What We Treat
Compassionate, individualized care for suicidal thoughts and the pain underneath them from licensed clinicians, in person in San Pedro or online.
If you are in immediate danger or thinking about acting on thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911. Both are free, confidential, and available 24 hours a day. Coastwise provides ongoing outpatient therapy, not emergency crisis care, so please reach a crisis line or emergency services first if you are not safe right now.
Thoughts of suicide are more common than most people realize, and having them does not mean you are broken or beyond help. They usually arrive when pain feels permanent and options feel like they have run out. That feeling is real, and it is also treatable. Reaching out, the way you are right now, is a sign of strength, not weakness.
Suicidal thoughts exist on a spectrum. For some people they look like a quiet wish to not wake up, or a sense that others would be better off. For others they include more active thoughts, plans, or urges. Wherever you fall on that spectrum, it is worth talking about with someone trained to help.
Hopelessness, or a sense of being a burden to the people around you.
Thinking the pain will never ease or that there is no path out.
Wishing you could disappear or simply not wake up.
More active urges or plans, which call for immediate support and a crisis line.
Pulling away from people, or feeling numb and disconnected.
Suicidal thoughts usually arrive on top of something else, and treating what is underneath is part of the same work. Each area below has a page that explains how we approach it.
Low mood and hopelessness that suicidal thoughts so often grow out of.
Painful experiences that can leave despair feeling permanent, treated alongside the thoughts.
A nervous system stuck on high alert after trauma, a common driver of hopelessness.
Trauma from prolonged or repeated harm, which can deepen a sense of being trapped.
Related but distinct, and often present alongside suicidal thoughts, treated with the same care.
Mood swings that can intensify hopelessness, and that need treatment in their own right.
We begin where you are. Early sessions focus on collaborative safety planning, identifying what helps you stay grounded, who you can reach, and how to get through the hardest moments. From there, we treat what is driving the thoughts rather than the thoughts alone.
Well suited to intense emotion, hopelessness, and self-harm urges, building concrete skills for tolerating distress and regulating overwhelming feelings.
Works on the thinking patterns that make despair feel like fact, so the thoughts lose some of their grip.
Because suicidal thoughts so often grow out of depression, trauma, or grief, we treat those underlying conditions as part of the same work.
| Approach | Best suited for | How it works |
|---|---|---|
| Safety planning | Getting through the hardest moments | Builds a clear, personal plan for staying grounded and knowing who to reach. |
| DBT | Intense emotion, hopelessness, and self-harm urges | Builds distress-tolerance and emotion-regulation skills for overwhelming feelings. |
| CBT | Thinking patterns that make despair feel like fact | Reworks the thoughts that keep the situation feeling hopeless. |
Starting therapy should feel clear, not overwhelming. Here is how it works at Coastwise.
We start with a short, private conversation to understand what you are carrying and what you want from therapy.
We pair you with a licensed clinician experienced with suicidal thoughts and the depression or trauma underneath them, not whoever happens to be free.
Your clinician starts with safety planning and builds a plan with you, working at a pace you can manage.
Outpatient therapy is a strong fit for ongoing suicidal thoughts, for the depression or trauma underneath them, and for rebuilding a sense of purpose over time. It is not a substitute for emergency care. If you are in acute crisis or unsafe right now, a crisis line (988) or emergency services (911) is the right first step, and we are glad to be the ongoing support once you are stable. If a higher level of care is ever needed, we will help you find it.
See us in person at our San Pedro office or work with a clinician securely online anywhere in California. We will help match you to a therapist experienced with this, and we treat what you bring with care and without judgment.
If you are in immediate danger or thinking about acting on suicidal thoughts, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911. These services are free, confidential, and available 24 hours a day. Coastwise provides ongoing outpatient therapy rather than emergency crisis care, so please reach a crisis line or emergency services first if you are not safe right now.
Yes. Suicidal thoughts are usually a sign of pain that has become overwhelming, often driven by depression, trauma, loss, or hopelessness. Therapy works on both the thoughts themselves, through safety planning and coping skills, and the conditions underneath them. Many people who once felt there was no way forward go on to rebuild a life that feels worth living.
Talking about suicidal thoughts does not automatically lead to hospitalization. Therapists are trained to talk about these thoughts openly and to work with you on staying safe. Involuntary hospitalization is reserved for situations of imminent danger. Honesty with your therapist is what makes good care possible, and most of that care happens in ordinary outpatient sessions.
We start with collaborative safety planning and then treat what is driving the thoughts. Dialectical Behavior Therapy (DBT) helps with intense emotion, hopelessness, and self-harm urges. CBT addresses the thinking patterns that fuel despair. We also treat the underlying depression, trauma, or anxiety, because relief usually comes from addressing the whole picture.
We work with insurance, and many clients use their benefits toward therapy with us. Call (424) 536-3002 to learn how your insurance can help cover the cost of therapy. Cost should never be the reason you don't reach out.
If you are safe right now and ready to talk, call us for a free, confidential consultation and we will match you to a clinician who treats this. If you are in crisis, call or text 988 first.
Call (424) 536-3002 Get Started