The Crisis Intervention Lineage
When staying alive is the treatment goal \u2014 the clinical tradition that works at the edge
Clinical and evidence statements in this lineage remain under review. The source checks below apply only to their stated treatment, population and outcome.
Guideline sources for approaches in this lineage
Safety Planning
Guidelines and official sources (4)
3 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Assessment and Management of Patients at Risk for Suicide
Insufficient evidence for or against
Recommendation 7 is neutral because evidence is insufficient for this outcome. The guideline also incorporates safety planning in routine care; these statements need to be read together. No Safety Planning Intervention studies and one crisis-response-planning trial met this review’s inclusion criteria; this is not a statement that no SPI research exists.
Scope: Reducing attempts in adults aged 18 and over with recent suicidal ideation and/or a lifetime attempt history.
- Study Evaluates Prevalence of Four Recommended Practices for Suicide Prevention
Discussed in the source
The Joint Commission article describes formal safety planning as expert-recommended practice and distinguishes it from explicit National Patient Safety Goal requirements.
Scope: Hospital suicide-prevention and discharge practices.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO conditionally supports considering safety-planning-type interventions that include several components or follow-up/support, with very low-certainty evidence. It found insufficient evidence to recommend safety planning as a stand-alone intervention.
Scope: People with thoughts or plans of self-harm in the past month, or acts of self-harm in the past year.
- Self-harm: assessment, management and preventing recurrence (NG225)
Recommendation for the stated population
NICE says to consider a plan with the person. This practice recommendation draws on committee experience and supporting qualitative/component evidence; it does not independently prove that a standalone plan prevents attempts.
Scope: Collaborative safety planning as part of care for people who have self-harmed.
CAMS
Guidelines and official sources (2)
1 clinical guideline check · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Assessment and Management of Patients at Risk for Suicide
Insufficient evidence for or against
The 2024 guideline finds insufficient evidence for or against CAMS for reducing suicidal ideation. Inclusion in the guideline is not a positive recommendation. The guideline describes a small pooled ideation benefit versus alternative interventions but no statistically clear benefit in military/Veteran samples, with limitations in study quality and delivery.
Scope: Adults aged 18 and over at risk of suicide; CAMS for reducing suicidal ideation.
- Treatment for Suicidal Ideation, Self-Harm, and Suicide Attempts Among Youth
Discussed in the source
SAMHSA describes CAMS but distinguishes assessment-tool validation from youth treatment efficacy. Its dated evidence statement should not be read as a current review of all youth trials.
Scope: Youth assessment and suicide-focused care; source published in 2020.
Psychological First Aid
Guidelines and official sources (3)
1 clinical guideline check · 2 professional reference checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Psychological First Aid Field Operations Guide: resource listing
Discussed in the source
SAMHSA lists the guide developed by NCTSN and the National Center for PTSD. A resource listing does not itself establish a graded treatment recommendation.
Scope: Immediate support for disaster and terrorism survivors and their families.
- Psychological First Aid workshops
Discussed in the source
The Red Cross offers PFA workshops for coping and support through deployment and transitions. This verifies training provision, not a universal clinical standard.
Scope: Service members, veterans, military families and their support networks.
- Support based on psychological first aid principles after a traumatic event
Recommendation for the stated population
WHO conditionally recommends considering access to support based on PFA principles, with very low-quality evidence. This concerns immediate support, not treatment of established PTSD or suicidality.
Scope: People in acute distress who have recently experienced a traumatic event.
DBT
Guidelines and official sources (9)
8 clinical guideline checks · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Borderline personality disorder: recognition and management (CG78)
Recommendation for the stated population
NICE says to consider a comprehensive DBT programme for this specified population. This does not establish a recommendation for every personality disorder or every presentation.
Scope: Women with BPD for whom reducing recurrent self-harm is a priority.
- Assessment and Management of Patients at Risk for Suicide
Insufficient evidence for or against
The 2024 guideline finds insufficient evidence for or against DBT for these outcomes. This recommendation is separate from NICE’s BPD recommendation.
Scope: Adults aged 18 and over at risk of suicide; DBT for reducing suicidal ideation, suicide attempts or suicide.
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
DBT is named among recommended specialist BPD treatments.
Scope: BPD; treatment delivered as described and studied
- Dialectical behavior therapy for BPD
Discussed in the source
The archive lists Strong under 1998 criteria, with 2015 re-evaluation pending; this is an evidence listing.
