Background and Aim: Suicidal ideation and low distress tolerance are key risk factors in adolescents. This study aimed to evaluate the sustained efficacy of logotherapy and to examine the mediating role of "meaning in life" in this process.

Methodology: In a quasi-experimental design with pre-test, post-test, a three-month follow-up, and a control group, 60 adolescents (14-18 years old) with a history of suicide attempts were randomly assigned to either a logotherapy group (8 sessions) or a treatment-as-usual group. Participants completed the Beck Scale for Suicide Ideation (BSSI), the Distress Tolerance Scale (DTS), and the Meaning in Life Questionnaire (MLQ). Data were analyzed using repeated-measures ANOVA and mediation analysis (PROCESS Macro).

Findings: The results showed a significant time × group interaction effect for both dependent variables ( ). The logotherapy group demonstrated a significant reduction in suicidal ideation and a significant increase in distress tolerance at post-test and follow-up compared to the control group. Mediation analysis confirmed that the increase in "meaning in life" fully mediated the intervention's effect on the reduction of suicidal ideation ( ) and the increase in distress tolerance ( ).

Conclusion: Logotherapy is an effective and sustainable intervention for adolescents at risk of suicide. By directly enhancing meaning and purpose in life, this approach indirectly leads to a decrease in suicidal thoughts and an increase in the capacity to cope with painful emotions.