Self-determination theory, motivational interviewing, and the treatment of clients with acute suicidal ideation.

An overwhelming number of individuals who die by suicide suffer from mental disorders, but comparatively few are seen in psychological or psychiatric treatment. Given the efficacy of psychosocial interventions in decreasing suicide-related behavior, the development of strategies to increase motivation for treatment is critical for clients with acute suicidal ideation. Self-Determination Theory (SDT) provides a framework for understanding how the therapeutic relationship can affect clients' motivation for treatment. When working with clients with serious suicidal ideation, clinicians can use the principles of SDT or interventions that are congruent with SDT, such as motivational interviewing (MI), to increase clients' engagement in treatment and improve treatment outcome. SDT-based suggestions and an adaptation of MI are introduced to guide clinicians through this process. (c) 2007 Wiley Periodicals, Inc.