Suicidal Ideation Counselling in North West London, London

Photo of Irene Brown-Martin, Psychotherapist, MA, MBACP
Irene Brown-Martin
Psychotherapist, MA, MBACP
Verified Verified
Serves Area
I have extensive experience in the assessment and management of self harm and suicidal ideation.
I am a clinical lead with 14 years of experience in working in NHS services. My years of experience has taught me that effective psychotherapy involves treatment that includes a bio psychosocial approach. Clients receive a comprehensive assessment, then collaboratively outline treatment goals. Treatment is always tailored to the individual person.
I have extensive experience in the assessment and management of self harm and suicidal ideation.
I am a clinical lead with 14 years of experience in working in NHS services. My years of experience has taught me that effective psychotherapy involves treatment that includes a bio psychosocial approach. Clients receive a comprehensive assessment, then collaboratively outline treatment goals. Treatment is always tailored to the individual person.
020 4538 8269 View 020 4538 8269
Photo of Dr Nicole Harvey, Psychologist, HCPC - Forensic Psych.
Dr Nicole Harvey
Psychologist, HCPC - Forensic Psych.
Verified Verified
Online Only
I have significant experience working with individuals with big emotions, suicidal/self-harming thoughts, relational difficulties, mood swings, feelings of emptiness, fears of abandonment, impulsivity, low mood, and anxiety.
If you're reading this you're probably looking for some support to make important changes to your life. Maybe you’ve noticed unhealthy or unwanted patterns in your relationships. Maybe you’re struggling to make sense of your emotions and behaviours. I will help you to understand yourself and support you to make the changes you may have been struggling to make on your own. You've come to the right place.
I have significant experience working with individuals with big emotions, suicidal/self-harming thoughts, relational difficulties, mood swings, feelings of emptiness, fears of abandonment, impulsivity, low mood, and anxiety.
If you're reading this you're probably looking for some support to make important changes to your life. Maybe you’ve noticed unhealthy or unwanted patterns in your relationships. Maybe you’re struggling to make sense of your emotions and behaviours. I will help you to understand yourself and support you to make the changes you may have been struggling to make on your own. You've come to the right place.
020 4572 0474 View 020 4572 0474
Photo of Dr Cristian A Nica, Psychologist, MSc, HCPC - Couns. Psych.
Dr Cristian A Nica
Psychologist, MSc, HCPC - Couns. Psych.
Verified Verified
North West London, London NW1
My research interests include risk-taking, flow, suicide ideation, vulnerability, sexual fantasies and success expectancies.
Psychologist, HCPC-registered supervisor in clinical, counselling, health and occupational psychology. Providing services for individuals, couples and families beginning from eclectic CBT interventions (ACT, DBT, ST) - the most effective and intuitive psychological framework. I address all psychopathologies. My goal is to provide you with a strong mental platform and the skills to help you keep your life in reach. Progress means change, rehearsing new ways of thinking or a range of strategies to iterate development safely. The result, a genuine approach for you to always find a better way forward.
My research interests include risk-taking, flow, suicide ideation, vulnerability, sexual fantasies and success expectancies.
Psychologist, HCPC-registered supervisor in clinical, counselling, health and occupational psychology. Providing services for individuals, couples and families beginning from eclectic CBT interventions (ACT, DBT, ST) - the most effective and intuitive psychological framework. I address all psychopathologies. My goal is to provide you with a strong mental platform and the skills to help you keep your life in reach. Progress means change, rehearsing new ways of thinking or a range of strategies to iterate development safely. The result, a genuine approach for you to always find a better way forward.
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Photo of Sheryl Noik, Psychotherapist, MBACP
Sheryl Noik
Psychotherapist, MBACP
Verified Verified
North West London, London NW11
I specialise in childhood bereavement, relationship issues, chronic illness, anxiety, panic attacks, depression, divorce, self-harm, suicide ideation, sexual and gender identity, OCD, ASD and ADHD.
Hello, my name is Sheryl and I am an Integrative counsellor and psychotherapist. Whether you're experiencing anxiety, depression, panic attacks, relationship issues, struggling with parenting or coping with bereavement, therapy will be tailor-made for your situation. Therapy is a safe, non-judgemental space where you can bring your worries, explore thoughts and share your feelings, and be heard with compassion and empathy. I work with adults, couples and adolescents.
