)
Get access Rights & Permissions [Opens in a new window]

Abstract

Problem-solving and coping skills deficits have been shown in adolescents who experience suicide-related behaviours, including suicidal ideation. Little evidence exists about effective interventions for this population. We undertook a pilot study of an Internet-based CBT programme that included problem-solving skills training to investigate its impact on skills deficits. The study employed a pre-test/post-test design. Outcomes of interest were negative problem orientation, emotion- and task-focused coping, and adolescents’ perception of helpfulness of the intervention. Participants, recruited via the school wellbeing team, were assessed at baseline, at weekly intervention sessions and immediately post-intervention. Twenty-one adolescents completed the intervention. Over the course of the intervention, negative problem-solving orientation improved and students relied less on emotion-focused coping strategies. Because there was no control group, we cannot be certain that the changes seen between baseline and post-intervention can be attributed to the intervention. Adolescents rated the problem-solving and cognitive restructuring modules as particularly helpful. Interventions that include enhancement of problem-solving skills, as well as cognitive restructuring to address adolescents’ appraisal of problems and their ability to solve them appear promising for adolescents with suicidal ideation. Further investigation is warranted.

Keywords

Adolescentscognitive behavioural therapyInternetsuicidal ideation

Information

Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 7 , December 2014 , e13
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Recommended follow-up reading

Brent, DA, McMakin, DL, Kennard, BD, Goldstein, TR, Mayes, TL, Douaihy, AB (2013). Protecting adolescents from self-harm: a critical review of intervention studies. Journal of the American Academy of Child and Adolescent Psychiatry 52, 1260–1271.Google Scholar
Bridge, JA, McBee-Strayer, SM, Cannon, EA, Sheftall, AH, Reynolds, B, Campo, JV, Pajer, KA, Barbe, RP, Brent, DA. (2012). Impaired decision making in adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry 51, 394–403.Google Scholar
Ghahramanlou-Holloway, G, Bhar, SS, Brown, GK, Olsen, C, Beck, AT (2012). Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide. Psychological Medicine 42, 1185–1193.Google Scholar
Hawton, K, Saunders, KEA, O’Connor, RC (2012). Self-harm and suicide in adolescents. Lancet 379, 2373–2382.CrossRefGoogle ScholarPubMed

