TABLE 1.
Study characteristics | Participants | Psychotherapy delivery, format and context | Therapists | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Study number and reference | Country | Design | Sample population and study setting | Therapy arm sample size | Mean age | Ethnicity and Gender | Psychotherapy type and session length | Length and setting of psychotherapy | N and qualifications | Supervision |
1. Shearin and Linehan (1992) | USA | Cohort/longitudinal | People with a diagnosis of BPD and parasuicidal behaviour in the community | 4 | Not reported | Not reported; 100% female | Dialectical behavioural therapy (DBT): 60‐min individual sessions and 150‐min group skills per week | Up to 31 sessions over 7 months at an outpatient university research clinic | 4 psychology and nursing graduate students | Supervision provided to ensure adherence to DBT protocol, but no further details reported |
2. Turner (2000) | USA | Two‐armed RCT; active control | People with a diagnosis of BPD in the community |
Total: 24 DBT: 12 |
Total: 22.00 |
Total: 79.17% Caucasian; 79.17% female |
DBT: Individual (DBT skills sessions provided in individual sessions) a | Up to 84 individual sessions over 12 months at a community mental health outpatient clinic |
4 therapists; background in client‐centred, psychodynamic and family systems conducted both therapies DBT: Trained to conduct DBT |
Weekly group supervisions (one for each therapeutic modality). Reviewed therapy audio recordings to monitor treatment fidelity |
Active control: 12 | Active control: Individual client‐centred therapy a | Active control: Trained to work with people diagnosed with BPD | ||||||||
3. Goldman and Gregory (2009) | USA | Two‐armed RCT; TAU control | Diagnosis of BPD; clinical settings—non‐specific | 15 | 27.40 | 85.70% Caucasian; 90% female | Dynamic deconstructive psychotherapy: Individual a | Up to 52 sessions over 12 months b | 5 therapists; 1 expert therapist, 4 third‐year trainee psychiatrists | Weekly group supervision. Biweekly individual supervision was used to review audio recordings to monitor treatment fidelity |
4. Hirsh et al. (2012) | Canada | Two‐armed RCT; active control | People with a diagnosis of BPD and experience of suicidal behaviour and NSSI outpatient |
Total: 87 DBT: 43 |
Total: 31.41 DBT: 30.56 |
Not reported; 100% female | DBT: 60‐min individual sessions, 120‐min skills group and 120‐min phone coaching | Sessions delivered weekly over 1 year at two teaching hospitals c |
25 therapists DBT: 13 therapists 3 psychiatrists, 4 PhD level psychologists, 5 master's level clinicians and 1 nurse |
DBT: Weekly group supervision (2 h) |
Active control: 44 | Active control: 32.25 | Not reported | Active control: Individual general psychiatric management (includes dynamically informed psychotherapy) a |
Active control: 12 therapists 8 psychiatrists, 1 PhD level psychologist, 1 master's level clinician and 2 nurses |
Active control: Weekly group supervision (90 min) | |||||
5. Bryan et al. (2012) | USA | Cohort/longitudinal |
Military Primary care clinic |
497 | 37.14 | 54.10% Caucasian; 57.7% female | CBT: 30‐min individual sessions | Up to 8 sessions at a primary care clinic | 22 therapists; 8 clinical psychologists (6 trainers and 2 externship trainees), 9 predoctoral clinical psychology interns and 5 social worker interns | Interns were trained under the supervision of clinical psychologists to deliver CBT. No further details on supervision reported |
6. Perry et al. (2013) | Canada | Cohort/longitudinal | People with diagnoses of anxiety, depression and/or PD outpatient—psychiatry | 53 | 30.90 | Not reported; 77% female | Long‐term dynamic psychotherapy: Individual a | Up to 339 sessions over a median of 4.19 years at an outpatient clinic | 22 therapists; psychiatrists, psychologists, social workers and advanced practice nurses; 20 were also psychoanalysts | No supervision groups or specific therapy manual used |
