Treating Outpatient Suicidal Adolescents: Guidelines from the Empirical Literature

By Muehlenkamp, Jennifer J.; Ertelt, Troy W. et al. | Journal of Mental Health Counseling, April 2008 | Go to article overview
Save to active project

Treating Outpatient Suicidal Adolescents: Guidelines from the Empirical Literature

Muehlenkamp, Jennifer J., Ertelt, Troy W., Azure, Jeri Ann, Journal of Mental Health Counseling

Mental health counselors identify treating suicidal clients as one of the most stressful aspects of their work. Treating suicidal adolescents poses a range of additional challenges. Literature on suicidal behavior continues to grow and potentially efficacious treatments are being developed, however clinicians in the field are provided few guidelines for treating suicidal clients. In this paper we provide a brief review of evidenced-based treatments with suicidal adolescents and offer guidelines for the treatment of suicidal adolescents within outpatient settings. We conclude with a brief overview of special considerations for treating adolescents who are suicidal.


Suicide remains a significant cause of death in the United States, particularly among youth. Suicide is the third leading cause of death among 15 to 19 year olds (National Center for Health Statistics, 2004), and rates of death from suicide increase with age from childhood through adulthood (Gould, Greenberg, Velting, & Shaffer, 2003). Consistent findings from the Youth Risk Behavior Survey conducted by the Center for Disease Control and Prevention have shown that significant numbers (e.g., 16.9%) of high school students reported serious suicidal ideation with plans in the proceeding year (Grunbaum, Kann, Kinches, et al., 2004). Furthermore, Grunbaum et al. (2004) documented that 8.5% of high school students reported attempting suicide within a 12-month period, and 2.9% made an attempt that required medical intervention. Thus, suicide remains a considerable problem among youth.

Suicidal behavior, including ideation and attempts, is one of the most commonly encountered emergencies for the mental health clinician (Beutler, Clarkin, & Bongar, 2000; Pope & Tabachnick, 1993), up to 20% of whom will have a client who dies by suicide during treatment (Campbell, 2006; Chemtob, Hamada, Bauer, Kinney, & Torigoe, 1988). Unfortunately, clinicians are often not adequately prepared for managing and treating suicidal clients (Bongar, 2002). Utilization of inpatient hospitalization for suicidal clients has significantly decreased in recent years due to the effects of managed care and findings that hospitalization confers little to no positive treatment effect (Comtois & Linehan, 2006; Rissmiller, Steer, Ranieri, Rissmiller, & Hogate, 1994). As a result, much of the responsibility for the care of a suicidal client falls upon clinicians working in outpatient care settings. Unfortunately, clinicians lack clear guidelines for treating suicidal persons; particularly suicidal youth. Our primary goals for this review are to provide a brief overview of empirically supported treatments for suicidal adolescents and to offer empirically based guidelines for working with suicidal youth. We will also briefly address special challenges specific to treating adolescents who are suicidal.


The empirical literature regarding the treatment of suicidal persons is remarkably sparse, particularly with regard to suicidal adolescents (Gould et al., 2003; Hawton, et al., 1999; Miller & Glinski, 2000). Conclusions drawn from reviews of randomized controlled trials and uncontrolled studies of suicide treatments with adult samples are mixed at best. Generally, it appears as though cognitive-behavioral interventions that incorporate a problem-solving element have promise for reducing suicide ideation, attempts, and symptoms of concomitant disorders (Comtois & Linehan, 2006; Hawton, et al., 1998; Rudd, 2000). Furthermore, in a recent study of cognitive therapy, Brown and colleagues (2007) found that suicidal patients who received l0 sessions of cognitive therapy had significantly fewer suicide attempts and lower rates of depression at 18 months post-treatment. While it would appear that cognitive-behavioral based approaches may be best, other treatment modalities, such as interpersonal psychotherapy, have shown promise for reducing suicidality (e.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Treating Outpatient Suicidal Adolescents: Guidelines from the Empirical Literature


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?