Feasibility, Acceptability, and Preliminary Outcomes of a Group‐Based Brief Cognitive‐Behavioral Therapy Protocol for Suicide Prevention in a Brazilian Public Mental Health Service: A Mixed‐Methods Pilot Study

Abstract

ABSTRACT Introduction We evaluated the feasibility, acceptability, and preliminary outcomes of group‐adapted brief cognitive‐behavioral therapy for suicide prevention (BCBT) in a Brazilian public psychiatric outpatient service. Methods This single‐arm, nonrandomized, mixed‐methods pilot enrolled 27 adults across two cohorts receiving 16 weekly group sessions. Feasibility and acceptability were assessed, and suicidal ideation was monitored weekly using the Beck Scale for Suicide Ideation (BSI). Results Enrollment targets were met; 70.4% had ≥ 4 recorded sessions, and no intervention‐related adverse events were recorded. All six questionnaire respondents rated recommendation at 8–10. Four provided qualitative responses, highlighting shared suffering recognition and an interpretive theme of hope instillation. The linear BSI slope was nonsignificant (B = −0.29, p = 0.129); multiple imputation yielded B = −0.36 (p = 0.018). An exploratory quadratic model indicated greater decline later in treatment (p = 0.008). Among 18 participants with ≥ 4 recorded sessions and baseline BSI, scores decreased by 8.2 points from baseline to the last observation (d = −0.67; p = 0.011). Conclusions Group‐adapted BCBT showed preliminary feasibility and acceptability, with uncontrolled signals of reduced suicidal ideation. Controlled evaluation is needed to establish efficacy.