心理治疗中的治疗联盟与自杀经历之间的关系：系统评价

The relationship between the therapeutic alliance in psychotherapy and suicidal experiences: A systematic review

--原载《临床心理学与心理治疗》杂志网络版2022年2月15日--

<Clinical Psychology and Psychotherapy>, 2022, February 15

【摘要】众所周知，有必要建立一个强大的治疗联盟，以在心理治疗中取得积极成果。然而，很少有人知道这如何适用于减少自杀经历的心理疗法。目前的叙述性综述总结了研究心理治疗中的治疗联盟与心理治疗之前、期间和之后的一系列自杀经历之间的关系的文献。系统检索了 MEDLINE、PsycINFO、Webof Science、EMBASE 和 BritishNursing Index。检索返回6472项研究，其中19项研究符合本综述的条件。研究结果未能证明心理治疗之前或期间的自杀经历与心理治疗期间治疗联盟的后续发展和维持之间的明确联系。然而，在心理治疗早期报道的一个强大的治疗联盟与随后的自杀意念和尝试减少有关。研究的异质性、不同的样本量和不一致的报告可能会限制综述结果的普遍性。对未来的心理治疗研究提出了几项建议。治疗师的培训和监督不仅应该强调在与有自杀经历的人一起工作时发展和维持心理治疗中的治疗联盟的重要性，而且还应该适应来访者对关系的看法以及在治疗期间讨论自杀经历的担忧。

【关键词】心理治疗，自杀，系统评价，治疗联盟

[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 6472 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 generalizability 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.

[Keywords] psychotherapy, suicide, systematic review, Therapeutic alliance

论文原文：Charlotte Huggett, Patricia Gooding, Gillian Haddock, Jody Quigley, Daniel Pratt (2022). The relationship between the therapeutic alliance in psychotherapy and suicidal experiences: A systematic review. Clinical Psychology and Psychotherapy, First published: 15 February 2022. https://doi.org/10.1002/cpp.2726

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