I specialise in childhood bereavement, relationship issues, chronic illness, anxiety, panic attacks, depression, divorce, self-harm, suicide ideation, sexual and gender identity, OCD, ASD and ADHD.
Hello, my name is Sheryl and I am an Integrative counsellor and psychotherapist. Whether you're experiencing anxiety, depression, panic attacks, relationship issues, struggling with parenting or coping with bereavement, therapy will be tailor-made for your situation. Therapy is a safe, non-judgemental space where you can bring your worries, explore thoughts and share your feelings, and be heard with compassion and empathy. I work with adults, couples and adolescents.
020 3835 3016 View 020 3835 3016
Photo of Jodi Mishcon, Psychotherapist, DCounsPsych, MBACP
Jodi Mishcon
Psychotherapist, DCounsPsych, MBACP
Verified Verified
2 Endorsed
North West London, London NW11
Additional training areas include: Group Analysis, Eating Disorders, Addiction, Suicidal thoughts and behaviour.
I offer warmth, openness and curiosity, providing a creative and flexible environment in which you can feel safe enough to explore all parts of yourself including those that might feel challenging or unacceptable. I hope that our work together will enable you to begin to heal and grow. At the core of my practice is my belief in the importance of seeing the individual in front of me and I aim to hear and learn to understand your needs in relation to you.
Additional training areas include: Group Analysis, Eating Disorders, Addiction, Suicidal thoughts and behaviour.
I offer warmth, openness and curiosity, providing a creative and flexible environment in which you can feel safe enough to explore all parts of yourself including those that might feel challenging or unacceptable. I hope that our work together will enable you to begin to heal and grow. At the core of my practice is my belief in the importance of seeing the individual in front of me and I aim to hear and learn to understand your needs in relation to you.
020 3835 4359 View 020 3835 4359
Photo of Bukola James, Counsellor
Bukola James
Counsellor
Verified Verified
Online Only
I am experienced in dealing with adults, young people and teens on issues such as anxiety, depression, OCD, Self-harming, suicidal ideations, spirituality, family relationship difficulties, peer problems at school, Trauma related to sexual assaults/abuse, romantic relationship problems, self-esteem.
I offer a safe confidential space and compassionate listening ears for clients to explore any issue. I work collaboratively with clients of any or no faith to build hope and achieve desired outcomes, helping people on their journey to restoration. This has included a variety of issues ranging from anxiety, depression, trauma and other emotional distresses.
I am experienced in dealing with adults, young people and teens on issues such as anxiety, depression, OCD, Self-harming, suicidal ideations, spirituality, family relationship difficulties, peer problems at school, Trauma related to sexual assaults/abuse, romantic relationship problems, self-esteem.
I offer a safe confidential space and compassionate listening ears for clients to explore any issue. I work collaboratively with clients of any or no faith to build hope and achieve desired outcomes, helping people on their journey to restoration. This has included a variety of issues ranging from anxiety, depression, trauma and other emotional distresses.
020 3319 1372 View 020 3319 1372
Photo of Beverley Beckett Pncps (Acc.) Specialist Tailored Counselling, Psychotherapist, PNCPS Acc.
Beverley Beckett Pncps (Acc.) Specialist Tailored Counselling
Psychotherapist, PNCPS Acc.
Verified Verified
North West London, London NW1
I regularly work across a number of different areas and can support you if you are struggling with: addiction, trauma, abuse, bereavement, neurodiversity, bullying and relationship issues, gender conflict, self-harm, depression, anxiety or suicide.
Person-centred counselling puts you at the centre of our sessions, while I guide our discussions and support you by introducing psychotherapy tools to provide structure to your thinking. The guiding purpose is to allow you to discover the best way forward for you as an individual - we are all unique. There are a number of reasons why you might want to engage in therapy and often our conversations can cover unexpected topics. I am a fully qualified counsellor and psychotherapist, with professional accreditation from the NCPS and I am registered with the BACP.
I regularly work across a number of different areas and can support you if you are struggling with: addiction, trauma, abuse, bereavement, neurodiversity, bullying and relationship issues, gender conflict, self-harm, depression, anxiety or suicide.