Scope: DBT for BPD
- Self-harm: assessment, management and preventing recurrence (NG225)
Discussed in the source
NICE says to consider the adolescent adaptation, DBT-A, for this specified self-harm population. This does not grade every DBT programme or suicide-related outcome.
Scope: Children and young people with significant emotional dysregulation and frequent self-harm
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against DBT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend one of these treatment arrangements over the other. This does not assess DBT for BPD.
Scope: Adults with PTSD; DBT plus PE versus DBT alone.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
DBT is named in the reviewed third-wave therapy category. WHO recommends that category alongside other structured therapies; it does not give DBT a separate recommendation or separate certainty rating here.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
WHO conditionally supports digital interventions based on approaches including DBT, with low-certainty evidence. This is not a recommendation for every full DBT program, and the reviewed trials did not establish benefit for attempts or deaths and were underpowered for those outcomes.
Scope: Digital support for people with suicidal thoughts.
CBT
Guidelines and official sources (59)
58 clinical guideline checks · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Depression in adults: treatment and management (NG222)
Recommendation for the stated population
CBT is a named adult depression treatment option.
Scope: Adults with depression
- Generalised anxiety disorder and panic disorder in adults (CG113)
Recommendation for the stated population
NICE recommends CBT for specified GAD and panic-disorder presentations. The relevant protocol and treatment step matter.
Scope: Adults with GAD or panic disorder
- Post-traumatic stress disorder (NG116)
Recommendation for the stated population
NICE recommends trauma-focused CBT protocols, including CPT, cognitive therapy for PTSD, NET and PE; generic CBT is too imprecise.
Scope: Adults with acute stress disorder or clinically important PTSD symptoms; time since trauma matters
- Obsessive-compulsive disorder and body dysmorphic disorder: treatment (CG31)
Recommendation for the stated population
NICE recommends CBT including ERP, with intensity matched to impairment.
Scope: Adults with OCD; intensity and combined treatment depend on impairment
- Psychosis and schizophrenia in adults: prevention and management (CG178)
Recommendation for the stated population
NICE recommends CBT delivered to the specified psychosis protocol.
Scope: Adults with psychosis or schizophrenia
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD strongly recommends CPT, EMDR and PE by name. This does not give every form of CBT the same recommendation.
Scope: Adults with PTSD
- Cognitive therapy for depression
Discussed in the source
The archive rates this specific treatment Strong under 1998 criteria; this is not a universal CBT rating or CPG grade.
Scope: Cognitive therapy for depression
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends the trauma-focused CBT family for adult PTSD. Footnote 4 defines a broad grouping, not a specific therapy.
Scope: Adults with PTSD; trauma-focused CBT family compared with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
VA/DoD weakly suggests trauma-focused cognitive behavioral psychotherapy for PTSD prevention in acute stress disorder. This is distinct from immediate support for everyone exposed to trauma.
Scope: Adults diagnosed with acute stress disorder; prevention of subsequent PTSD.
- Assessment and Management of Patients at Risk for Suicide
Recommendation for the stated population
VA/DoD weakly suggests suicide-focused CBT-based psychotherapy to reduce attempts in this population. Generic CBT is not interchangeable with a suicide-focused protocol.
Scope: Suicide-focused CBT-based psychotherapy for adults aged 18 and over with suicidal behavior within the past six months.
- Assessment and Management of Patients at Risk for Suicide
Recommendation for the stated population
VA/DoD weakly suggests suicide-focused CBT, including problem-solving-based psychotherapies. The ideation outcome differs from recommendation 5’s attempt outcome.
Scope: Adults aged 18 and over with a history of self-directed violence; reducing suicidal ideation.
- Clinical Practice Guideline for the Management of Pregnancy
Recommendation for the stated population
VA/DoD strongly recommends offering CBT for prevention in this at-risk population. Treatment of an existing depressive episode is addressed separately.
Scope: Pregnant patients at risk of perinatal depression; individual or group delivery.
- Clinical Practice Guideline for the Management of Pregnancy
Recommendation for the stated population
VA/DoD weakly suggests CBT for treating perinatal depression.
Scope: Depression during pregnancy or postpartum.
- Clinical Practice Guideline for the Management of Pregnancy
Recommendation for the stated population
VA/DoD weakly suggests psychotherapy, naming CBT as an example, or yoga or both for this population.
