Evidence map›Paper›PMID 42482621›Full record

ArticleSuicide & life-threatening behavior2026

Examining the Longitudinal Effects of Therapeutic Alliance Based on Session Rating Scale Scores on Suicidal Desire in Homebound Older Adults.

Cheolwoo Park, Laura Shannonhouse, Alexander Kirpich, Matthew C Fullen, Erika L LeBlanc, Hailey Clark, Jared Rivera, Fang Xue

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In one paragraph

Article in Suicide & life-threatening behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Cheolwoo ParkDepartment of Counselor Education and School Psychology, University of Central Florida, Orlando, Florida, USA.ORCID https://orcid.org/0000-0001-8337-9180
Laura ShannonhouseHuman Development and Organizational Studies in Education, University of Florida, Gainesville, Florida, USA.
Alexander KirpichDepartment of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA.
Matthew C FullenSchool of Education, Virginia Tech, Blacksburg, Virginia, USA.ORCID https://orcid.org/0000-0002-6534-6622
Erika L LeBlancCollege of Education and Human Development, University of Louisiana at Lafayette, Lafayette, Louisiana, USA.
Hailey ClarkHuman Development and Organizational Studies in Education, University of Florida, Gainesville, Florida, USA.
Jared RiveraHuman Development and Organizational Studies in Education, University of Florida, Gainesville, Florida, USA.
Fang XueDepartment of Counseling and Psychological Services, Georgia State University, Atlanta, Georgia, USA.

Funding

U.S. Department of Health and Human Services 90INNU0049-01-00
6 · The paper itself

Abstract

introductionThe Session Rating Scale (SRS) is widely used to assess therapeutic alliance in clinical settings, yet its application in paraprofessional-delivered interventions for older adults remains underexplored. This study examined whether therapeutic alliance predicted improvements in suicide desire among community-dwelling older adults participating in a warm-calling intervention.

methodsBinomial generalized linear mixed-effects models were used with dichotomized high-score responses for thwarted belongingness (TB) and perceived burdensomeness (PB) to evaluate the role of therapeutic alliance (SRS) over time. Participants were assigned to one of two 8-week conditions: (1) BE, emphasizing empathy and connection through befriending and reminiscence; or (2) BE + ASIST, which incorporated an aging-adapted LivingWorks Applied Suicide Intervention Skills Training (ASIST). Trained paraprofessionals delivered all sessions.

resultsFor PB, the odds of being classified as elevated decreased over time, and this decrease was statistically significant. For TB, a three-way interaction among condition, time, and SRS further showed that higher SRS scores predicted greater reductions in the odds of elevated TB within the BE + ASIST condition.

conclusionFindings underscore the importance of therapeutic alliance in enhancing paraprofessional-led interventions for late-life suicide prevention.

Indexed as

Homebound PersonsSuicidal IdeationSuicide PreventionTherapeutic AllianceAgedAged, 80 and overFemaleHumansLongitudinal StudiesMalemoderationolder adultssuicide desiretherapeutic alliance

Identifiers

PMID42482621
PMCPMC13389554

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