Addressing Suicide Risk in Indonesian Early Adolescents: Investigation of Combined Therapeutic Approaches
Article Sidebar
Main Article Content
Abstract
Suicide is a significant global public health problem, including in Indonesia. This study investigated a combined therapeutic approach to reduce suicide risk in early adolescents in Jakarta, Indonesia. The intervention group of 75 individuals received a combined therapy that included group therapy, cognitive behavioral therapy, and thought-stopping techniques, while the control group of 79 individuals received education only. Data were collected through pre-tests and post-tests using the Adolescent Mental Resilience Instrument. Data were analyzed using SPSS in two stages to obtain descriptive (mean) and inferential (chi-square) descriptions. Results showed that the intervention group experienced a significant reduction in suicide risk compared to the control group during the intervention period. In the analysis of participant characteristics, most adolescents had high levels of protection and low levels of suicide risk. This study indicates that a combined intervention that includes group therapy, cognitive behavioral therapy, and thought-stopping can effectively reduce suicide risk in early adolescence.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
• Anugerah, P. (2023, January 25). Insiden bunuh diri di Indonesia bisa empat kali “lebih tinggi dari data resmi”, menurut penelitian terbaru - Apa imbasnya? [Suicide incidents in Indonesia may be four times "higher than official data," according to recent research - What are the impacts?]. BBC News Indonesia. https://www.bbc.com/indonesia/articles/ce9zm56z8v6o
• Asmika, A., Harijanto, & Handayani. (2013). Prevalensi depresi dan gambaran stressor psikososial pada remaja sekolah menengah umum di wilayah Kotamadya Malang [The prevalence of depression and description of psychosocial stressors in adolescents of senior high schools in Malang District]. Jurnal Kedokteran Brawijaya, 24(1), 15–21. https://doi.org/10.21776/ub.jkb.2008.024.01.2
• Bakker, G. M. (2009). In defence of thought stopping. Clinical Psychologist, 13(2), 59–68. https://doi.org/10.1080/13284200902810452
• Bass, J., Neugebauer, R., Clougherty, K. F., Verdeli, H., Wickramaratne, P., Ndogoni, L., Speelman, L., Weissman, M., & Bolton, P. (2006). Group interpersonal psychotherapy for depression in rural Uganda: 6-month outcomes: Randomised controlled trial. The British Journal of Psychiatry, 188(6), 567–573. https://doi.org/10.1192/bjp.188.6.567
• BPS - Statistics Indonesia. (2024, June 28). Jumlah penduduk pertengahan tahun (ribu jiwa), 2022-2024 [Mid-year population (thousand people), 2022-2024]. https://www.bps.go.id/indicator/12/1975/1/jumlah-penduduk-pertengahan-tahun.html
• Bridge, J. A., Ruch, D. A., Sheftall, A. H., Hahm, H. C., O’Keefe, V. M., Fontanella, C. A., Brock, G., Campo, J. V., & Horowitz, L. M. (2023). Youth suicide during the first year of the COVID-19 pandemic. Pediatrics, 151(3), Article e2022058375. https://doi.org/10.1542/peds.2022-058375
