Conference Agenda

Background: Men have a significantly higher risk of dying by suicide, yet they are less likely to seek help during a suicidal crisis or after discharge from inpatient psychiatric care. Empirical evidence on barriers to care for men is limited, and research informing tailored interventions is urgently needed.

Method: Study 1 examined the use of outpatient psychotherapeutic and psychiatric services by men (18–81) six months after discharge following a suicide attempt or suicidal crisis. Study 2 investigated differences between planned service use (as part of discharge management) and actual use among 74 male psychiatric patients (18–72) three weeks post-discharge. Study 3 explored help-seeking in men using qualitative interviews.

Results: In Study 1, 52% of men reported no use of outpatient psychotherapeutic or psychiatric services within six months after discharge. In Study 2, 90.7% of male patients stated that further outpatient treatment had been planned before discharge, with no significant gender differences (90.7% men vs. 92.6% women, p = .850). However, three weeks after discharge, 51.6% of men had not received any further outpatient treatment, and only 25.4% had attended outpatient psychotherapy, with significant differences between men and women. Study 3 identified facilitating factors for help-seeking, such as access to professional support, social support, positive experiences with the support system, and symptom burden. Inhibiting factors included perceived inaccessibility of professional support, psychological barriers to seeking help, negative experiences with the support system, stigma, guilt and shame, and hegemonic masculinity norms.

Conclusion: Men in suicidal crises are less likely to seek help and face greater challenges accessing outpatient care after discharge. The findings across studies highlight multiple avenues for improving care. Implementing gender-specific suicide prevention measures is essential to enhance service engagement and reduce suicide risk among men.

Suicide prevention efforts have advanced considerably, yet individuals with childhood trauma remain among the highest-risk groups and continue to fall through gaps in traditional care. Trauma-focused therapies often exclude individuals with active suicidality from clinical trials, while suicide-specific interventions may not fully address the developmental, somatic, cognitive, affective, and relational impacts of early adversity. This creates a clinical gap in integrated, developmentally informed approaches for those managing both trauma and suicide risk. This presentation introduces Integrated Suicide and Trauma Therapy (ISTT), a 12-week intervention designed specifically for adults with childhood trauma and current suicide risk. The rationale for ISTT was strengthened by our Canada-wide evaluation of Brief Skills for Safer Living (Brief-SfSL), a single session therapy, in which over 60% of participants reported childhood trauma and often linked the onset of suicidal thoughts to those early experiences. Brief-SfSL led to meaningful reductions in suicidal ideation at three months, while also highlighting unmet trauma-related needs within this population. ISTT integrates Brief-SfSL’s suicide-focused strategies with trauma-informed techniques grounded in neurobiology, attachment theory, and parts-based models. The goal is to help individuals understand suicidal thoughts within the context of trauma and identify and manage trauma-related triggers that intensify suicidality, supporting safety even when suicidal thoughts persist. This talk will review (1) current evidence on treating suicidality in the context of childhood trauma, (2) the theoretical rationale and core components of ISTT, and 3) preliminary quantitative and qualitative findings from ISTT.

Theoretical background: Suicidal ideation and trauma-related distress frequently co-occur and share overlapping cognitive-emotional mechanisms. Crisis Response Planning (CRP) is an empirically supported intervention for suicide risk, yet it is often delivered separately from trauma-focused treatments such as those for posttraumatic stress disorder (PTSD).

Research question: How can CRP be systematically integrated into evidence-based PTSD psychotherapies to improve patient safety, enhance emotional stabilization, and better address shared drivers of suicidal ideation and trauma-related suffering?

Method: Drawing on emerging clinical and pilot work, integrative strategies—including sequencing, blending, and reinforcing complementary procedures—are applied to harmonize CRP with trauma-processing elements. This includes embedding crisis response strategies within narrative processing, self-monitoring routines, and emotion regulation skills to create coherent therapeutic pathways.

