Brain Changes During Social Reward Psychotherapy for Mid- and Late-Life Suicidality

Social disconnection peaks in middle and late life and leads to an increased risk of suicide, persistent depression, and poor response to psychosocial interventions. There is a critical need to develop a mechanistic understanding of the link between social disconnection and suicidality, identify biological targets, and address targets with scalable interventions. The investigators developed a novel psychotherapy, Engage \& Connect, aimed to improve functions of the Positive Valence System (PVS) that are impaired in suicidality through increased engagement in rewarding social activities. This study will use state-of-the-art precision imaging methods and clinical measures to evaluate brain- and behavioral changes in the PVS during psychotherapy. Participants will: * Be randomly assigned to 9-weekly sessions of either Engage \& Connect therapy or Symptom Review and Psychoeducation * Complete 4 research assessments * Complete 3 MRI scans