Amelioration of suicidal ideation in routine care psychotherapy: Preliminary findings from a large multicenter assessment

•Suicidal ideation was assessed in n = 4549 adult outpatients before and after routine psychotherapy.•Suicidal ideation was reported by 36.7% of the patients pretreatment and by 17.6% posttreatment.•4.4% reported an increase in suicidal ideation from pre- to posttreatment.•Residual posttreatment suicidal ideation was most prevalent among individuals suffering from recurrent major Depression, Dystymia, and borderline personality disorder. Suicidal ideation represents a major concern in clinical practice. Yet, little is known about the effects of routine psychotherapy on the amelioration of suicidal ideation. Therefore, the aim of the current study is to assess mental disorder-specific changes of suicidal ideation in a large sample of adult outpatients undergoing routine-care cognitive-behavioural therapy in Germany. A total of N = 4549 adult outpatients, 64.2% female; age: M(SD) = 36.83 (14.03), range: 18–89 years of age, who completed cognitive-behavioral therapy at one of 26 outpatient clinics in Germany were included in the current study. Amelioration of suicidal ideation was assessed using the Suicide Item (Item 9) of the Beck-Depression Inventory. Suicidal ideation was reported by 36.7% of the patients pretreatment and by 17.6% posttreatment. Effect sizes were small to moderate (d = 0.25 -0.51) and 4.4% reported an increase in suicidal ideation. Residual suicidal ideation at the posttreatment assessment was more likely in patients diagnosed with recurrent Major Depression, Dystymia, and Borderline Personality Disorder, and older patients. The study relies on a naturalistic sample, no waitlist or control conditions were involved. Across primary diagnoses, a significant proportion of patients experience an amelioration of suicidal ideation over the course of routine-care psychotherapy. Still, a substantial proportion of patients report no change or an increase in suicidal ideation during treatment. Thus, continuous monitoring of suicidal ideation appears to be imperative throughout the psychotherapeutic process.