The Limits of 988 and Why Ongoing Therapy Still Matters

Kathryn September 22, 2025

In 2022, the United States launched the 988 Suicide and Crisis Lifeline, a three-digit number designed to make crisis support more accessible. This development marked a major step forward in suicide prevention, ensuring that people in moments of acute despair could quickly connect with trained counselors.

While 988 is a vital lifeline, it is not designed to address the deeper roots of suicidal despair. The limits of 988 and why ongoing therapy still matters become clear when we consider the difference between crisis intervention and long-term healing.

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The Purpose and Strength of 988

The 988 Suicide and Crisis Lifeline provides immediate support for people who are thinking about suicide or experiencing another type of mental health crisis. Calls, chats, and texts are answered 24 hours a day by trained crisis counselors who listen, provide emotional support, and connect callers to resources in their community.

For many, 988 has been life-saving. The ability to reach someone quickly in moments of panic or despair reduces isolation and creates a bridge to safety. It can help de-escalate immediate risk and ensure that the person is not alone in their darkest moments.

This accessibility is a profound strength of 988. It represents a cultural recognition that suicide prevention is essential and that help must be readily available. Yet, as valuable as it is, 988 was never meant to replace the depth of ongoing therapeutic care.

The Limits of 988

While 988 can interrupt a crisis, it does not address the complex layers of pain that often lead to suicidal thoughts. Crisis hotlines are designed for moments of acute risk, not for the long-term processing of trauma, depression, or systemic stressors that contribute to despair.

Other limitations include:

  • Scope of support: Crisis counselors provide stabilization, but they do not typically engage in therapeutic exploration or skill-building.

  • Continuity: Each call is answered by a different counselor, which means there is no ongoing relationship or consistent support.

  • Resources: While 988 connects callers to local referrals, systemic barriers such as waitlists, cost, or lack of access can prevent people from following through.

  • Stigma and fear: Some callers worry about law enforcement involvement or loss of privacy, which may discourage them from using the service.

988 is invaluable for emergencies, but it cannot provide the sustained care necessary for long-term healing.

Why Ongoing Therapy Still Matters

Ongoing therapy offers what 988 cannot: depth, continuity, and relational healing. Suicidal thoughts rarely appear out of nowhere. They often emerge from years of layered pain, unresolved trauma, chronic stress, or systemic inequities. Therapy provides space to explore these roots with compassion and curiosity.

A Safe and Consistent Relationship

Unlike 988, therapy builds a relationship over time. Clients and therapists co-create a space where trust deepens, and this trust itself becomes healing. The relationship offers a sense of being consistently seen, heard, and valued—counteracting isolation that fuels suicidal despair.

Uncovering Root Causes

Therapy allows individuals to explore underlying contributors to suicidal thinking, such as trauma, perfectionism, attachment wounds, discrimination, or burnout. Modalities like cognitive-behavioral therapy (CBT), narrative therapy, and somatic experiencing help reframe painful experiences, process emotions, and reconnect people with their inner strengths.

Building Skills and Resilience

Crisis hotlines focus on survival in the moment, but therapy equips people with coping strategies for the long term. Clients learn tools for emotional regulation, self-compassion, boundary-setting, and safety planning. These skills reduce vulnerability to crises and help individuals develop resilience over time.

Integration of Support Systems

Therapists can also guide clients in connecting with wider networks of support. This may include strengthening relationships, confronting structural barriers such as workplace stress or discrimination, and drawing on community resources. Therapy integrates personal healing into a larger context, reducing isolation and empowering change.

The Interplay Between 988 and Therapy

988 and therapy are not opposites—they complement one another. 988 provides immediate support during moments of acute crisis, while therapy sustains long-term transformation.

For example, someone might call 988 during a suicidal crisis and then begin therapy to address the deeper roots of their pain. Or, someone already in therapy may use 988 as a stabilizing tool between sessions when suicidal urges escalate. Together, they create a continuum of care that addresses both immediacy and depth.

Why This Distinction Matters

Recognizing the limits of 988 and the necessity of therapy reduces stigma. Many people assume that using a crisis line should be “enough,” and when suicidal thoughts return, they feel shame. Understanding that crisis services and therapy serve different roles reframes this as a system of layered support, not as failure.

It also matters for policy and advocacy. Expanding crisis support is important, but without equal investment in affordable, accessible therapy, individuals remain vulnerable. Sustainable suicide prevention requires both immediate crisis care and ongoing therapeutic infrastructure.

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FAQ: The Limits of 988 and Why Therapy Still Matters

What should I expect when I call 988?

When you call 988, you will be connected with a trained crisis counselor who will listen, validate your feelings, and help you navigate the immediate crisis. They may guide you through calming exercises, assess your level of safety, and connect you with local resources. While this support can be life-saving in the moment, it is important to understand that the call will not address the deeper causes of suicidal thoughts. That is where therapy becomes essential.

How does therapy address suicidal thoughts differently than 988?

Therapy offers a consistent and long-term process. Unlike 988, which focuses on crisis stabilization, therapy provides ongoing exploration of the root causes of despair, such as unresolved trauma, chronic stress, or systemic oppression. A therapist helps clients build coping strategies, reframe painful experiences, and establish safety plans that protect against future crises. This depth of work cannot be achieved in a single call.

Can 988 and therapy work together?

Yes. Many people benefit from using 988 in moments of crisis while continuing therapy for long-term healing. Think of 988 as an emergency parachute and therapy as the process of repairing the plane so it can fly safely again. Together, they provide a safety net that offers both immediate and lasting support.

What are some risks of relying only on 988?

Relying exclusively on 988 can create a cycle where immediate relief is followed by recurring crises. Because callers speak with different counselors each time, there is no consistent relationship. Additionally, systemic barriers like limited therapy access or financial challenges may prevent people from moving beyond crisis stabilization. Without therapy, the underlying issues fueling suicidal thoughts often remain unresolved.

How do therapists help address the shame or stigma of suicidal thoughts?

Therapists provide a nonjudgmental space where suicidal thoughts can be named and explored without fear. They validate that suicidal ideation is not a personal weakness but often a response to overwhelming pain. By normalizing the conversation, therapists help clients release shame and begin to see themselves as worthy of care and healing.

What types of therapy are most effective for suicidal thoughts?

Several therapeutic approaches have strong evidence for addressing suicidal ideation. Cognitive-behavioral therapy (CBT) helps individuals identify and reframe distorted thoughts. Dialectical behavior therapy (DBT) is especially effective for people who struggle with emotional regulation or self-harm. Somatic therapies address how trauma and despair are held in the body. The most effective therapy depends on each person’s unique history, needs, and goals.

How can therapy support people who fear reaching out to 988?

Some people avoid 988 due to fear of police involvement or stigma. Therapy provides a confidential and ongoing space where individuals can process those fears and create personalized crisis plans. A therapist may also help clients identify safe alternatives, such as trusted support networks, community-based hotlines, or crisis centers that align with their values.

Why is therapy considered a protective factor against suicide?

Therapy is protective because it does more than reduce symptoms—it builds resilience. By strengthening coping skills, deepening self-understanding, and addressing both personal and systemic stressors, therapy empowers individuals to navigate future challenges without reaching the point of crisis. Over time, this reduces both the intensity and frequency of suicidal thoughts.

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