• Bryan, C. J. (2019). Cognitive behavioral therapy for suicide prevention (CBT‐SP): Implications for meeting standard of care expectations with suicidal patients. Behavioral Sciences & the Law, 37(3), 247–258. https://doi.org/10.1002/bsl.2411
• Calati, R., & Courtet, P. (2016). Is psychotherapy effective for reducing suicide attempts and non-suicidal self-injury rates? Meta-analysis and meta-regression of literature data. Journal of Psychiatric Research, 79, 8–20. https://doi.org/10.1016/j.jpsychires.2016.04.003
• De Jaegere, E., van Landschoot, R., van Heeringen, K., van Spijker, B. A. J., Kerkhof, A. J. F. M., Mokkenstorm, J. K., & Portzky, G. (2019). The online treatment of suicidal ideation: A randomised controlled trial of an unguided web-based intervention. Behaviour Research and Therapy, 119, Article 103406. https://doi.org/10.1016/j.brat.2019.05.003
• Erickson, D. H., Janeck, A. S., & Tallman, K. (2007). A cognitive-behavioral group for patients with various anxiety disorders. Psychiatric Services (Washington, D.C.), 58(9), 1205–1211. https://doi.org/10.1176/ps.2007.58.9.1205
• Eugene, D. R., Blalock, C., Nmah, J., & Baiden, P. (2023). Suicidal behaviors in early adolescence: The interaction between school connectedness and mental health. School Mental Health, 15(2), 444–455. https://doi.org/10.1007/s12310-022-09559-6
• Frey, D. H., Motto, J. A., & Ritholz, M. D. (1983). Group therapy for persons at risk for suicide: An evaluation using the intensive design. Psychotherapy, 20(3), 281–293. https://doi.org/10.1037/h0090210
• Fukuya, Y., Fujiwara, T., Isumi, A., & Ochi, M. (2021). Association of birth order with mental health problems, self-esteem, resilience, and happiness among children: Results from a child study. Frontiers in Psychiatry, 12, Article 638088. https://doi.org/10.3389/fpsyt.2021.638088
• Galanter, M., Hayden, F., Castañeda, R., & Franco, H. (1998). Group therapy, self-help groups, and network therapy. In R. Frances, S. Miller, & A. Mack (Eds.), Clinical textbook of addictive disorders (3rd ed., pp. 502–527). Guilford Press.
• Geoffroy, M. C., Orri, M., Girard, A., Perret, L. C., & Turecki, G. (2021). Trajectories of suicide attempts from early adolescence to emerging adulthood: Prospective 11-year follow-up of a Canadian cohort. Psychological Medicine, 51(11), 1933–1943. https://doi.org/10.1017/S0033291720000732
• Ghosh, D., Bhattacharya, S., Raj, S., Singh, T., Verma, S. K., & Arya, Y. K. (2023). Application of mindfulness-based cognitive therapy on suicidal behavior: A case study. In C. R. Martin, V. B. Patel, & V. R. Preedy (Eds.), Handbook of cognitive behavioral therapy by disorder (pp. 491–497). Elsevier.
• Giles, M. V., & Hughes, R. (2023). Failing our daughters: Teenage girls attempted suicide, COVID-19, and the broken Canadian mental healthcare system. In L. R. Ennis (Ed.), Are the kids alright?: The impact of the pandemic on children and their families (pp. 25–36). Demeter Press.
• Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1
• Hu, S., Mo, D., Guo, P., Zheng, H., Jiang, X., & Zhong, H. (2022). Correlation between suicidal ideation and emotional memory in adolescents with depressive disorder. Scientific Reports, 12(1), Article 5470. https://doi.org/10.1038/s41598-022-09459-4
