{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:20:08Z","timestamp":1787732408464,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["90INNU0049\u201001\u201000"],"award-info":[{"award-number":["90INNU0049\u201001\u201000"]}],"id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Suicide &amp; Life Threat Behav"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Session Rating Scale (SRS) is widely used to assess therapeutic alliance in clinical settings, yet its application in paraprofessional\u2010delivered interventions for older adults remains underexplored. This study examined whether therapeutic alliance predicted improvements in suicide desire among community\u2010dwelling older adults participating in a warm\u2010calling intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Binomial generalized linear mixed\u2010effects models were used with dichotomized high\u2010score 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\u2010week conditions: (1) BE, emphasizing empathy and connection through befriending and reminiscence; or (2) BE\u2009+\u2009ASIST, which incorporated an aging\u2010adapted LivingWorks Applied Suicide Intervention Skills Training (ASIST). Trained paraprofessionals delivered all sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For PB, the odds of being classified as elevated decreased over time, and this decrease was statistically significant. For TB, a three\u2010way interaction among condition, time, and SRS further showed that higher SRS scores predicted greater reductions in the odds of elevated TB within the BE\u2009+\u2009ASIST condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings underscore the importance of therapeutic alliance in enhancing paraprofessional\u2010led interventions for late\u2010life suicide prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sltb.70126","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T07:31:44Z","timestamp":1784705504000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining the Longitudinal Effects of Therapeutic Alliance Based on Session Rating Scale Scores on Suicidal Desire in Homebound Older Adults"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-9180","authenticated-orcid":false,"given":"Cheolwoo","family":"Park","sequence":"first","affiliation":[{"name":"Department of Counselor Education and School Psychology University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Shannonhouse","sequence":"additional","affiliation":[{"name":"Human Development and Organizational Studies in Education University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kirpich","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, School of Public Health Georgia State University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6534-6622","authenticated-orcid":false,"given":"Matthew C.","family":"Fullen","sequence":"additional","affiliation":[{"name":"School of Education Virginia Tech  Blacksburg Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika L.","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"College of Education and Human Development University of Louisiana at Lafayette  Lafayette Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey","family":"Clark","sequence":"additional","affiliation":[{"name":"Human Development and Organizational Studies in Education University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Rivera","sequence":"additional","affiliation":[{"name":"Human Development and Organizational Studies in Education University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Counseling and Psychological Services Georgia State University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0085885"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0295834"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2011.02.002"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12716"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359\u2010023\u201001080\u2010y"},{"key":"e_1_2_13_7_1","unstructured":"Drapeau C. W. andJ. L.McIntosh.2025.\u201cU.S.A. Suicide: 2023 Official Final Data.\u201dhttps:\/\/jmcintos.pages.iu.edu\/2023datapgsv1a.pdf."},{"issue":"1","key":"e_1_2_13_8_1","first-page":"3","article-title":"The Session Rating Scale: Psychometric Properties of a \u201cWorking\u201d Alliance Measure","volume":"3","author":"Duncan B. 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