TY - JOUR
PY - 2019//
TI - Associations between clinicians' emotional responses, therapeutic alliance, and patient suicidal ideation
JO - Depression and anxiety
A1 - Barzilay, Shira
A1 - Schuck, Allison
A1 - Bloch-Elkouby, Sarah
A1 - Yaseen, Zimri S.
A1 - Hawes, Mariah
A1 - Rosenfield, Paul
A1 - Foster, Adriana
A1 - Galynker, Igor
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - BACKGROUND: Mental health clinicians frequently experience intense negative emotional responses to suicidal patients, which have been related to treatment outcome. This study examines the therapeutic alliance as a mediator of the relationship between clinicians' negative emotional responses at the initial encounter and patients' suicidal ideation (SI) concurrently and 1 month later.
METHODS: We assessed 378 adult psychiatric outpatients (62.7% female; mean age = 39.1 ± 14.6 years) and their 61 treating clinicians. Following the initial encounter, self-report questionnaires assessed clinicians' emotional responses to their patients, patients' and clinicians' perception of the therapeutic alliance, and patients' SI. The SI was reassessed 1 month after the initial visit. Multilevel mediation analyses were performed.
RESULTS: Patients' (but not clinicians') perception of the therapeutic alliance mediated the relationship between clinicians' negative emotional responses to patients and patients' SI 1 month following the initial visit (indirect effect estimate = 0.015; p < .001).
CONCLUSIONS: The association between clinicians' negative emotional response and patients' prospective SI appears to be transmitted, at least partly, through the patients' perception of the poorer early quality of the therapeutic alliance. Thus, clinicians' awareness and management of their emotional states appear essential both for the identification of suicidal risk and to enhance therapeutic alliance and treatment outcomes.
© 2019 Wiley Periodicals, Inc. Language: en
LA - en
SN - 1091-4269
UR - http://dx.doi.org/10.1002/da.22973
ID - ref1
ER -