Scope: Anxiety symptoms during or after pregnancy.
- Clinical Practice Guideline for Diagnosis and Treatment of Hypertension in Primary Care
Discussed in the source
The discussion reports studies combining CBT with dietary support. Recommendation 19 strongly favors low-sodium diet plus physical activity; its strength cannot be assigned to CBT by itself.
Scope: Combined lifestyle interventions for hypertension, including low-sodium diet with CBT.
- Clinical Practice Guideline for the Non-Surgical Management of Hip and Knee Osteoarthritis
Discussed in the source
The appendix names CBT as an optional psychosocial or behavioral intervention, guided by availability and patient preference. This is ungraded implementation guidance, not a separately graded osteoarthritis recommendation.
Scope: Conceptual approach to chronic primary (nociplastic) pain when self-management strategies are insufficient.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests cognitive behavioral therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.
Scope: Adults with uncomplicated MDD choosing psychotherapy.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD strongly recommends first-line evidence-based psychotherapy, referring to the list that includes cognitive behavioral therapy. This is a class-level recommendation, with no preferred individual approach.
Scope: Pregnant or breastfeeding adults with mild-to-moderate MDD.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests CBT during continuation treatment to reduce relapse or recurrence (weak for). CBT, IPT and MBCT are not ranked against one another.
Scope: Remitted MDD with high risk of relapse or recurrence.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD suggests first-line psychotherapy, including CBT, considering preferences and medication safety (weak for). The recommendation does not establish one psychotherapy as superior.
Scope: Adults aged 65 or older with mild-to-moderate MDD.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD suggests CBT-based bibliotherapy as an adjunct, or an alternative when other treatments are declined or inaccessible (weak for). This concerns a specific delivery format.
Scope: Adults with MDD; CBT-based bibliotherapy.
- Management of Bipolar Disorder
Recommendation for the stated population
VA/DoD suggests CBT alongside pharmacotherapy (weak for). It finds insufficient evidence to prefer CBT over the other listed adjunctive psychotherapies.
Scope: Adults with bipolar I or II who are not acutely manic.
- Management of Bipolar Disorder
Recommendation for the stated population
VA/DoD suggests CBT for residual anxiety in this defined population (weak for). This does not extend to acute mania.
Scope: Adults with fully or partially remitted bipolar disorder and residual anxiety symptoms.
- Management of First-Episode Psychosis and Schizophrenia
Discussed in the source
VA/DoD suggests psychosis-focused CBT with medication (weak for). The recommendation should not be transferred to arbitrary CBT programmes.
Scope: Adults with schizophrenia or prodromal/early psychosis.
- Clinical Practice Guideline for the Management of Substance Use Disorders
Recommendation for the stated population
VA/DoD includes CBT among treatment options: weak recommendations for alcohol and cannabis use disorders, and a strong recommendation for initial cocaine-use-disorder treatment. Preference and availability guide selection.
Scope: Adults with alcohol-, cannabis-, or cocaine-use disorder.
- Clinical Practice Guideline for Tobacco Use Treatment
Insufficient evidence for or against
VA/DoD strongly supports more intensive counseling and finds insufficient evidence to prefer another counseling approach over standard CBT. That comparative uncertainty is not a recommendation against CBT.
Scope: Behavioral counseling for adult tobacco cessation.
- Clinical Practice Guideline for the Management of Chronic Multisymptom Illness
Recommendation for the stated population
VA/DoD weakly recommends CBT, drawing substantially on indirect evidence from these symptom syndromes. This is a recommendation for managing symptoms and function, not a claim that the illness is psychological or that CBT cures it.
Scope: Chronic multisymptom illness and symptoms consistent with fibromyalgia, IBS, or ME/CFS.
- Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury
Discussed in the source
VA/DoD discusses a brief CBT trial and describes CBT as a possible fatigue-management approach. These passages are not a separate graded CBT recommendation for treating mTBI.
Scope: Behavioral symptoms or fatigue in people with symptoms attributed to post-acute mTBI.
- Diagnosis and Treatment of Low Back Pain
Recommendation for the stated population
VA/DoD suggests CBT for chronic low back pain with a weak recommendation. This is narrower than a recommendation for every pain condition or acute low back pain.
Scope: Adults with chronic low back pain.
- Management of Headache
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against CBT for headache. This neutral recommendation is not a recommendation against treatment.
Scope: CBT for headache treatment or prevention.
