[Therapeutic Alliance, Self-Efficacy and Suicidal Ideation: A Sub-Analysis].

Abstract

This study examines changes in therapeutic alliance and self-efficacy in the flexible, suicide-specific Attempted Suicide Brief Intervention Programme (ASSIP flex). It also examines the relationship between self-efficacy and suicidal ideation.The study was designed as a sub-analysis of a longitudinal observational study. The sample consists of 64 patients (51,6% women) aged 19-83 years (M=39,6, MD=35,5, SD=15,7) with suicidal behaviour who participated in ASSIP flex. The survey was conducted at two measurement points, before (t0) and after (t1) the ASSIP flex treatment, and after each of the three ASSIP flex sessions. Sociodemographic characteristics (e. g. age, gender), health-related data (e. g. therapeutic alliance, self-efficacy) and information on suicidal ideation and behaviour (e. g. intensity of suicidal thoughts, number of suicide attempts) were collected at both measurement points. The therapeutic alliance was recorded after each ASSIP flex session.Over the three therapy sessions, an increase in therapeutic alliance was observed (F(1, 63)=48,081, p<0,001). An increase in self-efficacy was observed from t0 to t1 (t(63)=-3,410, p<0,001). A positive relation between self-efficacy at t0 and the therapeutic alliance was found at both the first (β=0,433, p<0,001) and the third therapy session (β=0,293, p=0,041). Patients' suicidal ideation decreased from t0 to t1 (BSS: β=-0,220, p<0,001). Higher self-efficacy was associated with lower suicidal ideation (BSS: β=-0,315, p<0,001).The findings highlight the importance of the therapeutic alliance and self-efficacy in suicide prevention treatment. The narrative approach of ASSIP flex offers a structured way to specifically strengthen both the therapeutic alliance and self-efficacy. Follow-up studies are needed to better understand the relation between these constructs with suicidal ideation and to further develop targeted intervention strategies.