@article{c6e130b6070a43b69020b565f2279781,
title = "The relationship between the therapeutic alliance in psychotherapy and suicidal experiences: A systematic review",
abstract = "It is well-established that there is a fundamental need to develop a robust therapeutic alliance to achieve positive outcomes in psychotherapy. However, little is known as to how this applies to psychotherapies which reduce suicidal experiences. The current narrative review summarizes the literature which investigates the relationship between the therapeutic alliance in psychotherapy and a range of suicidal experiences prior to, during and following psychotherapy. Systematic searches of MEDLINE, PsycINFO, Web of Science, EMBASE and British Nursing Index were conducted. The search returned 6,472 studies of which 19 studies were eligible for the present review. Findings failed to demonstrate a clear link between suicidal experiences prior to or during psychotherapy and the subsequent development and maintenance of the therapeutic alliance during psychotherapy. However, a robust therapeutic alliance reported early on in psychotherapy was related to a subsequent reduction in suicidal ideation and attempts. Study heterogeneity, varied sample sizes and inconsistent reporting may limit the generalisability of review findings. Several recommendations are made for future psychotherapy research studies. Training and supervision of therapists should not only highlight the importance of developing and maintaining the therapeutic alliance in psychotherapy when working with people with suicidal experiences, but also attune to client perceptions of relationships and concerns about discussing suicidal experiences during therapy. ",
author = "Charlotte Huggett and Patricia Gooding and Gillian Haddock and Jody Quigley and Daniel Pratt",
note = "Funding Information: DP and PG were part of a team who developed a treatment manual which has been published as a book (Tarrier et al., 2013 ). This published work is under copyright. PG, GH, DP and CH are funded to work on the CARMS (Cognitive AppRoaches to coMbatting Suicidality) trial by the Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership (Gooding et al., 2020 ). The CARMS trial is testing the efficacy of a Cognitive Behavioural Suicide Prevention (CBSP) Therapy in people experiencing non‐affective psychosis and suicidal thoughts and behaviours. At the time the current study was conducted, CH was the trial manager. PG and GH are co‐principal investigators and DP is a co‐investigator on the CARMS trial. CH, PG, GH and DP published a paper examining the relationship between the therapeutic alliance in CBSP and suicidal experiences (pre‐ and post‐therapy; Huggett et al., 2021 ). The Huggett et al. ( 2021 ) study was conducted alongside the present review, addressed some limitations from the existing literature and has been included in the current review. PG, GH, DP and CH previously worked on the INSITE trial, which was funded by the NIHR RfPB programme (Haddock et al., 2019 ). INSITE tested the feasibility and acceptability of CBSP for inpatients with suicidal experiences. This trial is an included study. CH has previously worked for a mental health charity in the North West of England and has published a research article with this affiliation. JQ has declared that she has no conflicts of interest. Publisher Copyright: {\textcopyright} 2022 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.",
year = "2022",
doi = "10.1002/cpp.2726",
language = "English",
journal = "Clinical Psychology & Psychotherapy",
issn = "1063-3995",
publisher = "John Wiley & Sons Ltd",
}