- Tinnitus
Recommendation for the stated population
VA/DoD weakly recommends provider-delivered CBT and sound therapy combined with CBT in a multidisciplinary team. The scope is tinnitus management, not elimination of the tinnitus sound.
Scope: Adults with bothersome tinnitus; CBT delivered by a trained provider.
- Management of Adult Overweight and Obesity
Discussed in the source
VA/DoD weakly supports cognitive behavioral interventions for internalized weight stigma. The discussion defines a broad category; this is not a recommendation for CBT to treat every weight concern or an eating disorder.
Scope: Adults experiencing internalized weight bias and stigma within overweight/obesity care.
- Use of Opioids in the Management of Chronic Pain
Discussed in the source
The algorithm lists CBT as a non-opioid psychological treatment option. This sidebar is not a separately graded CBT recommendation or an opioid-use-disorder treatment guideline.
Scope: Non-opioid options within chronic pain care.
- Primary Care Management of Chronic Kidney Disease
Discussed in the source
The appendix names CBT among behavioral pain-management options, selected by availability and preference. This is ungraded guidance; much supporting evidence comes from people without kidney disease.
Scope: Adults with chronic kidney disease and chronic pain; self-management insufficient.
- Clinical Practice Guideline for the Primary Care Management of Asthma
Recommendation for the stated population
VA/DoD weakly recommends CBT for these outcomes. This recommendation was carried forward without a new evidence review and does not replace usual asthma care.
Scope: Adults with asthma; asthma-related quality of life and self-reported control.
- Clinical Practice Guideline for Management of Stroke Rehabilitation
Recommendation for the stated population
VA/DoD weakly recommends psychotherapy and explicitly names CBT as an example. This recommendation concerns treating depression after stroke, rather than preventing stroke or restoring motor function.
Scope: Depression following stroke.
- Clinical Practice Guideline for Psychological and Other Nonpharmacological Treatment of Chronic Musculoskeletal Pain in Adults
Recommendation for the stated population
APA strongly recommends offering CBT for this comparison.
Scope: Adults with chronic musculoskeletal pain; CBT versus usual care or another active intervention.
- Clinical Practice Guideline for Psychological and Other Nonpharmacological Treatment of Chronic Musculoskeletal Pain in Adults
Discussed in the source
APA reports insufficient evidence for this comparison. The table groups these approaches without assigning separate protocol grades.
Scope: Knee osteoarthritis; the reviewed CBT/motivational-interviewing/pain-coping-skills category versus usual care.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer trauma-focused CBT over those comparators. Its recommendation versus no treatment or usual care does not establish superiority over active therapy.
Scope: Adults with PTSD; trauma-focused CBT versus the other active psychological treatments listed in the table.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends adding trauma-focused treatment in this specific combined-care comparison.
Scope: Adults with PTSD and co-occurring SUD; trauma-focused CBT plus usual SUD care versus usual SUD care alone.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Insufficient evidence for or against
APA found insufficient evidence for a CBT recommendation in this age group. Adolescents have a separate recommendation.
Scope: Children with depressive disorders; initial treatment.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
APA recommends CBT as one initial psychotherapy option.
Scope: Adolescents with depressive disorders; initial treatment, excluding psychotic depression.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
For combined treatment, APA recommends CBT plus a second-generation antidepressant. It does not identify a superior psychotherapy monotherapy.
Scope: Adult depressive disorders, excluding psychotic depression; bipolar disorder is outside scope.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
APA recommends group CBT over no treatment.
Scope: Adults aged 60 or older with MDD; group CBT, alone or added to usual care.
- mhGAP: brief structured psychological treatment for depression
Recommendation for the stated population
WHO strongly recommends structured psychological interventions including CBT for this population, based on moderate-certainty evidence.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
- mhGAP: brief structured psychological interventions for anxiety
Recommendation for the stated population
WHO strongly recommends brief structured interventions based on CBT principles for GAD/panic, based on moderate-certainty evidence.
Scope: Adults with generalized anxiety disorder or panic disorder, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes individual, group and digital trauma-focused CBT in a conditional recommendation. The 2023 guideline book rates certainty as low, while WHO’s web summary reports moderate quality; that discrepancy remains unresolved. Delivery requires appropriate training and supervision.
Scope: Adults with PTSD, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO conditionally recommends considering CBT, with low-certainty evidence. The 2023 edition retains the 2015 recommendation because eligible new evidence was insufficient; suitability requires an individual assessment.
