Sitting with suicide: Mindfulness-based cognitive therapy for suicide prevention in military Veterans

Abstract: With recent studies citing that as many as 44 Veterans die by suicide daily, Veteran suicide is a pressing public health concern (America's Warrior Partnership. (2022). Operation deep dive summary of interim report. https://e55c5558-502f-457d-8a07-a49806f5ff14.usrfiles.com/ugd/e55c55_086099607d86 49aa8b5227f106f24865.pdf). Despite this alarming statistic, few evidence-based psychotherapies specifically target suicide prevention. Mindfulness-based cognitive therapy for suicide prevention (MBCT-S) is a nine-week, manualized group intervention that integrates mindfulness-based cognitive therapy (MBCT) with the safety planning intervention to address suicidality. A randomized controlled trial (n = 140) found that MBCT-S significantly reduced suicide attempts, suicidal behaviors, and psychiatric hospitalizations among participating Veterans. To illustrate the application of this intervention and maintain participant anonymity, this paper presents a case composite highlighting the intervention's rationale and the facilitator's role in teaching Veterans the skill of staying present with intensely painful, harmful, and self-alienating experiences without resorting to suicidal behavior. The embodied presence of the MBCT-S facilitator emerges as a critical agent of change, fostering curiosity, compassion, and openness when addressing complex and isolating suicidal thoughts. This presence creates a foundation for connectedness within the group, which is essential for Veterans at risk of suicide. By illustrating these processes, the paper highlights the potential of MBCT-S to transform clinicians' capacity to support individuals in building equanimity and life-saving resilience.

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