Comparative Effectiveness of Individual, Group, Family and Combined Therapy Formats on Suicidality: A Meta-Analysis

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-07-02 DOI:10.1002/cpp.70112

Nikki Lyka van Eijk, Renske Gilissen, Daan Creemers, Lizanne J. S. Schweren, Wouter van Ballegooijen

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Abstract

Through carefully choosing psychotherapeutic interventions based on treatment characteristics, we may increase the relatively small effect sizes for suicidal outcomes. This study aims to evaluate the efficacy of different psychotherapy formats in reducing suicidal ideation and attempts, including individual, group and family-based therapies, as well as combined modalities involving individual and group or individual and family interventions. We conducted a meta-analysis after systematically searching databases for randomised controlled trials up to April 1, 2024. Included studies targeted any mental health issue, were delivered in any setting, compared with any control group, and reported on suicidal ideation or attempts. Data extraction and quality assessment were performed independently by two researchers, and a mixed-effects model was used for data synthesis. One hundred and seventy-two studies were eligible, totalling 198 comparisons with a total of 22,440 participants. Individual therapy significantly reduced suicidal ideation (g = −0.33, p < 0.001, k = 72 comparisons), as did group therapy (g = −0.39, p < 0.001, k = 27 comparisons). For reducing suicide attempts, individual therapy (RR = 0.75, p < 0.001, k = 63 comparisons), and notably, combinations of individual with group (RR = 0.42, p = 0.010, k = 7 comparisons) and individual with family-based therapy (RR = 0.59, p = 0.041, k = 8 comparisons) were effective. Subgroup analysis showed that combined therapies were associated with larger effect sizes compared to single modalities in reducing suicide attempts (p < 0.001). This meta-analysis highlights that combined psychotherapy approaches, integrating individual sessions with group or family sessions, yields significantly higher effect sizes, reducing the risk of suicide attempts by 50%. These findings support the adoption of combined therapeutic strategies in clinical settings to effectively address suicidality.

Summary

Individual or group therapy is effective for reducing suicidal ideation. Family therapy seems less effective than other formats.
Individual therapy, or combining individual therapy with group therapy or family therapy, is effective for preventing suicide attempts.
A combination of individual therapy with group or family therapy seems more effective at preventing suicide attempts than other formats.

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个体、团体、家庭和联合治疗形式对自杀的比较效果：一项meta分析

通过仔细选择基于治疗特点的心理治疗干预措施，我们可能会增加自杀结果的相对较小的效应大小。本研究旨在评估不同心理治疗形式在减少自杀意念和企图方面的效果，包括个人、团体和家庭治疗，以及涉及个人和团体或个人和家庭干预的联合模式。在系统检索数据库中随机对照试验后，我们进行了一项荟萃分析，截止到2024年4月1日。包括针对任何心理健康问题的研究，在任何环境下进行，与任何对照组进行比较，并报告自杀意念或企图。数据提取和质量评估由两位研究者独立完成，采用混合效应模型进行数据合成。172项研究符合条件，共有198项比较，共有22,440名参与者。个体治疗显著降低自杀意念（g = - 0.33, p < 0.001, k = 72比较），团体治疗也显著降低自杀意念（g = - 0.39, p < 0.001, k = 27比较）。对于减少自杀企图，个体治疗（RR = 0.75, p < 0.001, k = 63比较），值得注意的是，个体与群体联合治疗（RR = 0.42, p = 0.010, k = 7比较）和个体与家庭联合治疗（RR = 0.59, p = 0.041, k = 8比较）是有效的。亚组分析显示，与单一治疗方式相比，联合治疗在减少自杀企图方面具有更大的效应（p < 0.001）。这项荟萃分析强调，结合心理治疗方法，将个人治疗与团体或家庭治疗结合起来，效果显著提高，将自杀企图的风险降低了50%。这些发现支持在临床环境中采用联合治疗策略来有效地解决自杀问题。个人或团体治疗对于减少自杀意念是有效的。家庭治疗似乎不如其他形式有效。个体治疗，或将个体治疗与团体治疗或家庭治疗相结合，对预防自杀企图是有效的。个人治疗与团体或家庭治疗相结合似乎比其他形式更有效地预防自杀企图。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.