Many young clients experience subacute suicidal ideation that does not require more intensive interventions but still warrants attention in treatment. A recent article in Cognitive and Behavioral Practice introduces a brief Cognitive Behavior Therapy (CBT) module designed to reduce suicidal ideation by targeting perceived burdensomeness, a key cognitive risk factor. The module offers clinicians a focused strategy to address suicide risk within standard CBT treatment.  

Key Findings 

The intervention, called the Give to Others (GO) module, includes four structured components: psychoeducation using the cognitive model, cognitive restructuring of burden-related thoughts, engagement in prosocial activities of the client’s choosing, and a parent message activity reinforcing the adolescent’s positive impact on others. Examples of prosocial activities include:

  • Helping a parent or friend with a task or chore
  • Preparing a meal for someone else
  • Writing an encouraging note or leaving a positive comment for someone on social media; or
  • Doing something creative with a friend or caregiver.
Young adult looking at her phone looking sad.

These elements are designed to modify maladaptive beliefs while promoting experiences that strengthen positive self-perception. The GO module can be delivered as a standalone intervention or embedded within standard CBT treatment. The module has been administered to 47 clinic-referred adolescents receiving outpatient mental health services.

In an initial pilot trial involving 18 adolescents, results showed statistically significant reductions in perceived burdensomeness when the module was integrated into standard CBT.  Engagement and acceptability were high, with 79% of youth and 83% of parents completing assigned activities independently. An ongoing randomized controlled trial involving 29 adolescents has demonstrated similarly strong feasibility. Outcome data on suicidal ideation from this trial are forthcoming. 

Commentary and Clinical Takeaways from Dr. Judith Beck 

“This research highlights the importance of targeting specific cognitions that contribute to suicidal ideation,” says Dr. Judith Beck, Beck Institute President. “Perceived burdensomeness is a negative belief that can maintain emotional distress and increase suicide risk. This intervention combines cognitive restructuring with behavioral experiments to help adolescents gather evidence that contradicts their negative beliefs. When clients engage in meaningful actions and observe their positive impact, they gather evidence that their negative beliefs are not true or not completely true.”

Importantly, the brief and structured nature of the module makes it especially useful to clinicians. “CBT clinicians need effective evidence-based interventions that can be integrated into treatment,” Dr. Beck explains. “This module provides a practical way to target suicide-related cognitions directly while reinforcing young clients’ senses of connection and value.”

For CBT clinicians, the findings underscore the importance of identifying and addressing beliefs related to perceived burden as part of suicide risk assessment and intervention. Targeting these cognitions may reduce vulnerability and improve treatment outcomes.

This brief CBT module represents a promising, scalable approach to targeting perceived burdensomeness and reducing suicide risk in adolescents. As additional randomized trial data become available, this intervention may become an important addition to CBT clinicians’ toolkit for treating youth with suicidal ideation.

If you work with children and adolescents, we hope you will learn more about our CBT certification program for clinicians working with youth. This brand-new program ensures clinicians are trained in evidence-based CBT strategies tailored to the needs of young clients. By earning certification, clinicians not only strengthen their own practice—they contribute to raising the standard of care for youth mental health everywhere.  

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Reference: 

Morales, I., Hill, R. M., Balser, D., Pettit, J. W., & Buitron, V. (2026). Brief Cognitive-Behavioral Therapy to Mitigate Subacute Suicidal Ideation Among Youth. Cognitive and Behavioral Practice.

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