Therapeutische Allianz, Selbstwirksamkeit und suizidales Erleben: Eine Subanalyse

Zusammenfassung

Ziel der Studie

Die Studie untersucht im Rahmen des flexiblen, suizidspezifischen Attempted Suicide Short Intervention Program (ASSIP flex) Veränderungen in der therapeutischen Allianz und der Selbstwirksamkeit. Zudem wird der Zusammenhang zwischen der Selbstwirksamkeit und dem suizidalen Erleben analysiert.

Methode

Die Studie ist als Subanalyse einer längsschnittlichen Beobachtungsstudie konzipiert. Die Stichprobe umfasste 64 Patient/-innen (51,6% Frauen) im Alter von 19–83 Jahren (M=39,6, MD=35,5, SD=15,7) mit suizidalem Verhalten, die an ASSIP flex teilnahmen. Die Befragung erfolgte zu zwei Messzeitpunkten, vor (t0) und nach (t1) der ASSIP flex-Behandlung sowie im Anschluss an jede der drei ASSIP flex-Sitzungen. Zu den beiden Messzeitpunkten wurden soziodemografische Merkmale (z. B. Geschlecht, Alter), gesundheitsbezogene Daten (z. B. therapeutische Allianz, Selbstwirksamkeit) sowie Angaben zum suizidalen Erleben und Verhalten (z. B. Intensität der Suizidgedanken, Anzahl Suizidversuche) erhoben. Die therapeutische Allianz wurde nach jeder ASSIP flex-Sitzung erfasst.

Ergebnisse

Im Verlauf der drei Therapiesitzungen wurde eine Zunahme der therapeutischen Allianz festgestellt (F(1, 63)=48,081, p<0,001). Von t0 zu t1 wurde eine Erhöhung der Selbstwirksamkeit beobachtet (t(63)=−3,410, p<0,001). Ein positiver Zusammenhang zwischen der Selbstwirksamkeit zu t0 und der therapeutischen Allianz wurde sowohl in der ersten (β=0,433, p<0,001) als auch in der dritten Therapiesitzung (β=0,293, p=0,041) festgestellt. Das suizidale Erleben der Patient/-innen verringerte sich von t0 zu t1 (BSS: β=−0,220, p<0,001). Eine höhere Selbstwirksamkeit war mit geringerem suizidalem Erleben assoziiert (BSS: β=−0,315, p<0,001).

Schlussfolgerung

Die Ergebnisse unterstreichen die Relevanz der therapeutischen Allianz und der Selbstwirksamkeit in der suizidpräventiven Behandlung. Der narrative Ansatz von ASSIP flex bietet dabei eine strukturierte Möglichkeit, um sowohl die therapeutische Allianz als auch die Selbstwirksamkeit gezielt zu stärken. In Follow-up Studien sollten die Zusammenhänge dieser Konstrukte mit dem suizidalen Erleben und Verhalten über einen längeren Zeitraum untersucht und gezielte Interventionsstrategien weiterentwickelt werden.

Abstract

Objective

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.

Methods

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.

Results

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).

Conclusion

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.

Schlüsselwörter

suizidales Erleben und Verhalten - Attempted Suicide Short Intervention Program flex (ASSIP flex) - therapeutische Allianz - Selbstwirksamkeit

Keywords

suicidal ideation and behaviour - Attempted Suicide Short Intervention Program flex (ASSIP flex) - therapeutic alliance - self-efficacy

Publication History

Received: 24 September 2024

Accepted: 06 June 2025

Article published online:
29 July 2025

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