Scope: People living with dementia and mild-to-moderate depression.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO conditionally recommends considering CBT among the listed non-pharmacological interventions, with low-certainty evidence. This does not equate CBT with cognitive stimulation or cognitive training.
Scope: People living with dementia.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
WHO strongly recommends psychosocial interventions incorporating CBT, psychoeducation and family-focused approaches, with low-certainty evidence. This is a prevention recommendation for a defined group, rather than a general child-disorder treatment recommendation.
Scope: Children whose parents have mental health conditions; prevention of depression and anxiety.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO strongly recommends CBT, with moderate-certainty evidence. The discussion emphasizes adaptations and the ability to engage with CBT; it does not establish identical suitability across all developmental or communication needs.
Scope: Children and adolescents with autism who have anxiety.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes individual and group face-to-face trauma-focused CBT in a strong recommendation based on moderate-certainty evidence. Clinicians need relevant training and demonstrated competence; lay providers require comprehensive training and close supervision.
Scope: Children and adolescents with PTSD.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO conditionally recommends individual CBT and other listed psychological interventions as adjuncts to pharmacological treatment, with low-certainty evidence. This concerns maintenance in remission, not acute mania or a blanket depression recommendation.
Scope: Adults with bipolar disorder in remission.
- Psychosocial support for psychostimulant use disorders
Recommendation for the stated population
WHO strongly recommends CBT, with low-certainty evidence. This finding is specific to cocaine and stimulant dependence, rather than all substance use conditions.
Scope: Adults with cocaine or stimulant dependence.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
CBT is discussed within the reviewed psychosocial interventions. WHO conditionally recommends structured psychosocial treatment as a group, with low-certainty evidence, while noting uncertainty about individual therapy types versus usual care.
Scope: Adults with alcohol dependence.
- Self-harm: assessment, management and preventing recurrence (NG225)
Recommendation for the stated population
NICE says to offer a tailored intervention and explicitly names CBT and problem-solving therapy. This does not endorse every generic protocol or establish a reduction in suicide deaths.
Scope: Adults who have self-harmed; a structured, person-centred CBT-informed intervention tailored to their needs.
- Attention deficit hyperactivity disorder: diagnosis and management (NG87)
Recommendation for the stated population
NICE says the required ADHD-focused psychological support may include CBT components or a full course; CBT is not compulsory or universally first-line.
Scope: Adults with ADHD in the specified indications for non-drug or combined care.
- Chronic pain (primary and secondary) in over 16s (NG193)
Recommendation for the stated population
NICE says to consider pain-focused CBT; outcomes and evidence limitations are described separately from other pain diagnoses.
Scope: Chronic primary pain, age 16 and over; trained pain-focused CBT.
- Sexual and Reproductive Health: Management of Erectile Dysfunction
Recommendation for the stated population
EAU gives a strong recommendation for this indicated combined-care use; it does not cover every sexual dysfunction.
Scope: Men with erectile dysfunction; indicated CBT involving the partner and combined with medical treatment.
Seeking Safety
Guidelines and official sources (3)
3 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds the evidence insufficient for a recommendation for or against this treatment.
Scope: Seeking Safety for adult PTSD treatment.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports no difference in effect on PTSD symptoms or substance use and makes no recommendation for or against these comparisons.
Scope: Adults with PTSD and co-occurring SUD; Seeking Safety, with or without usual care, compared with usual SUD care.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer either side of these active-treatment comparisons.
Scope: Adults with PTSD and co-occurring SUD; Seeking Safety compared with COPE or Creating Change in the reviewed care arrangements.
Problem-Solving Therapy
Guidelines and official sources (10)
9 clinical guideline checks · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Depression in adults: treatment and management (NG222)
Recommendation for the stated population
NICE includes problem-solving among treatment options. The format and choice depend on depression severity, clinical needs and patient preferences.
Scope: Adults with depression; guided self-help or individual problem-solving options.
- Problem-Solving Therapy for Depression
Discussed in the source
The archive records a 1998 strong rating and a 2015 status awaiting re-evaluation. These are evidence-registry classifications, separate from NICE’s recommendations.
Scope: Depression; historical Division 12 treatment ratings.
- Assessment and Management of Patients at Risk for Suicide
Recommendation for the stated population
VA/DoD includes problem-solving-based psychotherapies within its weak recommendation for suicide-focused CBT to reduce suicidal ideation. This recommendation concerns ideation and does not establish fewer suicide attempts or deaths for generic PST.
