Suicide is a global issue that has led researchers to seek interventions that will have a significant impact on mental health and wellbeing. Veterans comprise the largest number of suicides annually compared to other groups. There is a higher prevalence of mental disorders due to combat related experiences that may play a role in increased rates of suicide. Examined clinical diagnoses in this study include posttraumatic stress disorder (PTSD), depression, alcohol use and substance use. This study explores how group therapy and working alliance play a role in reducing suicidality in a group therapy setting. The first hypotheses is that clinical dysfunction, as evidenced by presence of PTSD depression severity, alcohol and drug use at the baseline will negatively impact therapeutic alliance at the 1- and 3-month time points. The second hypothesis is that greater therapeutic alliance scores will be associated with more rapid improvements in clinical outcomes of interest. Results indicate that individuals with various clinical diagnoses are able to form a working alliance and suicidal ideation scores significantly decrease over time
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