The Efficacy of No-Suicide Contracts with Clients in Counseling on an Outpatient Basis

Abstract

Clients at two outpatient facilities who self-identified as having expressed suicidal thoughts or engaged in suicidal behaviors during some point in their counseling treatment were invited to participate in a survey to assess their perception of the relative effectiveness of 22 suicidal behavior treatment methods in order to determine the perceived efficacy of no-suicide contracting as compared with other treatment methods. Sixty-six participants anonymously completed surveys to provide demographic data and to indicate their perception of the relative effectiveness of the treatment methods. Results of multiple regression analysis and criterion-coding techniques indicated that the use of the no-suicide contract was perceived by the participants of this study to be the least effective treatment method of those assessed. Seven of the treatment methods assessed, including the use of medication, discussion of contributing stress factors, improvement in lifestyle health, increase in the number of appointments, open discussion of suicidal thoughts, improvement in problem-solving skills, and increase in social activities formed a statistically significant cluster of perceived highly effective treatment methods. No positive correlation between the demographic factors of age, gender, time in treatment, or number of suicide attempts and the perceived relative effectiveness of the treatment methods assessed was found. Limitations of the study, comparisons with similar studies, implications of the results, and future research directions are noted.