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.

中文翻译：

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心理治疗中的治疗联盟与自杀经历之间的关系：系统评价

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。对 MEDLINE、PsycINFO、Web of Science、EMBASE 和 British Nursing Index 进行了系统搜索。搜索返回 6472 项研究，其中 19 项研究符合本次审查的条件。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。