Person-centred counselling puts you at the centre of our sessions, while I guide our discussions and support you by introducing psychotherapy tools to provide structure to your thinking. The guiding purpose is to allow you to discover the best way forward for you as an individual - we are all unique. There are a number of reasons why you might want to engage in therapy and often our conversations can cover unexpected topics. I am a fully qualified counsellor and psychotherapist, with professional accreditation from the NCPS and I am registered with the BACP.
07401 263192 View 07401 263192
Photo of Alison Goolnik, Psychotherapist, MA, MBACP
Alison Goolnik
Psychotherapist, MA, MBACP
Verified Verified
North West London, London NW1
Self-harm & suicide training, CBT anxiety/social anxiety, Imposter syndrome, .
Feeling overwhelmed by anxiety? Facing new job or exam jitters or university challenges? Are you depressed or self-harming? Do you dream of healthier relationships or improved self-esteem? I am an experienced psychotherapist, passionate about helping individuals manage anxiety, navigate life transitions, and improve self-esteem. I support individuals on their journey to positively change their mental health and emotional well-being.
Self-harm & suicide training, CBT anxiety/social anxiety, Imposter syndrome, .
Feeling overwhelmed by anxiety? Facing new job or exam jitters or university challenges? Are you depressed or self-harming? Do you dream of healthier relationships or improved self-esteem? I am an experienced psychotherapist, passionate about helping individuals manage anxiety, navigate life transitions, and improve self-esteem. I support individuals on their journey to positively change their mental health and emotional well-being.
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Photo of Laura Jayne Arstall - In Toto Counselling, Counsellor, DCounsPsych, MBACP
In Toto Counselling
Counsellor, DCounsPsych, MBACP
Verified Verified
Online Only
I have lots of experience working with suicidal thoughts and self-harm.
I am an integrative counsellor offering talking therapy focused on you and your needs. Sometimes this will mean providing a safe place to openly discuss your concerns and difficulties without judgement and sometimes this will be providing solutions and guidance around practical elements to help overcome your concerns and difficulties, depending on what best suits your needs. I work with children, young people, adults and couples across a range of presenting issues.
I have lots of experience working with suicidal thoughts and self-harm.
I am an integrative counsellor offering talking therapy focused on you and your needs. Sometimes this will mean providing a safe place to openly discuss your concerns and difficulties without judgement and sometimes this will be providing solutions and guidance around practical elements to help overcome your concerns and difficulties, depending on what best suits your needs. I work with children, young people, adults and couples across a range of presenting issues.
01772 288309 View 01772 288309
Photo of Ben Scanlan, Psychotherapist, MSc, MBACP
Ben Scanlan
Psychotherapist, MSc, MBACP
Verified Verified
Serves Area
This range of experiences has seen me work with people who are suicidal and have been labelled in a variety of ways - ultimately all of them have been looking for a greater understanding of life.
Life is difficult. Do more, be more. Be what others want. I offer a space where we examine where you are in life, what's brought you here, what it's like being you and you in relation to others, and how you're contributing to where you're at. How will we do this? Through our relationship, where I'll offer support, care, empathy and challenge to help you examine life.
This range of experiences has seen me work with people who are suicidal and have been labelled in a variety of ways - ultimately all of them have been looking for a greater understanding of life.
Life is difficult. Do more, be more. Be what others want. I offer a space where we examine where you are in life, what's brought you here, what it's like being you and you in relation to others, and how you're contributing to where you're at. How will we do this? Through our relationship, where I'll offer support, care, empathy and challenge to help you examine life.
020 3962 1562 View 020 3962 1562
Photo of Jade Byford - Jades Counselling Service, Counsellor, MSc, MBACP Accred
Jades Counselling Service
Counsellor, MSc, MBACP Accred
Verified Verified
Serves Area
I have over 10 years experience & I am a successful author fully trained in bereavement, depression & anxiety, couples therapy, troubled relationships, childhood abuse, trauma, suicidal thoughts & self harm.
As a trainer for therapists, a clinical supervisor & a successful author I have gained a wealth of knowledge & skills that I can bring to our sessions. I have years of experience working with couples & adult clients. My therapy room offers a peaceful, calm environment that is essential for helping you feel relaxed. Fees start at £30.
I have over 10 years experience & I am a successful author fully trained in bereavement, depression & anxiety, couples therapy, troubled relationships, childhood abuse, trauma, suicidal thoughts & self harm.
