Introduction: The brief therapy "Attempted Suicide Short Intervention Program" (ASSIP) significantly reduces the risk of further suicide attempts by approximately 80%. It clarifies underlying patterns of suicidality and develops preventive measures. However, treating patients with suicidal behavior remains challenging as they often do not engage in aftercare or terminate treatment prematurely. ASSIP flex is an advanced version that offers suicide-specific therapy, integrating the patient's environment to bridge transitions from inpatient to outpatient to home settings. The present study aims to investigate which patients benefit from ASSIP flex. Additionally, the study aims to analyze whether ASSIP flex can enhance perceived self-efficacy and the therapeutic alliance. Method: The present study examined 64 patients (females: n = 33; Mage: = 39.62, SDage = 15.74). All patients participated in three to four ASSIP flex sessions. Questionnaires on suicidal ideation (Suicidal Experience and Behavior Scale, SSEV; Beck Scale for Suicide Ideation, BSS) as well as perceived self-efficacy (General Self-Efficacy, GSE) were conducted in a pre-post therapy design, up to 4?6 weeks later. The therapeutic alliance was assessed immediately after each ASSIP flex session using the Working Alliance Inventory short version (WAI-SR). Results: The results showed a significant decrease in suicidal ideation from session one to session three (SSEV: Mdiff = 2.55, t63 = 2.75, p < .01, d = 0.34; BSS: Mdiff = 0.18, t63 = 4.28, p < .01, d = 0.54). Furthermore, perceived self-efficacy significantly increased in the pre-post therapy design (GSE: Mdiff = -1.88, t63 = -2.19, p < .05, d = 0.27). The therapeutic alliance significantly improved over the three ASSIP flex sessions (F1.57, 98.96 = 68.29, p < .01, ?2 = .52). improved. Conclusion: Patients in the ASSIP flex program exhibited positive outcomes within the flexible setting. Both the therapeutic alliance and self-efficacy were improved. Moreover, suicidal ideation decreased. This suggests that the flexible version not only has the potential to fill gaps in healthcare but is also perceived as supportive by patients.