• Kirshner, K. S. (1994). Fostering the sense of self: Group psychotherapy for girls in early adolescence. Journal of Child and Adolescent Group Therapy, 4(1), 27–45. https://doi.org/10.1007/BF02550057
• Malkinson, R. (2001). Cognitive-behavioral therapy of grief: A review and application. Research on Social Work Practice, 11(6), 671–698. https://doi.org/10.1177/104973150101100603
• Méndez-Bustos, P., Calati, R., Rubio-Ramírez, F., Olié, E., Courtet, P., & Lopez-Castroman, J. (2019). Effectiveness of psychotherapy on suicidal risk: A systematic review of observational studies. Frontiers in Psychology, 10, Article 277. https://doi.org/10.3389/fpsyg.2019.00277
• Miegel, F., Peth, J., Rubel, J., Runde, A., Arlt, S., Gallinat, J., & Jelinek, L. (2023). Session-specific effects on suicidality in group therapy: No evidence for contagion. Archives of Suicide Research, 27(2), 540–553. https://doi.org/10.1080/13811118.2021.2022051
• Miller, I. W., Camargo, C. A., Arias, S. A., Sullivan, A. F., Allen, M. H., Goldstein, A. B., Manton, A. P., Espinola, J. A., Jones, R., & Hasegawa, K. (2017). Suicide prevention in an emergency department population: The ED-SAFE study. JAMA Psychiatry, 74(6), 563–570. https://doi.org/10.1001/jamapsychiatry.2017.0678
• Mirzaian, N., Vafaeinejad, Z., Zamanpour, Z., Shabannejad, A., & Abbasian, A. (2023). The effectiveness of cognitive-behavioral therapy (CBT) on rumination in self-harming adolescents without suicidal intent. Journal of Adolescent and Youth Psychological Studies, 4(3), 119–125. https://doi.org/10.61838/kman.jayps.5.8.14
• Mubasyiroh, R., Putri, E. I. K., & HT, D. (2017). Determinan gejala mental emosional pelajar SMP-SMA di Indonesia tahun 2015 [Mental emotional symptoms’ determinants of junior-senior high school students in Indonesia 2015]. Buletin Penelitian Kesehatan, 45(2), 103–112. http://dx.doi.org/10.22435/bpk.v45i2.5820.103-112
• Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry, 70(3), 300–310. https://doi.org/10.1001/2013.jamapsychiatry.55
• O′Hare, K. J. M., Poulton, R., & Linscott, R. J. (2021). Psychotic experiences and schizotypy in early adolescence predict subsequent suicidal ideation trajectories and suicide attempt outcomes from age 18 to 38 years. Schizophrenia Bulletin, 47(2), 456–464. https://doi.org/10.1093/schbul/sbaa151
• Onie, S., Vina, A., Taufik, K., Abraham, J., Setiyawati, D., Colucci, E., Nilam, J. F., Onie, S., Hunt, A., Saputra, A. F., Hidayati, N. E., Harsono, C., Bestari, D., Muhdi, N., Wolter, A., Liem, A., Rochmawati, I., Ardian, J., Prasojo, R. E., ... Larsen, M. E. (2023). Indonesian first national suicide prevention strategy: Key findings from the qualitative situational analysis. Lancet Regional Health - Southeast Asia, 16, Article 100245. https://doi.org/10.1016/j.lansea.2023.100245
• Osborn, T. L., Wasil, A. R., Venturo-Conerly, K. E., Schleider, J. L., & Weisz, J. R. (2020). Group intervention for adolescent anxiety and depression: Outcomes of a randomized trial with adolescents in Kenya. Behavior Therapy, 51(4), 601–615. https://doi.org10.1016/j.beth.2019.09.005
• Patra, K. P., & Kumar, R. (2023). Screening for depression and suicide in children. StatPearls Publishing.