7. Tsai et al. (2014) | Canada | Cohort/longitudinal | People with a diagnosis of depression who were outpatient/in the community | 80 | 47.82 | 76.10% Caucasian; 73% female | CBT for depression: 120‐min group sessions | Up to 10 sessions over 10 weeks at an outpatient community mental health service/hospital | 2 therapists; 1 clinical psychologist and 1 psychiatrist | Not reported |
8. Bedics et al. (2015) | USA | Two‐armed RCT; active control | People with a diagnosis of BPD and experience of suicidal behaviour and NSSI in the community |
Total: 101 DBT: 52 |
Total: 29.30 | Total: 86.50% Caucasian; 100% female | DBT: 60‐min individual sessions and 150 min of group skills and telephone consultations per week | Sessions delivered over 1 year at university outpatient clinic and community practice c |
37 therapists DBT: 15 (12 of whom had a doctoral degree) |
DBT: Weekly group supervision |
Active control: 49 | Active control: Community treatment by experts (eclectic/psychodynamic therapy) a | Active control: 25 (14 of whom had a doctoral degree) | Active control: Not required to attend supervision | |||||||
9. Gysin‐Maillart et al. (2016) d | Switzerland | Two‐armed RCT; TAU control | People who had recently attempted suicide who are attending a psychiatry outpatient department | 60 | 36.50 | Not reported; 60% female | Attempted Suicide Short Intervention Program (ASSIP):Up to 90‐min individual sessions | 3 sessions (4 if necessary) delivered weekly at an outpatient department | 4 therapists; 1 psychiatrist and 3 clinical psychologists (2 of whom were experienced in clinical suicide prevention) | Regular supervision to review therapy video recordings to ensure therapy fidelity |
10. Gysin‐Maillart et al. (2017) d | Switzerland | RCT; TAU control | People who had recently attempted suicide who are attending a psychiatry outpatient department | 60 | 36.50 | Not reported; 60% female | ASSIP: Up to 90‐min individual sessions | 3 sessions (4 if necessary) delivered weekly at an outpatient department | 4 therapists; 1 psychiatrist and 3 clinical psychologists (2 of whom were experienced in clinical suicide prevention) | Regular supervision to review therapy video recordings to ensure therapy fidelity |
11. Plöderl et al. (2017) | Austria | Cohort/longitudinal | People who had attempted suicide and/or had suicidal ideation and were admitted to an inpatient ward | 633 | 39.19 | Not reported; 51% female | Individual and group psychotherapeutic crisis intervention (eclectic, pan‐theoretical and flexible) a | Up to 15 weekly sessions over 3 weeks on the inpatient ward and up to 5 further follow‐up sessions over 6 months delivered at a clinic or via telephone | 7 therapists; psychiatrists, psychotherapists/psychologists | Not reported |
12. Rufino and Ellis (2018) | USA | Cohort/Longitudinal | People with diagnoses related to mood, anxiety and/or PD and suicidal thoughts and admitted to an inpatient ward | 434 | 33.44 | 91.00% Caucasian; 53.5% female | Individual therapy; psycho‐educational and therapeutic groups; family therapy a | Sessions delivered on an inpatient ward c | Not reported | Not reported |
13. Ibrahim et al. (2018) d | USA | Two‐armed RCT; active control | People who were experiencing depression and suicidal thoughts recruited from a mix of clinical and non‐clinical settings |
Total: 115 Attachment‐based family therapy: 60 |
Total: 14.96 | Total: 28.70% Caucasian; 82.9% female | Attachment‐based family therapy: 90‐min individual and family therapy sessions | 16 weekly sessions over 16 weeks delivered at a university research lab/intervention clinic | 17 therapists; all at least master's level | Not reported |
Active Control: 55 |
Active control: Family‐enhanced non‐directive supportive therapy Individual a sessions and 4 60‐min parent psycho‐educational sessions |
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14. Haddock et al. (2019) | UK | Two‐armed RCT; TAU control | People with experiencing of suicidal thoughts and/or behaviours and admitted to an inpatient ward | 24 | 33.88 | 91.67% Caucasian; 58% female | Cognitive behavioural suicide prevention therapy: Up to 70‐min individual sessions | 20 sessions delivered over 6 months on an inpatient ward and followed up in the community | 2 therapists; both clinical psychologists who met the British Association for Behavioural and Cognitive Psychotherapies minimum standards for CBT accreditation | Weekly supervision |