References

Andrews, G, Slade, T (2001). Interpreting scores on the Kessler Psychological Distress Scale (K10). Australian and New Zealand Journal of Public Health 25, 494–497.CrossRefGoogle ScholarPubMed
Arie, M, Apter, A, Orbach, I, Yefet, Y, Zalzman, G (2008). Autobiographical memory, interpersonal problem solving, and suicidal behavior in adolescent inpatients. Comprehensive Psychiatry 49, 22–29.CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics (2011). Causes of Death. Canberra, Commonwealth of Australia.Google Scholar
Calear, AL, Christensen, H (2010). Review of internet-based prevention and treatment programs for anxiety and depression in children and adolescents [Review]. Medical Journal of Austtalia 192 (11 Suppl.), S12–14.Google Scholar
Cavanagh, K (2010). Turn on, tune in and (don’t) drop out: engagement, adherence, attrition, and alliance with internet-based interventions. In: Oxford Guide to Low Intensity CBT Interventions (ed. Bennett-Levy, J., Richards, D., Farrand, P., Christensen, H, Griffiths, K., Kavanagh, D., Klein, B., Lau, M. A., Proudfoot, J., Ritterband, L., White, J. & Williams, C.), pp. 227–232. New York: Oxford University Press.CrossRefGoogle Scholar
Chan, SM, Fung, TCT (2014). Reliability and validity of K10 and K6 in screening depressive symptoms in Hong Kong adolescents. Vulnerable Children and Youth Studies 9, 75–85.CrossRefGoogle Scholar
Christensen, H, Griffiths, K, Farrer, L (2009). Adherence in internet interventions for anxiety and depression: systematic review. Journal of Medical Internet Research 11, e13.Google Scholar
Cull, JG, Gill, WS (1988). Suicide Probability Scale (SPS) Manual. Los Angeles: Western Psychological Services.Google Scholar
Curry, JF, Miller, Y, Waugh, S, Anderson, WB (1992). Coping responses in depressed, socially maladjusted, and suicidal adolescents. Psychological Reports 71, 80–82.Google Scholar
D’Zurilla, TJ (1986). Problem-solving Therapy: A Social Competence Approach to Clinical Intervention. New York: Springer.Google Scholar
D’Zurilla, TJ, Chang, EC, Nottingham, EJIV, Faccini, L (1998). Social problem-solving deficits and hopelessness, depression, and suicidal risk in college students and psychiatric inpatients. Journal of Clinical Psychology 54, 1091–1107.Google Scholar
Dixon, WA, Heppner, PP, Anderson, WP (1991). Problem-solving appraisal, stress, hopelessness, and suicide ideation in a college population. Journal of Counseling Psychology 38, 51.Google Scholar
Dixon, WA, Heppner, PP, Rudd, MD (1994). Problem solving appraisal, hopelessness and suicide ideation: evidence of a mediational model. Journal of Counseling Psychology 41, 91–98.Google Scholar
Endler, NS, Parker, JDA (1990). Coping Inventory for Stressful Situations (CISS): Manual. Toronto: Multi-Health Systems.Google Scholar
Endler, NS, Parker, DA (1994). Assessment of multidimensional coping: task, emotion and avoidance strategies. Psychological Assessment 6, 50–60.Google Scholar
Eskin, M, Ertekin, K, Demir, H (2008). Efficacy of a problem-solving therapy for depression and suicide potential in adolescents and young adults. Cognitive Therapy and Research 32, 227–245.Google Scholar
Gould, MS, Munfakh, JLH, Lubell, K, Kleinman, M, Parker, S (2002). Seeking help from he Internet during adolescence. Journal of the Academy of Child and Adolescent Psychiatry 41, 1182–1189.Google Scholar
Grover, KE, Green, KL, Pettit, JW, Monteith, LL, Garza, MJ, Venta, A (2009). Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence. Journal of Clinical Psychology 65, 1281–1290.Google Scholar
Grunbaum, JA, Kann, L, Kinchen, S, Ross, J, Hawkins, J, Lowry, R (2004). Youth risk behavior surveillance – United States 2003. Morbidity and Mortality Weekly Report (Surveillance Summaries) 53, 1–96.Google Scholar
Hawton, K, Rodham, K, Evans, E, Weatherall, R (2002). Deliberate self harm in adolescents: self report survey in schools in England. British Medical Journal 325, 1207–1211.CrossRefGoogle ScholarPubMed
Hawton, KKE, Townsend, E, Arensman, E, Gunnell, D, Hazell, P, House, A, Von Heeringen, K (1999). Psychosocial and pharmacological treatments for deliberate self-harm. Cochrane Database of Systematic Reviews. Issue 4. Art. no. CD001764.Google Scholar
Horwitz, AG, Hill, RM, King, CA (2011). Specific coping behaviors in relation to adolescent depression and suicidal ideation. Journal of Adolescence 34, 1077–1085.CrossRefGoogle ScholarPubMed
Kessler, RC, Andrews, G, Colpe, LJ, Hiripi, E, Mroczek, DK, Normand, SLT, Watters, EE, Zaslavsky, AM (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine 32, 959–956.CrossRefGoogle ScholarPubMed
Khurana, A, Romer, D (2012). Modeling the distinct pathways of influence of coping strategies on youth suicidal ideation: a national longitudinal study. Prevention Science 13, 644–654.Google Scholar
Labelle, R, Breton, JJ, Pouliot, L, Dufresne, MJ, Berthiaume, C (2013). Cognitive correlates of serious suicidal ideation in a community sample of adolescents. Journal of Affective Disorders 145, 370–377.CrossRefGoogle Scholar
Lazarus, RS, Folkman, S (1984). Stress, Appraisal and Coping. New York: Springer.Google Scholar
Lewinsohn, PM, Rohde, P, Seeley, JR (1996). Adolescent suicidal ideation and attempts: prevalence, risk factors, and clinical implications. Clinical Psychology: Science and Practice 3, 25–46.Google Scholar
Mathew, A, Nanoo, S (2013). Psychosocial stressors and patterns of coping in adolescent suicide attempters. Indian Journal of Psychological Medicine 35, 39–46.Google Scholar
