Adult Suicidality and Therapeutic Engagement: A Systematic Review.
Background: Engagement in mental health care among adults with suicidality remains significantly low, with limited understanding of the factors influencing treatment retention and dropout. Aims: Exploring the factors influencing therapeutic engagement, such as attendance, active participation and co...
| Published in: | Clinical Psychology & Psychotherapy Vol. 32; no. 6; pp. 1 - 19 |
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| Main Authors: | , , |
| Format: | research systematic review tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Nov/Dec2025
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190405499&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190405499 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10633995 BUX jtl: Clinical Psychology & Psychotherapy issn: 10633995 maglogo: Y pubinfo: dt: Nov/Dec2025 vid: 32 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 190405499 190405499 190405499 10.1002/cpp.70170 190405499 ppf: 1 ppct: 18 formats: tig: atl: Adult Suicidality and Therapeutic Engagement: A Systematic Review. aug: au: Muscat, Chloé Verhaegen, Frédéric Clesse, Christophe affil: INTERPSY, Université de Lorraine, Nancy, France sug: subj: Suicidal Ideation Therapy Suicide Psychosocial Factors Suicide Prevention Methods Patient Participation Task Performance and Analysis Preventive Health Care Human Female Male Adult Middle Age Aged Aged, 80 and Over Systematic Review Descriptive Statistics Patient Attitudes Evaluation PubMed Embase Psycinfo Thematic Analysis Content Analysis Suicide, Attempted Suicidal Ideation Prevention and Control Time Factors Income Health Services Accessibility Stigma Health Beliefs Trust Mental Health Personnel Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: Background: Engagement in mental health care among adults with suicidality remains significantly low, with limited understanding of the factors influencing treatment retention and dropout. Aims: Exploring the factors influencing therapeutic engagement, such as attendance, active participation and completion of therapeutic tasks among adults with suicidality, could offer valuable insights for suicide prevention and management. Methods: This systematic review explored quantitative and qualitative studies examining barriers and/or facilitators to treatment engagement. Four main databases have been explored (PubMed, Embase, PsycInfo and Web of Science). Data were analysed and thematically organised with the help of a content analysis. Results: Eighteen studies focusing on adults experiencing various forms of suicidality, including suicidal ideation, behaviours, plans and attempts, have been included. Engagement is mainly perceived through appointment attendance, active participation or a multidimensional combination of factors. Logistical constraints (service availability, time and money) emerge as the most significant barrier to engagement, followed by stigma, treatment‐related experiences and beliefs and patient perception factors. No consensus between studies can be isolated regarding the impact of social support, severity of suicidal symptoms and psychiatric comorbidities. Trust in mental health professionals and interventions facilitating active patient participation positively influence treatment continuation. Conclusion: This review highlights the need to increase mental health funding to enhance service availability and improve the training of mental health professionals in suicide prevention and management. Developing integrative and empowering interventions fosters an essential climate of trust and hope in therapy that enhances engagement. Future research should prioritise study designs that distinguish between perceived and actual barriers to engagement to develop targeted interventions. Summary: Actively addressing logistical barriers such as cost, time and service availability can support therapeutic engagement in adults experiencing suicidality.Exploring and acknowledging patients' previous treatment experiences, beliefs and experiences of stigma may help reduce barriers to engagement.Therapeutic engagement is enhanced when clinicians foster active patient participation and a sense of empowerment. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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