15. Johnson et al. (2019) | USA | Two‐armed RCT; active control | Veterans who had recently attempted suicide and recently discharged from an inpatient ward |
Total: 134 Suicide‐focused assessment group therapy: 69 |
Total: Not reported Suicide Focused Assessment Group Therapy: 47.72 | 70.90% Caucasian; 11.9% female | Suicide‐focused assessment group therapy: Group sessions a | Suicide‐focused assessment group therapy: Up to 12 weekly sessions delivered in an outpatient setting | 2 therapists facilitated both group therapies; 1 clinical psychologist and 1 social worker | Observation and spot checks by the principal investigator ensured adherence and fidelity to suicide‐focused assessment group therapy |
Active control: 65 | Active control: 48.33 |
Active control: Usual assessment group therapy Group sessions a |
Active control: Up to 12 weekly sessions delivered in an outpatient setting | |||||||
16. Ryberg et al. (2019) | Norway | Two‐armed RCT; active control | People with ongoing suicidal ideation, intent, and behaviour in both inpatient and outpatient settings |
Total: 78 Collaborative Assessment and Management of Suicidality (CAMS): 37 |
Total: 39.90 CAMS: 38.40 |
Not reported; 53% female | CAMS with psychodynamic, cognitive or eclectic psychotherapy: Up to 60‐min individual sessions | CAMS: A mean of 17.80 therapy sessions were attended weekly, of which 7.90 were CAMS specific. Therapy sessions were delivered in inpatient and outpatient settings. Number of sessions not predetermined | 43 therapists; CAMS: 8 psychologists and 1 psychiatrist | CAMS: Once therapists were adherent to the CAMS procedure, supervision was available by request |
Active control: 41 | Active control: 33.70 | Active control: Psychodynamic, cognitive or eclectic psychotherapy up to 45‐min individual sessions | Active control: A mean of 14.6 weekly sessions delivered in inpatient and outpatient settings. Number of sessions not predetermined | Active control: 15 psychologists, 4 residents, 6 psychiatrists and 9 psychiatric nurses | Active control: Not reported | |||||
17. Stratton et al. (2020) | Canada | Two‐armed RCT; waitlist control | People with diagnosis of BPD; suicidal behaviour and NSSI in an outpatient setting | 43 | 27.29 | Not reported; 83.3% female | DBT skills: 120‐min group | 20 weekly sessions delivered at a teaching hospital | 5 therapists; 2 PhD, 3 MSW | Weekly group supervision |
18. Huggett et al. (2021) | UK | Two‐armed RCT; TAU control | People with non‐affective psychosis‐related diagnoses; suicidal ideation and/or behaviour in both inpatient and outpatient settings | 64 | 36.83 | 88% Caucasian; 43.75% female | Cognitive behavioural suicide prevention therapy: Up to 180‐min individual sessions | Up to 24 sessions delivered over 6 months in outpatient and inpatient settings | 8 individuals who were clinical psychologists, mental health nurses and a social worker and met the British Association of Behavioural and Cognitive Psychotherapies minimum standards for CBT accreditation | Weekly group supervision, monthly individual supervision, and regular peer supervision to ensure and monitor therapy fidelity |
19. Ibrahim et al. (2021)d | USA | Two‐armed RCT; active control | People who were experiencing depression and suicidal thoughts recruited from a mix of clinical and non‐clinical settings | 118 | 14.96 | 28.7% Caucasian; 81.7% female | Attachment‐based family therapy: 90‐min individual and family therapy sessions | Up to 16 weekly sessions over 16 weeks delivered at a university research lab/intervention clinic | 17 therapists; all at least master's level | Weekly supervision, which included live supervision and review of therapy tapes |
Active control: Family‐enhanced nondirective supportive therapy Individual a sessions and 4 60‐min parent psychoeducation sessions |
Length of sessions not reported.
Setting not reported.
Number of sessions not reported.
Used the same RCT sample.