The Transtheoretical Model of Change and Recovery from a Suicidal Episode

The Transtheoretical Model of Change (TTM) is an established model outlining five stages of change within a psychotherapeutic context: pre-contemplation, contemplation, preparation, action, and maintenance. Research shows that these models benefit patients and clinicians by enhancing their understanding of complex processes and identifying optimal therapeutic support for an individual at a specific time. Although recognized as a promising approach for understanding suicidal thoughts and experiences, the TTM has not yet been applied to suicide recovery. In this study, we used a scoping review of qualitative articles describing recovery processes following a suicidal episode (N=57) and mapped studies outlining phases or stages (N=10) onto the TTM. The resulting model revealed a pattern of processes across each TTM stage of change. However, we found that the recovery process does not perfectly align with the TTM stages of change beyond contemplation. As a result, we developed a three-stage model of recovery that consolidates the final three TTM stages (action, maintenance, and termination) and better accommodates the specific changes found in suicide recovery: pre-contemplation, contemplation, and active growth. Future research should evaluate the benefits of incorporating stages of change into suicide-focused recovery interventions to develop more effective interventions.