Attempted Suicide Short Intervention Program

Domain II · Behavioural & cognitive · Michel, Gysin-Maillart · 2013 · Bern

What it is

ASSIP is a brief, manualised, suicide-specific intervention for adults seen soon after a suicide attempt: three (optionally four) face-to-face sessions of 60–90 minutes, followed by semi-standardised letters for 24 months. It is explicitly an add-on to usual care, not a stand-alone treatment and…

Format

• Target group and timing
• Adults after a recent suicide attempt (self-inflicted, potentially injurious behaviour with non-fatal outcome and some intent to die). In the RCT, patients were referred from the emergency department; high-risk patients were seen once safe for escorted transport. The developers aim for the three…

Who practises it, and how they are trained or regulated

• Delivered by a trained ASSIP therapist who is not the patient's primary therapist, alongside the patient's usual inpatient or outpatient care.
• Variants: in-person or telehealth via a secure video platform (US trial); clinic or home ("ASSIP flex", from inpatient care to home treatment); optional loved-ones session in Finland.
• Room: a defined ASSIP room or mobile set-up with two fixed cameras for split-screen or one wide-angle camera; stored handouts, report templates and a letter-administration system.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Patients with no ongoing care: arrange a referral before ending.
• The loved one being part of the trigger; the patient feeling pressured.
• Hopelessness making goals hard to name; start small and concrete. Goals go on the card (4.13).
• Distress stirred up by the narrative; repeat the check at each later session for high-risk patients.
• Signs that only appear once the suicidal mode is already active are too late on their own; look for earlier ones too.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.