Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
41,000 people kill themselves every year. For every suicide that is completed, 25
other individuals will make a suicide attempt. That means that there are more
than a million suicide attempts annually.
Suicide completion is 3.5 times more common in men than in women, and
white males make up approximately 70% of completed suicides. The highest rates
of suicide are in adults between the ages of 45 and 64 (19.3%) and among those
85 years or older (19.2%).
While men are more likely to die by suicide, women are more likely to attempt
suicide. Men are more likely to use deadly methods, such as firearms, while
women are more likely to attempt suicide by poisoning. While white, older
males have the highest rate of suicide completion, among minority ethnic
groups American Indians and Alaskan Natives tend to have the highest rate of
suicide. African Americans and Hispanics tend to have the lowest rates. The
most frequent method of completed suicide is by firearms, which account for almost
half of suicides.
Understanding who is at risk for suicide involves understanding the complex
factors among individual differences, long-term risk factors, and short-term
risk factors. Individuals who complete suicide demonstrate individual differences
in processing emotion, thinking, planning, problem solving, and decision
making. They may have long-term risk factors, such as childhood violence or
ongoing mental disorders. The interplay between these individual differences,
long-term factors, and triggering events, such as loss or exposure to suicide,
helps researchers and clinicians understand who is at risk. Suicide most often
occurs when stressors outweigh a person's ability to cope, particularly in individuals
with a mental health condition. Approximately 90% of people who complete
suicide have a co-occurring mental disorder; however, there are many risk
factors for suicide and a mental disorder alone does not necessarily make one
at risk for suicide. Documented risk factors for suicide include co-occurring
mental health problems, chronic physical pain, terminal illness, acute loss, family
history of suicide and/or mental disorders, and situational factors, such as
having access to guns or being incarcerated.
The interpersonal-psychological theory of suicidal behavior developed by
Thomas Joiner proposes that an individual will not die by suicide unless she or
he has both the desire to die by suicide and the ability to do so. The desire to die
by suicide is thought to be a combination of psychological states called perceived
burdensomeness and low sense of belonging. The ability to die by suicide
is proposed to be an acquired capability for suicide developed over time by exposure
to painful experiences that results in a fearlessness of pain, injury, and
death. While not conclusive, this theory has substantial evidence to support it
and gives clinicians a structured theory to understand suicide.
Depression is the mental disorder most commonly associated with suicide, and
is present in 50% of suicides. Individuals with depression are at 25 times greater
risk for suicide than individuals without depression, and an estimated 2% to
9% of individuals with depression will complete suicide. Untreated depression
increases this estimated range to 2% to 15%.
An estimated 3% to 20% of people diagnosed with bipolar disorder die by
suicide, and approximately half of individuals with bipolar disorder have
made a suicide attempt. Onset of the disorder, hopelessness, recent hospital
discharge, family history, and prior suicide attempts all raise the risk of
suicide in these individuals. The reasons for the seemingly higher rate of
suicide in persons with bipolar disorder compared with those who are only
diagnosed with depression are largely unknown; however, there is evidence
to support that comorbid anxiety disorders confer additional risk for suicide
in this population. Lifetime anxiety disorders were associated with
more than a doubling of the risk of a suicide attempt. Moreover, the more
anxiety disorders one has, the greater the risk for attempted suicide.
Among people diagnosed with schizophrenia, an estimated 20% to 40% attempt
suicide. Between 5% and 13% actually complete the act of suicide.
Compared to the general population, people with schizophrenia have a more
than eight-fold increased risk of suicide. Depression is one of the major risk
factors for suicide among individuals with schizophrenia. In one trial, suicidal
thoughts and plans, previous suicide attempts, and depressive symptoms
are among the strongest predictors of suicidality in patients presenting
with first-episode psychosis. A history of prior suicide attempts, drug misuse,
alcohol misuse, poor adherence to treatment, all increase risk for suicide
in patients with schizophrenia. Additionally, the presence of auditory
hallucinations and delusions increases risk of suicide among patients with
People with personality disorders are approximately three times as likely
to die by suicide as those without. Between 25% and 50% of these individuals
also have a substance abuse disorder or major depressive disorder. Personality
disorders confer risk for suicide above and beyond other risk
factors, meaning that individuals with both a psychiatric disorder, such as
anxiety or depression, and a personality disorder are at increased risk for
suicide attempts and completed suicide. Borderline personality disorder
(BPD) is highly associated with suicidality, with rates as high as 10% of sufferers.
Because suicidal behavior is a symptom of BPD, the estimated rate
of suicide attempts is between 40% to 85% in this group.
Anxiety disorders, especially panic disorder and PTSD, are independently
associated with suicide attempts. More than 70% of individuals who reported
making a suicide attempt had an anxiety disorder. Even after adjusting
for sociodemographic factors and other types of psychiatric
disorders, the presence of an anxiety disorder was significantly associated
with suicide attempts. Panic disorder and PTSD, when comorbid with personality
disorders, demonstrated much stronger associations with suicide
attempts over either disorder alone.
Compared with the general population, individuals with chronic pain have
higher levels of depression, PTSD, and any anxiety disorder. Patients with
chronic pain are twice as likely to commit suicide as individuals without.
Pain-specific risk factors include location (low back and widespread pain),
intensity (high), duration, and concomitant insomnia. Catastrophizing and
feelings of being a burden also are associated with suicidal ideation in the
pain population. Studies of patients with complex regional pain syndrome
(CRPS) or fibromyalgia have shown particularly high rates of suicidal ideation (74% and 48%, respectively).
There are many warning signs for suicide, including changes in behavior,
talking about being a burden, statements about feeling hopeless, physical
pain, having no reason to live, and insomnia. Specific behavioral changes
may include increased alcohol or drug use, looking or researching ways to
commit suicide, withdrawing from people, friends and activities, giving
things away, and increased aggressive and impulsive behaviors.
Protective factors buffer individuals from suicidal thoughts and behavior.
Although protective factors have not received as much research as risk factors,
there are some identified factors that help reduce risk. A strong therapeutic
relationship with a provider, access to clinical interventions, family
and community support, good problem-solving skills, and religious or spiritual
beliefs that discourage suicide are all thought to reduce risk for suicide.
Treatment for specific risk factors is the number-one prevention strategy
for suicide. Treatment for individuals who are at risk for suicide is multifaceted
and may involve both medication and psychotherapy to address the
underlying mental health disorder. Social support may also reduce the risk,
particularly for individuals who have had a recent significant loss. Cognitive
behavioral therapy for suicide attempters and dialectical behavior therapy
have been shown to reduce the rates of suicide.
There are many medications available to treat depression, anxiety disorders,
and substance use. At this time, clozapine is the only medication approved
by the FDA to treat suicide risk in patients with schizophrenia.
Antidepressant medications may increase anxiety, agitation, restlessness,
and irritability, which may increase risk for suicide when the medication is
started or the dosage is changed. These medications come with a black-box
warning, and symptoms should be closely monitored with the prescribing
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