Comparative Effectiveness of Individual, Group, Family and Combined Therapy Formats on Suicidality: A Meta-Analysis
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…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 22,440 participants or records.
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