Assessment and Treatment of Suicidal Thoughts and Behaviors in Youth
Book Chapter
Padron, M, Balser, DH, Pettit, JW. (2026). Assessment and Treatment of Suicidal Thoughts and Behaviors in Youth
. 231 75-89. 10.1007/978-1-0716-5134-6_5
Padron, M, Balser, DH, Pettit, JW. (2026). Assessment and Treatment of Suicidal Thoughts and Behaviors in Youth
. 231 75-89. 10.1007/978-1-0716-5134-6_5
Suicide in children and adolescents (youth) is a major public health crisis, with rates of suicide and suicide attempts showing alarming increases over the past two decades. This chapter describes the cognitive-behavioral approach to treatment of suicidal thoughts and behaviors in youth. We first review data on the prevalence of suicidal thoughts and behaviors in youth and describe prominent theoretical models of suicide. We then briefly summarize research on treatments for suicidal thoughts and behaviors in youth, including cognitive-behavioral therapy (CBT), and strategies for assessing and monitoring risk. We conclude with an overview of the basic principles of CBT for suicidal thoughts and behaviors in youth, followed by the structure and goals of treatment. CBT leverages a collaborative partnership between therapist and client, with the initial phase (psychoeducation and stabilization) prioritizing assessment and management of risk, including the use of safety planning. The initial phase also emphasizes psychoeducation on the cognitive-behavioral conceptualization of suicidal thoughts and behaviors as maladaptive coping strategies, setting up the goal of developing alternative, adaptive strategies for coping with distress. Information gathered during assessment is used to devise a treatment plan. During the second phase of treatment (application), the emphasis shifts to implementing the treatment plan with an eye toward building adaptive coping skills. Strategies and tasks in the application phase include the identification of reasons to live and creation of a hope box to promote motivation and connect youth with their value system, as well as the development of more adaptive thinking patterns and emotion regulation skills for managing difficult situations. Family dynamics are also a focus of the application phase, enhancing communication strategies, active listening, conflict resolution, and emotional validation to strengthen the family support system. In the final phase (skills consolidation and relapse prevention), the emphasis shifts to helping youth solidify skills learned during treatment to prepare for termination.
