Korean Clinical Psychology Association
[ Review Article ]
Korean Journal of Clinical Psychology - Vol. 38, No. 4, pp.400-414
ISSN: 1229-0335 (Print) 2466-197X (Online)
Print publication date 30 Nov 2019
Received 04 Oct 2019 Accepted 06 Nov 2019
DOI: https://doi.org/10.15842/kjcp.2019.38.4.006

자살행동의 근거기반치료

유성은 ; 김효중
충북대학교 심리학과
Evidence-Based Psychological Treatments of Suicidal Behavior
Sungeun You ; Hyojoong Kim
Department of Psychology, Chungbuk National University, Cheongju

Correspondence to: Sungeun You, Department of Psychology, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Korea; E-mail: syou@chungbuk.ac.kr


© 2019 Korean Clinical Psychology Association

초록

본 연구는 자살행동의 근거기반치료에 대한 개관을 목적으로 시행되었다. 구체적으로 본 연구에서는 메타연구와 무선할당통제연구를 중심으로 자살위기에 대한 단기 심리적 개입과 심리치료적 접근에 대한 치료 효과 연구를 개관하였다. 연구 결과, 단기 심리적 개입 중에는 WHO에서 개발한 단기 개입 및 추후 접촉(WHO-BIC), 안전계획 개입(SPI)과 위기 반응 계획(CRP)이 근거기반이 강한 또는 어느 정도인 치료인 것으로 나타났다. 심리치료적 접근 방법 중에는 자살행동의 감소를 목적으로 시행되는 인지행동치료(CBT)와 변증법적치료(DBT), 자살위기에 대한 협력적 평가 및 관리(CAMS)가 다양한 임상 집단에서 비교적 일관적으로 치료효과가 반복 검증되어 강한 근거 수준을 보였다. 하지만 자살행동에 대한 심리치료 효과에 대한 국내 연구는 자살생각의 감소만을 평가하였고 자살시도의 감소 또는 자살예방을 목적으로 한 치료효과 연구는 없는 것으로 나타나 현 시점에서 근거기반 수준을 평가하기에는 시기상조인 것으로 나타났다. 이에 본 연구에서는 해외 연구를 기반으로 자살행동에 대한 근거기반치료에 대한 권고안을 제시하였고 국내 연구 및 임상 현장에서의 적용에 대해 논의하였다.

Abstract

The aim of this study was to review evidence-based psychological treatments of suicidal behavior. Specifically, the effectiveness of brief psychological crisis interventions and suicide-specific psychological treatments were examined based on meta-analytic studies and randomized controlled studies. The results of the current review indicate that brief intervention and contact developed by World Health Organization (WHO-BIC), safety planning intervention (SPI), and crisis response planning (CRP) are evidence-based brief psychological interventions. Among psychological treatments, cognitive behavioral therapy, dialectical behavioral therapy, and collaborative assessment and management of suicidality (CAMS) are evidence-based. In Korea, treatment outcome studies of suicidal behavior have targeted for reducing suicidal ideation only, but not for suicide attempt or suicide. Thus, it is premature to determine the evidence level of psychological treatments of suicidal behavior in Korea. Based on studies in other countries, evidence-based psychological treatments for suicidal behavior are recommended, and directions for domestic research and practical applications are suggested.

Keywords:

suicide, suicidal behavior, evidence-based treatment

키워드:

자살, 자살행동, 근거기반치료

Acknowledgments

This work was conducted during the research year of Chungbuk National University in 2018.

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