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The current thesis explores psychological interventions for suicide in people who experience psychosis, and is presented as three separate papers: 1) a systematic literature review; 2) an empirical paper; and 3) a critical appraisal of the research process. Paper 1 systematically reviews the literature examining the impact of psychological interventions on suicidal experiences in people experiencing psychosis. Research within this specific population was relatively sparse, with only eight studies reporting on suicide-related outcomes as measured by standardised tools, and nine reporting on suicide-related serious adverse events (SAEs) only. Findings suggested that psychological interventions may be effective in reducing suicidal thoughts and behaviours in people experiencing psychosis. However, it was difficult to draw firm conclusions around factors influencing intervention effectiveness or maintenance of improvements over time, due to a diverse array of methodological designs, samples, measurement and reporting. Future research into interventions for suicidal thoughts and behaviours in this population should target psychosis-specific underlying mechanisms. Improvements in the consistency of both methodology and reporting are necessary, including more thorough measurement and reporting of SAEs. Paper 2 reports on an empirical study exploring how suicide-related content was discussed within psychological therapy sessions for people experiencing psychosis. The study had two parts: 1) the methodological adaptation of the Verona Coding Definitions of Emotional Sequences (VR-CoDES) for use within a psychotherapeutic context; and 2) the application of the adapted VR-CoDES to the examination of how suicide-related content is discussed in psychological therapy sessions. A pilot set of five audio-recordings of psychological therapy sessions to prevent suicide amongst people experiencing psychosis were used to adapt the VR-CoDES manual for the current context and content. Thirty-seven recordings for eight therapy participants were then coded using the adapted manual, and patterns were explored around how individuals communicated suicide-related content, and how therapists responded to those communications. The findings revealed that it was possible to adapt VR-CoDES for use in a psychotherapeutic context, and that such adaptation provided useful insights into how 'suicide talk' is managed within psychological therapy. Paper 3 provides a critical appraisal of the findings of Papers 1 and 2 within the context of the wider literature. The rationale for selected topics and methods is discussed, the research process is reflected upon, and the implications of the findings for both clinical practice and future research are considered. more...

Background and Aims: The current thesis explored whether the social norms approach might be applicable to suicidal and self-harming behaviours (SSHBs). A thorough literature review and three empirical studies were conducted. The review indicated that children's and adolescents' SSHBs appear to be related to SSHB in people they know, but the literature assumed accurate knowledge of others' behaviour, and individual behaviours and reference groups were not always well-defined. Study 1: A social norms survey indicated that undergraduate students tend to believe that those close to them are less likely to engage in SSHBs than they reported doing, but that more distal groups are more likely to do so. Proximal groups were also perceived as less likely to approve of SSHBs. Perceived proximal group norms tended to predict reported norms directly, while perceived distal group norms tended to show negative associations with reported norms. Study 2: Similar results were found in an adolescent social norms survey, with proximal groups perceived as less likely to engage in and approve of SSHBs, and distal groups perceived as more likely to do so. Conversely, close friends' norms were perceived similarly to distal group norms. Perceived norms again predicted reported norms, with close friends' norms showing particular importance. Study 3: The final study used qualitative methods to explore the beliefs and experiences behind undergraduates' normative perceptions. A range of knowledge, experience, judgements, and perceived causes, motivations and outcomes of SSHBs were identified, and conceptualisation was complex and often contradictory. Social desirability appeared to impact reported attitudes. Conclusions: Findings suggest that the social norms approach may well be applicable to SSHB, but in different ways to behaviours previously studied. Consideration of target population, reference group and moral/ethical judgements of SSHB is imperative. Implications for the development of theory and directions for further research are discussed. more...