Therapeutic Risk Management: Chain Analysis of Suicidal Ideation and Behavior

J Psychiatr Pract. 2019 Jan;25(1):46-53. doi: 10.1097/PRA.0000000000000358.


Structural approaches to suicide risk assessment (eg, evaluating the frequency and intensity of suicidal ideation and classifying types of suicidal behavior) often fall short of providing an idiographic and dynamic analysis of the factors driving and maintaining an individual's suicide risk. Structural approaches can be bolstered through chain analysis which facilitates an exploration of the factors maintaining suicidal ideation and behavior based on positive and negative reinforcement. By uncovering the factors causing suicidal ideation and behavior to persist, efficient intervention strategies can be selected to target these pathways. In this column, the authors delineate the use of chain analysis to guide suicide risk assessment and inform treatment planning.

MeSH terms

  • Humans
  • Psychotherapy*
  • Reinforcement, Psychology*
  • Risk Assessment / methods*
  • Suicidal Ideation*
  • Suicide, Attempted*