Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Massenbergstraße 9-13, 44787, Bochum, Germany.
Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Essen, Germany.
BMC Psychiatry. 2024 Oct 30;24(1):755. doi: 10.1186/s12888-024-06205-0.
The therapeutic alliance is central to psychotherapy. However, research on the relationship between alliance and suicidality is scarce. We examined whether pretreatment suicidality is associated with an impaired alliance formation in brief cognitive behavioral therapy (CBT) and whether the therapeutic alliance is associated with change in suicidal ideation (difference between pretreatment and posttreatment assessment).
N = 643 outpatients (64% female; age: M[SD] = 37.09[13.15], range: 18-73 years), received 12 sessions of manual-based short-term CBT for primary diagnosis treatment. Using self-report questionnaires, suicidal ideation and behavior were assessed before and after therapy, patient-rated therapeutic alliance was assessed after the fourth session and posttreatment. We performed correlation analyses and two hierarchical linear regressions, unadjusted and adjusted for possible confounding variables (age, gender, lifetime suicide attempts and depression).
Pretreatment suicidal ideation was not predictive of the quality of the early alliance. In addition, the therapeutic alliance was not predictive of change in suicidal ideation.
In the outpatient setting, no association was found between therapeutic alliance and suicidality. Future studies should investigate therapeutic alliance as a predictor of prospective suicidal behavior in different clinical settings.
治疗联盟是心理治疗的核心。然而，关于联盟与自杀倾向之间关系的研究却很少。我们研究了在简短认知行为疗法（CBT）中，治疗前的自杀倾向是否与联盟形成受损有关，以及治疗联盟是否与自杀意念的变化有关（治疗前和治疗后评估之间的差异）。
共有 643 名门诊患者（64%为女性；年龄：M[SD]=37.09[13.15]，范围：18-73 岁）接受了基于手册的为期 12 节的短期 CBT 治疗，用于主要诊断治疗。使用自我报告问卷，在治疗前和治疗后评估自杀意念和行为，在第四次治疗后和治疗后评估患者评定的治疗联盟。我们进行了相关分析和两次分层线性回归，未调整和调整了可能的混杂变量（年龄、性别、终生自杀尝试和抑郁）。
治疗前的自杀意念与早期联盟的质量没有预测关系。此外，治疗联盟也不能预测自杀意念的变化。
在门诊环境中，治疗联盟与自杀倾向之间没有关联。未来的研究应在不同的临床环境中，将治疗联盟作为预测未来自杀行为的一个指标进行研究。
