One of the main premises of family therapy is that many seemingly individual problems arise from, and are perpetuated within, a family structure. Suicidal ideation in adolescence is a classic case of a seemingly individual problem with a family dimension. Adolescents who feel suicidal, and who might have engaged in suicidal behaviors, might be reflecting some of the themes and tensions without their own families. Even if the basis of an adolescent’s suicidal ideation is genuinely disconnected from their family of origin, therapeutic solutions still have a family dimension. Putting solutions in place for a suicidally ideated adolescent means enlisting a family for support through the various approaches and techniques of family therapy.
A randomized controlled trial conducted by Diamond et al. (2010) measured the effectiveness of family therapy versus enhanced usual care for suicidally ideated adolescents. The study found that family therapy was superior in terms of lowering the suicidal ideations of adolescents, both immediately after the family therapy intervention and at subsequent follow-ups (the last of which was 24 weeks after the intervention). Diamond et al. found that 87% of adolescents in the family therapy treatment group met the established criteria for clinical recovery from suicidal ideation; however, only 51.7% of adolescents who received enhance usual care experienced clinical recovery from suicidal ideation.
Diamond et al.’s (2010) results suggest that family therapy is superior to enhanced usual care for treating suicidally ideated adolescents. The reasons for this superiority are likely to be rooted in systems theory. Suicidal ideation is a complex problem that is highly likely to arise within, and be perpetuated by, a family system. Therefore, addressing the family, rather than the individual adolescent, in the context of therapy is more likely to be successful. If suicidal ideation is a systemic problem, then an individual solution is not likely to be as effective as a system-oriented solution. In the context of family therapy, a suicidally ideated adolescent receives both individual and systemic attention in a manner that, as noted by Diamond et al., is more likely to result in recovery.
References
Diamond, G. S., Wintersteen, M. B., Brown, G. K., Diamond, G. M., Gallop, R., Shelef, K., & Levy, S. (2010). Attachment-based family therapy for adolescents with suicidal ideation: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 49(2), 122-131.