Results: Early findings suggest that integrating CRP into PTSD treatment can strengthen patients’ sense of safety, reduce destabilizing fluctuations in suicide risk during trauma work, and promote more consistent therapeutic engagement. The combined approach appears to accelerate clinical improvement and minimize treatment disruptions.

Conclusion: Integrating suicide-focused and trauma-focused interventions allows psychotherapy to respond more directly to the lived experiences of individuals with PTSD and elevated suicide risk. Such harmonized treatment models may enhance recovery trajectories, reduce fragmentation in care, and offer a more patient-centered approach to complex clinical presentations.

Background: Psychological pain is a key risk factor for suicidal ideation/behaviour, while nonverbal synchrony has been identified as an implicit interpersonal process that supports therapeutic alliance development. As alliance is closely linked to clinical improvement in suicidal individuals, this study examined whether movement synchrony in a suicide-specific therapeutic setting surpasses random synchrony and whether it relates to patients’ psychological pain.

Method: A total of 95 video-recorded sessions from the Attempted Suicide Short Intervention Program (ASSIP) were analyzed using Motion Energy Analysis (MEA) to quantify synchrony in head and upper body movements. Psychological pain was assessed with the Suicide Status Form II (SSF-II). Pseudosynchrony was generated statistically to determine whether observed synchrony exceeded random alignment.

Results: Authentic movement synchrony was significantly higher than pseudosynchrony (t(110.16) = 4.314, p < .001, d = 0.49, 95% CI [0.005, 0.014]), confirming that patient–therapist coordination reflects genuine interpersonal attunement rather than chance. Higher synchrony was associated with lower psychological pain (r(84) = –.319, p = .003), and this relationship remained significant when controlling for potential confounding factors (r(84) = –.302, p = .008).

Conclusion: These findings underscore the relevance of nonverbal synchrony in suicide-specific psychotherapy. The fact that synchrony exceeds random movement alignment and covaries with reduced psychological pain suggests that embodied coordination may serve as an important clinical indicator of interpersonal connection and therapeutic progress in individuals following a suicide attempt.

Background: The highest risk for suicide reattempt occurs shortly after discharge from acute care. Suicide-specific brief interventions such as the Attempted Suicide Short Intervention Program (ASSIP) have demonstrated substantial risk-reducing effects. ASSIP flex, a recent adaptation, expands access across inpatient, outpatient, and home-based settings. Although therapeutic alliance and self-efficacy are considered core mechanisms in suicide-focused psychotherapy, their interaction in brief interventions has not yet been systematically investigated. This study examined (1) changes in therapeutic alliance and self-efficacy, (2) their interrelation during treatment, and (3) associations between self-efficacy and suicidal ideation.

Methods: This sub-analysis of a longitudinal observational study included 64 patients (51.6% female; M age = 39.6, SD = 15.7) with a history of suicidal behaviour. Assessments took place before treatment (t₀), after completion (t₁), and after each of the three ASSIP flex sessions. Measures included the Working Alliance Inventory–Short Revised (WAI-SR), the General Self-Efficacy Scale (SWE), and the Beck Scale for Suicide Ideation (BSS). Analyses comprised repeated-measures ANOVAs, paired t-tests, linear regressions, and multilevel models.

Results: Therapeutic alliance increased significantly across the three sessions (F(1,63) = 48.08, p < .001). Self-efficacy improved from t₀ to t₁ (t(63) = -3.41, p < .001). Higher baseline self-efficacy predicted stronger alliance in both the first (β = .43, p < .001) and third sessions (β = .29, p = .041). Suicidal ideation decreased significantly from t₀ to t₁ (β = -.22, p < .001), and higher self-efficacy was associated with lower suicidal ideation (β = -.32, p < .001).

Conclusion: Findings underscore therapeutic alliance and self-efficacy as interlinked mechanisms within ASSIP flex and highlight their relevance for reducing suicidal ideation. The narrative, collaborative structure of ASSIP flex may strengthen patients’ sense of agency and crisis-management capacity. Further controlled and longitudinal research is needed to clarify causal pathways and optimise suicide-specific interventions.