The aim of the present study is to examine the effectiveness of Cognitive Therapy for Suicidal Patients (CT-SP) in reducing suicide risk for patients attending psychiatric services and experiencing STBs. 

An open label, single group with multiple assessment design will be adopted for the present study. The study will be conducted in two phases. The first would aim at examining the feasibility, acceptability and usefulness of the intervention, while the second is the main study. In the pilot phase, CT-SP will be administered on 5 patients with suicidal ideation and/or behaviours and the patients will be interviewed using an interview guide developed by the researcher. In the main phase, 50 individuals with STBs would be recruited from the inpatient and outpatient mental health services of National institute of Mental Health and Neurosciences based on specified inclusion and exclusion criteria. Recruited patients will be given 10 biweekly sessions of CT-SP. The assessments will be done using Columbia Suicide Severity Rating Scale (C-SSRS) (Screening and primary outcome measure), Beck Hopelessness Scale (BHS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Scale (HAM-D), Difficulties in Emotion Regulation Scale (DERS), Automatic Thoughts Questionnaire (ATQ), Cognitive Control and Flexibility Questionnaire (CCFQ), Personal Problem-Solving Inventory (PPSI) and Global Assessment of Functioning (GAF). The assessments will be carried out at baseline, post-intervention, and at 1-, 3- and 6-month follow-ups. The participants engagement in other therapy after the intervention will be recorded at follow-ups. Data obtained in each of the phases will be recorded, analyzed and interpreted using suitable methods. Qualitative content analysis will be used to understand usefulness and helpful aspects of therapy during the pilot phase. The data obtained using the tools will be tabulated and subjected to statistical analysis using R Software. Descriptive statistics such as mean, standard deviation, frequency and proportion will be used to express the data. The association between the demographic variables and the outcome variables will be examined. Paired t-test or the analogous non-parametric test will be used to compare the overall mean values between the pre and post measurements. P value less than 0.05 will be considered as statistically significant. Repeated Measures ANOVA will be used to assess change across different time points. Pearson’s correlation coefficient or Spearman’s Rho will be used to measure relationship between variables. The subgroups of treatment engagement reported at post-intervention will also be examined using appropriate tests of association. During the study period, the participants will be monitored for increase in suicidal risk. SOP for such situations would be implemented with steps such as making psychiatric referrals and involvement of a designated contact person who would be informed on steps to be taken in emergencies