Study results indicated thaat the combined CRP groups were more effective than TAU at reducing suicide attempts, hospitalizations, and suicidal ideation over a six month follow-up. The two versions of the CRP (with and without discussion of reasons for living) did not differ from each other.

When a therapist has many weeks or months to work with a patient at risk for suicide, there are a variety of approaches that have proven to be effective in lowering the risk. One is traditional psychotherapy, in which a therapist works with a patient over time to understand his or her problems and to help the patient feel better. During such treatment as usual the patient is typically supplied with a list of sources of support, such as suicide hotlines, for times of crisis. An additional technique that has been found to be effective is to provide the patient with an individualized crisis response plan, written on a note card, with a list of warning signs things to try in a crisis. It may, for example, remind the patient to try a certain relaxation technique that has worked in the past.

Another extra technique which has worked exceptionally well with patients from the military is to put together a list, again written on a note card that the patient keeps, of things that make the patient’s life worth living. These can be loved ones, happy memories, hopes and dreams—anything that reminds the patient of why he or she would wish to keep living and that could counteract the hopelessness and lack of connection that typically precedes a suicide a attempt.

Unfortunately, it is often the case that the only contact a suicidal person has with a clinician is at a moment of crisis, perhaps during a visit to an emergency room after a suicide attempt. Then a clinician has only a short period of time to deal with the patient, and there is no guarantee the patient will go somewhere for treatment later.

Thus Craig Bryan designed a study to see if the same techniques that work well in multi-session psychotherapy could also be effective in these single, crisis-triggered sessions. He and his coworkers tested the effectiveness of providing patients with note cards containing individualized crisis response plans and reasons for living. The study showed that crisis response planning is superior to contracting for safety. Crisis response planning was also effective in preventing suicide behaviors and reducing suicide ideation.