As a trainer for therapists, a clinical supervisor & a successful author I have gained a wealth of knowledge & skills that I can bring to our sessions. I have years of experience working with couples & adult clients. My therapy room offers a peaceful, calm environment that is essential for helping you feel relaxed. Fees start at £30.
07492 882860 View 07492 882860
Photo of Amanda Sandeman, Counsellor, MBACP Accred
Amanda Sandeman
Counsellor, MBACP Accred
Verified Verified
1 Endorsed
Serves Area
You may feel depressed, stressed, worthless or have suicidal thoughts.
My aim is to help you learn to manage difficult feelings and thoughts. I offer a confidential space and a calm presence in which you can explore any personal issues free of judgment. Once you feel listened to, heard and understood, we will work together to help you find the inner strength to implement the changes that you wish to make in your life.
You may feel depressed, stressed, worthless or have suicidal thoughts.
My aim is to help you learn to manage difficult feelings and thoughts. I offer a confidential space and a calm presence in which you can explore any personal issues free of judgment. Once you feel listened to, heard and understood, we will work together to help you find the inner strength to implement the changes that you wish to make in your life.
020 3994 2205 View 020 3994 2205
Photo of Analy Reed, Counsellor, MBACP
Analy Reed
Counsellor, MBACP
Verified Verified
Serves Area
I am particularly interested in working with depression, anxiety disorders, body and/or gender dysphoria, addiction, perfectionism and procrastination, social anxiety, self-harm, suicidal thoughts, eating disorders and performance anxiety .
In my practice I emphasise the role of focused and undivided attention in identifying and releasing emotional distress and unresolved traumas, while incorporating and bringing awareness to the new aspects of yourself as they present in the work. Eventually helping to materialise the changes you hope for.
I am particularly interested in working with depression, anxiety disorders, body and/or gender dysphoria, addiction, perfectionism and procrastination, social anxiety, self-harm, suicidal thoughts, eating disorders and performance anxiety .
In my practice I emphasise the role of focused and undivided attention in identifying and releasing emotional distress and unresolved traumas, while incorporating and bringing awareness to the new aspects of yourself as they present in the work. Eventually helping to materialise the changes you hope for.
020 3984 9132 View 020 3984 9132
Photo of Dr Cristian A Nica, Psychologist, MSc, HCPC - Clin. Psych.
Dr Cristian A Nica
Psychologist, MSc, HCPC - Clin. Psych.
Verified Verified
Serves Area
My research interests include risk-taking, flow, suicide ideation, vulnerability, sexual fantasies and success expectancies.
My goal is to enable a strong mental foundation where mindful skills will help you keep your life in reach. Progress means change, rehearsing new ways of thinking or a range of strategies to iterate development safely. The result, a genuine approach for you to always find a better way forward. I am HCPC-registered in clinical, counselling, health and occupational psychology. Supervisor, providing services for individuals, couples and organisations beginning from eclectic CBT interventions (ACT, DBT, ST) - the most effective and intuitive psychological framework.
My research interests include risk-taking, flow, suicide ideation, vulnerability, sexual fantasies and success expectancies.
My goal is to enable a strong mental foundation where mindful skills will help you keep your life in reach. Progress means change, rehearsing new ways of thinking or a range of strategies to iterate development safely. The result, a genuine approach for you to always find a better way forward. I am HCPC-registered in clinical, counselling, health and occupational psychology. Supervisor, providing services for individuals, couples and organisations beginning from eclectic CBT interventions (ACT, DBT, ST) - the most effective and intuitive psychological framework.
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Photo of Melissa Casares, Counsellor, MBACP
Melissa Casares
Counsellor, MBACP
Verified Verified
Online Only
I also spent 8 years volunteering at Samaritans, which provided experience working with those in immediate crisis or experiencing suicidal feelings.
Hello, I hope I can help. I trained in the Humanistic Integrative approach which means I work with each person as an individual, and can utilise different approaches to therapy. My aim is to work with you, focusing on what you bring to therapy, at your pace. Making the decision to contact a therapist is a big step, and I'd like to work with you in a confidential, supportive way to make this a positive step for you. If you are experiencing relationship difficulties, depression, anxiety, bereavement (including pets) or just feel that you need someone outside of friends and family to talk to, please get in touch by email or phone.
I also spent 8 years volunteering at Samaritans, which provided experience working with those in immediate crisis or experiencing suicidal feelings.
