COLUMNSTherapeutic Risk Management: Chain Analysis of Suicidal Ideation and BehaviorBORGES, LAUREN M. PhD; NAZEM, SARRA PhD; MATARAZZO, BRIDGET B. PSYD; BARNES, SEAN M. PhD; WORTZEL, HAL S. MDAuthor Information BORGES: Research and Clinical Psychologist, Rocky Mountain MIRECC, Aurora, CO NAZEM: Research and Clinical Psychologist, Rocky Mountain MIRECC, Aurora, CO MATARAZZO: Director of Clinical Services for the Rocky Mountain MIRECC, Aurora, CO BARNES: Research and Clinical Psychologist with the Rocky Mountain MIRECC, Aurora, CO WORTZEL: Michael K. Cooper Professor of Neurocognitive Disease, Director of Neuropsychiatry, Associate Professor in Psychiatry, Neurology, and Physical Medicine and Rehabilitation, and Faculty for the Forensic Psychiatry Fellowship at the University of Colorado, and Director of Neuropsychiatric Services for the Rocky Mountain MIRECC, Denver, CO The authors declare no conflicts of interest. Please send correspondence to: Lauren M. Borges, PhD, Research and Clinical Psychologist, Rocky Mountain MIRECC for Suicide Prevention, Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St, G3-116M, Aurora, CO 80045 (e-mail: firstname.lastname@example.org). Journal of Psychiatric Practice: January 2019 - Volume 25 - Issue 1 - p 46-53 doi: 10.1097/PRA.0000000000000358 Buy Metrics Abstract Structural approaches to suicide risk assessment (eg, evaluating the frequency and intensity of suicidal ideation and classifying types of suicidal behavior) often fall short of providing an idiographic and dynamic analysis of the factors driving and maintaining an individual’s suicide risk. Structural approaches can be bolstered through chain analysis which facilitates an exploration of the factors maintaining suicidal ideation and behavior based on positive and negative reinforcement. By uncovering the factors causing suicidal ideation and behavior to persist, efficient intervention strategies can be selected to target these pathways. In this column, the authors delineate the use of chain analysis to guide suicide risk assessment and inform treatment planning. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.