Using the Interpersonal Theory of Suicide to Inform Interpersonal Psychotherapy With a Suicidal Older Adult

Older adults in the United States and many countries around the world die by suicide at elevated rates compared with younger adults. However, relatively little is known about psychotherapeutic approaches to managing and treating suicide risk among older adults. The patient in this case presented with elevated suicide risk and was treated with interpersonal psychotherapy (IPT) informed by the Interpersonal Theory of Suicide. This theoretical model proposes that thwarted belongingness and perceived burdensomeness are causes of suicide ideation. IPT guides therapists to look for one of four interpersonal stressors that may be present in a client's life-grief, role transitions, interpersonal disputes, and interpersonal sensitivity (i.e., skills deficits). The Interpersonal Theory provides a rationale for choosing one problem focus over another. Specifically, the problem area that allows the therapist and patient to target and ameliorate thwarted belongingness and/or perceived burdensomeness is selected. The positive outcome of reduced suicide risk in this case illustrates how targeting the constructs of thwarted belongingness and perceived burdensomeness with IPT may help older adults resolve suicide ideation and prevent recurrences of suicidal crises.