Hello, I hope I can help. I trained in the Humanistic Integrative approach which means I work with each person as an individual, and can utilise different approaches to therapy. My aim is to work with you, focusing on what you bring to therapy, at your pace. Making the decision to contact a therapist is a big step, and I'd like to work with you in a confidential, supportive way to make this a positive step for you. If you are experiencing relationship difficulties, depression, anxiety, bereavement (including pets) or just feel that you need someone outside of friends and family to talk to, please get in touch by email or phone.
07480 537789 View 07480 537789
Photo of Maria Klatsa, Counsellor, MBACP
Maria Klatsa
Counsellor, MBACP
Verified Verified
Serves Area
I have worked with and have extensive experience with depression, anxiety, stress, trauma, addictions, eating disorders, abuse, bullying, loss, grief, suicide and suicidal ideation amongst many others.
I have found that understanding the past and how it presents in the here and now gives a powerful insight into our inner world. Together we explore what has brought you to therapy. We look at patterns of behaviour and feelings to better understand the root causes. Understanding these can be the first steps to meaningful change.
I have worked with and have extensive experience with depression, anxiety, stress, trauma, addictions, eating disorders, abuse, bullying, loss, grief, suicide and suicidal ideation amongst many others.
I have found that understanding the past and how it presents in the here and now gives a powerful insight into our inner world. Together we explore what has brought you to therapy. We look at patterns of behaviour and feelings to better understand the root causes. Understanding these can be the first steps to meaningful change.
020 4538 7672 View 020 4538 7672
Photo of Nicola Borthwick, Counsellor, MBACP
Nicola Borthwick
Counsellor, MBACP
Verified Verified
Serves Area
Anxiety, depression, bereavement, abuse, trauma, relationship/family difficulties, suicidal feelings, anger issues, OCD, adoption & domestic violence, as well as other issues, including personality disorders & Autism/ASC.
Hello, my name is Nicola and I'm an Integrative counsellor. This means that I can integrate a range of counselling approaches tailored to your needs, to help you find a way through difficulties so that you find your own answers. This includes the following types of counselling: Person Centred, Cognitive Behavioural therapy (CBT), Transactional Analysis (TA)/Communication. I am an accredited member of NCS and a member of BACP, in addition I am also a qualified Adult Community Co-ordinator in a large London College. I have worked in this sector for almost 30 years and offer training in mental health including Mindfulness.
Anxiety, depression, bereavement, abuse, trauma, relationship/family difficulties, suicidal feelings, anger issues, OCD, adoption & domestic violence, as well as other issues, including personality disorders & Autism/ASC.
Hello, my name is Nicola and I'm an Integrative counsellor. This means that I can integrate a range of counselling approaches tailored to your needs, to help you find a way through difficulties so that you find your own answers. This includes the following types of counselling: Person Centred, Cognitive Behavioural therapy (CBT), Transactional Analysis (TA)/Communication. I am an accredited member of NCS and a member of BACP, in addition I am also a qualified Adult Community Co-ordinator in a large London College. I have worked in this sector for almost 30 years and offer training in mental health including Mindfulness.
07480 537495 View 07480 537495
Photo of Sinead Marie Parker, Psychotherapist, MA, HCPC-Drama Therap.
Sinead Marie Parker
Psychotherapist, MA, HCPC-Drama Therap.
Verified Verified
Serves Area
I am particularly experienced in working with clients with EUPD, suicidal feelings, attachment issues, neurodiversity and burnout.
Hello! I am a warm, friendly and compassionate Creative and Embodied Psychotherapist offering a confidential, non judgemental, and collaborative therapy space. I embrace what makes you unique, prioritising safety and trust from the get go, so you can embark on a therapeutic journey of exploration, healing and change. Creative and Embodied Psychotherapy is a holistic and trauma informed approach to wellbeing, that works with the body and the mind to help you gain deeper insight and awareness into your inner world and experiences, whilst helping you connect with your strengths, resources and ability to heal.
I am particularly experienced in working with clients with EUPD, suicidal feelings, attachment issues, neurodiversity and burnout.
