Future Oriented Group Training for Suicidal Patients.

Research shows that hopelessness contributes to suicidality. Especially lack of positive future expectancies (as part of hopelessness) appears to be an important factor in developing suicidal ideations and behavior (MacLeod, Rose & Williams, 1993). Different forms of treatment for underlying mechanisms in suicidality have been developed and tested, but research in the United States (Kessler, Berglund, Borges, Nock Wang, 2005) showed that we can hardly observe consistent decrease in suicidal thoughts, plans, gestures or attempts after treatment. Suicidality on an individual level decreases after some forms of treatment, but the overall picture is not much different from that of two decades ago. Studying the effects of treatment is difficult, becasue suicide is rather unusual. Suicide has a low prevalence in the general population (0.01%), but suicide ideation is remarkably common (Gaynes, West, Ford, Frame, Klein & Lohr, 2004). We therefore choose to develop a program for this group of people. Suicide ideations precedes suicide most of the time and we expect this aspect to be better treatable and measurable, in an earlier stage of the suicidal process.

Our intervention consists of ten weekly group based training sessions of one and a half hour each. The central goals of the training are to help participants focus on a more positive future, to improve the skills needed to reach their personal goals and change their negative automatic thoughts and expectancies about their futures.

Our training method is based upon three major elements that have been discribed and investigated in research on suicidality and have been proven to be useful:

1. Cognitive Behavioral Therapy (Brown, G.K., Ten Have, T., Henriques, G.R., Xie, S.X., Hollander, J.E. & Beck, A.T.,2005).

2. Problem Solving Therapy (D´Zurilla, 1986).

3. Future Directed Thinking (MacLeod, Tata, Tyrer, Schmidt, Davidson, & Thompson, 2004).

We will use additional material from Positive Psychology and Time Perspective theory (Zimbardo & Boyd, 1999).

1. The level of suicide ideation is correlated with al ow level of positive future expectencies

2. Our future oriented training will help people to predict a more positive future

3. And this will lead to less suicide ideation

We developed a manual-based group training, including elements from:

1. motivational interviewing

2. cognitive behavioural therapy

3. problem solving treatment

4. future thinking

5. positive psychology

We compare three groups:

1. treatment as usual

2. TAU + experimental training

3. non suicidal control group