TY  - JOUR
PY  - 2017//
TI  - The relationship between therapeutic alliance and patient's suicidal thoughts, self-harming behaviours and suicide attempts: a systematic review
JO  - Journal of affective disorders
A1  - Dunster-Page, Charlotte
A1  - Haddock, Gill
A1  - Wainwright, Laura
A1  - Berry, Katherine
SP  - 165
EP  - 174
VL  - 223
IS  - 
N2  - BACKGROUND: Suicidality is a common concern for people with mental health problems. The interpersonal nature of suicidality suggests that therapeutic alliance may be important when working clinically with suicidal patients. This paper is a systematic review of studies investigating the association between alliance and treatment outcome relating to suicidal ideation and behaviours. <br><br>METHODS: Systematic searches of PsychINFO, MEDLINE, AMED, EMBASE, Web of Science and CINAHL were completed using words that captured the concepts of alliance and suicidality. Eligible studies: involved participants aged 18-years-old or over; used a validated measure of therapeutic alliance; and reported associations between alliance and suicidality. Abstracts, qualitative studies and articles not written in English were excluded. <br><br>RESULTS: Twelve studies were included. <br><br>FINDINGS indicated that alliance is associated with suicidality. Alliance was related to suicidality in eleven of the papers. Self-harming behaviours had the strongest association with patient-rated alliance. Suicide attempts had the weakest association, possibly due to the infrequency of suicide attempts in the studies reviewed. LIMITATIONS: The twelve studies were heterogeneous in terms of the measure of alliance used, method of assessing suicidality, clinical setting and professional-type. This variability limited the degree to which findings could be synthesised. <br><br>CONCLUSION: Therapists, care-coordinators and mental health teams should recognise the importance of building a strong therapeutic alliance with suicidal patients. Researchers should use consistent methods of measuring alliance and assessing suicidality in future studies. Clinicians and researchers should note that suicidal thoughts, self-harm and suicide attempts may be related to alliance in different ways and therefore should be assessed as separate constructs.<br><br>Copyright © 2017 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0165-0327
UR  - http://dx.doi.org/10.1016/j.jad.2017.07.040
ID  - ref1
ER  -