Hello! I am a warm, friendly and compassionate Creative and Embodied Psychotherapist offering a confidential, non judgemental, and collaborative therapy space. I embrace what makes you unique, prioritising safety and trust from the get go, so you can embark on a therapeutic journey of exploration, healing and change. Creative and Embodied Psychotherapy is a holistic and trauma informed approach to wellbeing, that works with the body and the mind to help you gain deeper insight and awareness into your inner world and experiences, whilst helping you connect with your strengths, resources and ability to heal.
020 3818 1061 View 020 3818 1061
Photo of Farhana Moussa, Psychotherapist, MSc, MBACP Accred
Farhana Moussa
Psychotherapist, MSc, MBACP Accred
Verified Verified
North West London, London NW11
In a therapeutic relationship we need to feel safe, where there is trust and unconditional acceptance, to allow us to explore difficult and challenging experiences. I am able to offer you a safe environment which is non-judgemental and a confidential space, this will allow you to explore your experiences to gain better insight. Life can often make us feel that we are unable cope, therefore we can become isolated, alone or set apart from society. I am here to share your exploration, supporting you to access better self-awareness; allowing you to implement good patterns of behaviours, leading to a healthier you.
In a therapeutic relationship we need to feel safe, where there is trust and unconditional acceptance, to allow us to explore difficult and challenging experiences. I am able to offer you a safe environment which is non-judgemental and a confidential space, this will allow you to explore your experiences to gain better insight. Life can often make us feel that we are unable cope, therefore we can become isolated, alone or set apart from society. I am here to share your exploration, supporting you to access better self-awareness; allowing you to implement good patterns of behaviours, leading to a healthier you.
07481 344650 View 07481 344650
Photo of Kim McAllister - Kim McAllister Counselling , Counsellor, MSc, MNCPS Acc.
Kim McAllister Counselling
Counsellor, MSc, MNCPS Acc.
Verified Verified
Serves Area
Award Winning Child Therapist. Children and young people require a safe space for them to explore their feelings and emotions and make sense of their world. Children need to feel accepted, heard and believed, so that they can explore their emotions and unravel their past. If you, your kid or anyone in your family could benefit from talking or play therapy, then get in touch. You can find me on other directories, registered with the BACP an accredited registrant with the NCS and on Facebook as: Kim McAllister Counselling Ltd.
Award Winning Child Therapist. Children and young people require a safe space for them to explore their feelings and emotions and make sense of their world. Children need to feel accepted, heard and believed, so that they can explore their emotions and unravel their past. If you, your kid or anyone in your family could benefit from talking or play therapy, then get in touch. You can find me on other directories, registered with the BACP an accredited registrant with the NCS and on Facebook as: Kim McAllister Counselling Ltd.
01253 835140 View 01253 835140
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Suicidal Ideation Counsellors

How does therapy for suicidal ideation work?

Stress, depression, anxiety, or upsetting circumstances can give rise to suicidal thinking. Therapy can address the events at the core of an individual’s suffering. Understanding why a person may be suicidal can help the therapist and the patient discover alternative methods of coping. A person with suicidal ideation may be mired in catastrophic thinking, and treatment like cognitive behavioural therapy is a good choice for breaking such patterns. In addition, treatment such as acceptance and commitment therapy can help a person manage their distress through better emotion regulation.

Which therapies are best for suicidal ideation?

Specific approaches used by professionals include cognitive behavioural, dialectical behaviour, psychodynamic, acceptance and commitment therapies, among others. Cognitive behavioural and dialectical behaviour therapies are two widely used therapies that can help individuals with painful thoughts and past traumas. These therapies help an individual tolerate distress, regulate emotions, and not act on dangerous urges.

Are there specific medications to be combined with therapy?

The use of medication for suicidal thoughts must be aligned with the underlying cause; conditions such as depression, anxiety, and psychosis may be at the root of suicidal ideation. A psychiatrist may prescribe medications for symptoms, which may include antipsychotics such as aripiprazole or antidepressants such as selective serotonin reuptake inhibitors.

How often and how long are therapy sessions for suicidal ideation?

As with any type of therapy, sessions depend on the individual. Patients may see improvement within 15 to 20 sessions, at an average of 50 minutes per session, while others may opt for 20 to 30 sessions over, perhaps, a six-month period. Still other patients, especially those with co-occurring conditions like major depression and anxiety, may need to continue sessions for up to 12 to 18 months. In some cases, residential treatment may be recommended for an individual who is judged to be at high risk of self-harm.