Thematic Analysis of Suicide Narrative Assessments in Brief Cognitive Behavioral Therapy (BCBT) for Suicide Prevention (Board#29)

Abstract : Over the last 20 years, the suicide rate among U.S. adults has drastically risen by approximately 40% (Marcotte & Hansen, 2023). In response, clinicians and researchers have sought to develop more effective interventions and assessment strategies to quell this national epidemic. Brief Cognitive-Behavioral Therapy (BCBT) for Suicide Prevention is a multiphase treatment aimed specifically at reducing suicidal thoughts and behaviors (STBs). Based on fluid vulnerability theory, BCBT conceptualizes suicide risk as involving stable and dynamic factors, each including interrelated cognitive, behavioral, affective, physiological, and social components. Central to BCBT is the suicide narrative assessment, which involves participants describing their most recent or “worst” suicidal crisis and collaboratively identifying their unique risk factors for suicide. Because of the unstructured narrative approach to the assessment, patients and clinicians are able to capture the dynamic, interrelated, and idiographic nature of their risk for suicide in ways not easily obtained by other methods. Using qualitative analytic methods (e.g., content and thematic analysis), we will analyze the suicide narrative assessments of highly suicidal participants who received BCBT as part of a completed randomized clinical trial (n = 26, mAge = 28.4; 53.8% female, 46% sexual minority, mlifetime attempts = 18.8). Three research questions will be examined: (a) How do various cognitive, behavioral, affective, physiological, and social risk factors interact with one another during a suicidal crisis? (b) what common risk networks emerge from participant suicide narrative assessments? and (c) how do suicide narrative assessments differ for people who have had a previous attempt vs those with thoughts about suicide and no prior history of attempts. Results will provide insights into the dynamic, interrelated, and idiographic nature of risk factors that occur during a suicidal crisis. Special attention will be given to themes identifying potential risk networks that commonly occur. Due to the complex and dynamic nature of STBs these results will help future researchers and clinicians understand what factors could be connected in the onset and development of a suicidal crisis. Our findings will also inform future researchers on how to modify screeners, assessments, and interventions based on the lived experience of other suicidal individuals.