Theoretical model of recovery following a suicidal episode (COURAGE): scoping review and narrative synthesis

Yosef Sokol, Chynna Levin, Mairav Linzer, Chayim Rosensweig, Shifra Hubner, Molly Gromatsky, Samantha Walsh, Lisa Dixon, Marianne Goodman

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Background Despite a significant need, there are currently no rigorously developed empirically based models for what personal recovery from a suicidal episode looks like. Aims To develop a theoretical model of personal recovery after a suicidal episode, based on a comprehensive literature review and stakeholder feedback. Method A scoping review of all empirical studies on this topic was conducted, followed by a thematic analysis to create a preliminary framework. Consultation-based revisions were then made based on feedback from a stakeholder panel to develop the final theoretical model. Results The final model comprised seven themes: choosing life, optimising identity, understanding oneself, rediscovering meaning, acceptance, growing connectedness and empowerment (acronym 'COURAGE'). Although there are some similarities between COURAGE and other models of personal recovery, there are components, such as 'choosing life' and 'understanding oneself', that are specific to recovery after an acute suicidal episode. Conclusions To our knowledge, this is the first study to use a comprehensive literature review with stakeholder feedback to develop a conceptual model of personal recovery after an acute suicidal episode. This model has important implications for both researchers and clinicians to consider. Looking ahead, COURAGE can inform the reconceptualisation of assessment, research and clinical care of individuals who have experienced a suicidal episode.

Original languageEnglish
Article numbere200
JournalBJPsych Open
Issue number6
StatePublished - 17 Nov 2022


  • Suicide
  • individual psychotherapy
  • personal recovery
  • qualitative research
  • recovery framework


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