Scope: Suicide-focused, problem-solving-based CBT for adults aged 18 and over with a history of self-directed violence.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests problem-solving therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.
Scope: Adults with uncomplicated MDD choosing psychotherapy.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD strongly recommends first-line evidence-based psychotherapy, referring to the list that includes problem-solving therapy. This is a class-level recommendation, with no preferred individual approach.
Scope: Pregnant or breastfeeding adults with mild-to-moderate MDD.
- Clinical Practice Guideline for Management of Stroke Rehabilitation
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against solution-focused psychological interventions, explicitly including problem-solving therapy. The finding is specific to post-stroke depression prevention.
Scope: Preventing the onset of depression following stroke.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
APA conditionally suggests the specified individual problem-solving treatments for these populations.
Scope: Older adults with MDD and executive dysfunction, or minor/MDD depression with dementia.
- mhGAP: brief structured psychological treatment for depression
Recommendation for the stated population
WHO includes problem-solving therapy among the structured psychological interventions that should be offered. The recommendation is strong, with moderate-certainty evidence.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
WHO conditionally supports digital interventions based on approaches including problem-solving therapy, with low-certainty evidence. This is not a recommendation for every full problem-solving therapy program, and the reviewed trials did not establish benefit for attempts or deaths and were underpowered for those outcomes.
Scope: Digital support for people with suicidal thoughts.
- Self-harm: assessment, management and preventing recurrence (NG225)
Recommendation for the stated population
NICE says to offer a tailored intervention and explicitly names CBT and problem-solving therapy. This does not endorse every generic protocol or establish a reduction in suicide deaths.
Scope: Adults who have self-harmed; a structured, person-centred CBT-informed intervention tailored to their needs.
Crisis intervention is the youngest lineage and the one with the highest stakes. It begins with Edwin Shneidman, who founded suicidology with a single insight: suicidal people don\u2019t want to die \u2014 they want to end unbearable psychological pain. Gerald Caplan formalized crisis theory. Marsha Linehan brought behavioral science to suicidality with DBT. Barbara Stanley and Gregory Brown developed collaborative safety planning. David Jobes developed CAMS, shifting from risk assessment to collaborative framework. The through-line: suicidality is not a diagnosis but a response to pain, and the clinical task is to understand the pain, not just categorize the risk.
A 2018 nonrandomized study at nine VA emergency departments associated safety planning plus follow-up calls with fewer recorded suicidal behaviors over six months. The adults studied did not require inpatient admission. This combined intervention does not establish the effect of a plan alone. For plan components, see VA/DoD 2024, Table 4.
Full Contents
Read all 6 entries as a single page
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Edwin Shneidman
Founded suicidology. Coined "psychache" — unbearable psychological pain as the common pathway to suicide. Established the first Suicide Prevention Center (1958).
Concepts: Psychache · Suicidology · Psychological autopsy · Ten commonalities of suicide
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Gerald Caplan
Formalized crisis theory: crises are time-limited disruptions where the person is temporarily more open to change. Brief intervention during the crisis window can be more effective than extended therapy after.
Concepts: Crisis theory · Homeostatic disruption · Crisis as opportunity · Time-limited intervention
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Marsha Linehan
Created DBT (1993) for chronically suicidal women with BPD. Demonstrated that suicidality could be directly treated rather than simply managed. Dialectic of acceptance AND change.
Concepts: DBT · Dialectics · Distress tolerance · Chain analysis · Phone coaching · Consultation team
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Thomas Joiner
Interpersonal Theory of Suicide (2005): suicide requires thwarted belongingness, perceived burdensomeness, AND acquired capability. Explains why desire alone rarely leads to attempts.
Concepts: Thwarted belongingness · Perceived burdensomeness · Acquired capability · Desire + capability
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Barbara Stanley & Gregory Brown
Developed the Safety Planning Intervention: a collaborative plan covering warning signs, coping, distraction contacts, people who can help, professional services, and safer access to means.
Concepts: Safety Planning · Six steps · Means restriction · Coping hierarchy
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David Jobes
Created CAMS. Clinician and patient sit side by side completing the Suicide Status Form — shared understanding rather than top-down risk assessment.
Concepts: CAMS · Suicide Status Form · Collaborative assessment · Suicidal drivers