• Raj, S., Sachdeva, S. A., Jha, R., Sharad, S., Singh, T., Arya, Y. K., & Verma, S. K. (2019). Effectiveness of mindfulness based cognitive behavior therapy on life satisfaction, and life orientation of adolescents with depression and suicidal ideation. Asian Journal of Psychiatry, 39, 58–62. https://doi.org/10.1016/j.ajp.2018.12.001
• Rozaki, A. (2012, September). Suicide among Indonesian children/teenagers. Kyoto Review of Southeast Asia. https://kyotoreview.org/issue-12/suicide-among-indonesian-childrenteenagers/
• Rudd, M. D., Bryan, C. J., Wertenberger, E. G., Peterson, A. L., Young-McCaughan, S., Mintz, J., Williams, S. R., Arne, K. A., Breitbach, J., & Delano, K. (2015). Brief cognitive-behavioral therapy effects on post-treatment suicide attempts in a military sample: Results of a randomized clinical trial with 2-year follow-up. American Journal of Psychiatry, 172(5), 441–449. https://doi.org/10.1176/appi.ajp.2014.14070843
• Tang, T., Jou, S., Ko, C., Huang, S., & Yen, C. (2009). Randomized study of school‐based intensive interpersonal psychotherapy for depressed adolescents with suicidal risk and parasuicide behaviors. Psychiatry and Clinical Neurosciences, 63(4), 463–470. https://doi.org/10.1111/j.1440-1819.2009.01991.x
• Tanrıverdi, D., & Bahar, A. (2023). The relationship between suicide risk and coping strategies among patients with depression. Euroasia Journal of Social Sciences & Humanities, 10(31), 96–108. https://doi.org/10.5281/zenodo.7942176
• Tarrier, N., Taylor, K., & Gooding, P. (2008). Cognitive-behavioral interventions to reduce suicide behavior: a systematic review and meta-analysis. Behavior Modification, 32(1), 77–108. https://doi.org/10.1177/0145445507304728
• Thimm, J. C., & Antonsen, L. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry, 14(1), Article 292. https://doi.org/10.1186/s12888-014-0292-x
• van Bentum, J. S., van Bronswijk, S. C., Sijbrandij, M., Lemmens, L. H. J. M., Peeters, F. F. P. M. L., Drukker, M., & Huibers, M. J. H. (2021). Cognitive therapy and interpersonal psychotherapy reduce suicidal ideation independent from their effect on depression. Depression and Anxiety, 38(9), 940–949. https://doi.org/10.1002/da.23151
• Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E., Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600. https://doi.org/10.1037/a0018697
• van Sprang, E. D., Maciejewski, D. F., Milaneschi, Y., Kullberg, M.-L., Hu, M. X., Elzinga, B. M., Van Hemert, A. M., Hartman, C. A., & Penninx, B. W. J. H. (2021). Familial resemblance in mental health symptoms, social and cognitive vulnerability, and personality: A study of patients with depressive and anxiety disorders and their siblings. Journal of Affective Disorders, 294, 420–429. https://doi.org/10.1016/j.jad.2021.06.072
• Wang, R., & Rong, X. (2023). Extended group decision making method for quality evaluation of mental health education of college students with hesitant triangular fuzzy information. Journal of Intelligent & Fuzzy Systems, 45(2), 2835–2845. https://doi.org/10.3233/JIFS-219434
• Weitz, E., Hollon, S. D., Kerkhof, A., & Cuijpers, P. (2014). Do depression treatments reduce suicidal ideation? The effects of CBT, IPT, pharmacotherapy, and placebo on suicidality. Journal of Affective Disorders, 167, 98–103. https://doi.org/10.1016/j.jad.2014.05.036
• Wiglesworth, A., Fiecas, M. B., Xu, M., Neher, A. T., Padilla, L., Carosella, K. A., Roediger, D. J., Mueller, B. A., Luciana, M., Klimes-Dougan, B., & Cullen, K. R. (2023). Sex and age variations in the impact of puberty on cortical thickness and associations with internalizing symptoms and suicidal ideation in early adolescence. Developmental Cognitive Neuroscience, 59, Article 101195. https://doi.org/10.1016/j.dcn.2022.101195
• Wirasto, R. T. (2012). Suicide prevention in Indonesia: Providing public advocacy. Japanese Medical Association Journal, 55, 98–104. https://www.med.or.jp/english/activities/pdf/2012_01/098_104.pdf
• World Health Organization. (2024, August 29). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide
• World Population Review. (2024). Suicide rate by country 2024. https://worldpopulationreview.com/country-rankings/suicide-rate-by-country
• Wu, H., Lu, L., Qian, Y., Jin, X. H., Yu, H. R., Du, L., Fu, X. L., Zhu, B., & Chen, H. L. (2022). The significance of cognitive-behavioral therapy on suicide: An umbrella review. Journal of Affective Disorders, 317, 142–148. https://doi.org/10.1016/J.JAD.2022.08.067