McWilliams, LA, Cox, BJ, Enns, MW (2003). Use of the Coping Inventory for Stressful Situations in a clinically depressed sample: factor structure, personality correlates, and prediction of distress. Journal of Clinical Psychology 59, 423–437.Google Scholar
Neil, AL, Batterham, P, Chrisensen, H, Bennett, K, Griffiths, KM (2009). Predictors of adherence by adolescents to a cognitive behavior therapy website in school and community-based settings. Journal Of Medical Internet Research 11, e6.Google Scholar
Nock, MK, Borges, G, Bromet, EJ, Cha, CB, Kessler, RC, Lee, S (2008). Suicide and suicidal behavior. Epidemiologic Reviews 30, 133–154.Google Scholar
Nrugham, L, Holen, A, Sund, A (2012). Suicide attempters and repeaters: depression and coping. A prospective study of early adolescents followed up as young adults. Journal of Nervous and Mental Disease 200, 197–203.Google Scholar
Oldershaw, A, Grima, E, Jollanta, F, Richards, C, Simica, M, Taylora, L, Schmidt, U (2009). Decision making and problem solving in adolescents who deliberately self-harm. Psychological Medicine 39, 95–104.CrossRefGoogle ScholarPubMed
Piquet, ML, Wagner, BM (2003). Coping responses of adolescent suicide attempters and their relation to suicidal ideation across a 2-year follow-up: a preliminary study. Suicide & Life-Threatening Behavior 33, 288–301.Google Scholar
Pollock, LR, Williams, JMG (1998). Problem solving and suicidal behavior. Suicide & Life Threatening Behavior 28, 375–387.Google Scholar
Pollock, LR, Williams, JMG (2004). Problem-solving in suicide attempters. Psychological Medicine 34, 163–167.Google Scholar
Prinstein, MJ, Nock, MK, Simon, V, Aikins, JW, Cheah, CSL, Spirito, A (2008). Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization. Journal of Consulting and Clinical Psychology 76, 92–103.Google Scholar
Puskar, K, Hoover, C, Miewald, C (1992). Suicidal and nonsuicidal coping methods of adolescents. Perspectives in Psychiatric Care 28, 15–20.Google Scholar
Richardson, T, Stallard, P, Velleman, S (2010). Computerised cognitive behavioural therapy for the prevention and treatment of depression and anxiety in children and adolescents: A systematic review. Clinical Child and Family Psychology Review 13, 275–290.CrossRefGoogle ScholarPubMed
Robichaud, M, Dugas, MJ (2005). Negative problem orientation (Part I): psychometric properties of a new measure. Behaviour Research and Therapy 43, 391–401.Google Scholar
Robinson, J, Hetrick, S, Martin, C (2011). Preventing suicide in young people: systematic review. Australian and New Zealand Journal of Psychiatry 45, 3–26.Google Scholar
Robinson, J, Hetrick, S, Cox, G, Bendall, S, Yuen, HP, Yung, A, Pirkis, J (in press a). Can an Internet-based intervention reduce suicidal ideation, depression and hopelessness among secondary school students: results from a pilot study. Early Intervention in Psychiatry.Google Scholar
Robinson, J, Hetrick, S, Cox, G, Bendall, S, Yung, A, Pirkis, J (in press b). The safety and acceptability of delivering an online intervention to secondary students at risk of suicide: findings from a pilot study. Early Intervention in Psychiatry.Google Scholar
Rudd, MD, Rajab, MH, Dahm, PF (1994). Problem solving appraisal in suicide ideators and attempters. American Journal of Orthopsychiatry 64, 136–149.Google Scholar
Sadowski, C, Kelley, ML (1993). Social problem solving in suicidal adolescents. Journal of Consulting and Clinical Psychology 61, 121–127.Google Scholar
Salkovskis, PM, Atha, C, Storer, D (1990). Cognitive-behavioural problem solving in the treatment of patients who repeatedly attempt suicide. A controlled trial. British Journal of Psychiatry 157, 871–876.Google Scholar
Schotte, DE, Clum, GA (1982). Suicide ideation in a college population: a test of a model. Journal of Consulting and Clinical Psychology 50, 690–696.Google Scholar
Schotte, DE, Clum, GA (1987). Problem-solving skills in suicidal psychiatric patients. Journal of Consulting and Clinical Psychology 55, 49–54.Google Scholar
Spek, V, Cuijpers, PIM, Nyklicek, I, Riper, H, Keyzer, J, Pop, V (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine 37, 319–328.Google Scholar
Spence, S, Sheffield, J, Donovan, C (2002). Problem-solving orientation and attributional style: moderators of the impact of negative life events on the development of depressive symptoms in adolescence? Journal of Clinical Child and Adolescent Psychology 31, 219–229.Google Scholar
Subrahmanyam, K, Lin, G (2007). Adolescents on the net: internet use and well-being. Adolescence 42, 659–677.Google Scholar
Townsend, E, Hawton, K, Altman, DG, Arensen, E, Gunnell, D, Hazell, P, House, A, Von Heeringen, K (2001). The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomized controlled trials with respect to depression, hopelessness and improvement in problems. Psychological Medicine 31, 979–988.Google Scholar
Weersing, VR, Rozenman, M, Gonzalez, A (2009). Core components of therapy in youth: do we know what to disseminate? Behavior Modification 33, 24–47.Google Scholar
WHO (2000). Preventing Suicide. A Resource for Teachers and Other School Staff. Geneva: World Health Organisation.Google Scholar
Wilson, KG, Stelzer, J, Bergman, JN, Kral, MJ, Inayatullah, M, Elliott, CA (1995). Problem solving, stress, and coping in adolescent suicide attempts. Suicide and Life Threatening Behavior 25, 241–252.Google Scholar
Submit a response

Comments

No Comments have been published for this article.