A specialized form of cognitive-behavioral therapy (CBT) may reduce symptoms of prolonged grief disorder in children and adolescents, an effect that continues up to a year after treatment, a study in AJP in Advance has found.
Paul A. Boelen, Ph.D., of Utrecht University, in Utrecht, the Netherlands, and colleagues compared the effectiveness of CBT Grief-Help with supportive counseling for 134 bereaved children and adolescents between 8 and 18 years old who had prolonged grief disorder as determined by a score of greater than 40 on the Inventory of Prolonged Grief for Children (IPG-C).
All patients received nine counseling sessions. Seventy-four of the patients received CBT Grief-Help, which includes exposure interventions such as imaginary exposure (telling the story of the loss), direct exposure (visiting the scene of the death), and writing (writing a letter to the lost person about what the patient misses most). Patients who receive CBT Grief-Help are also taught specific skills to replace maladaptive ways of coping with healthy ones. The remaining patients were assigned to the supportive counseling group. They received nondirective treatments for grief wherein therapists were unconditionally supportive of issues that the patients raised in their sessions as well as their attempts at solving problems without using exposure techniques or addressing patients’ thought processes.
Patients were assessed again immediately after treatment ended, and IPG-C scores suggested improvement in prolonged grief symptoms in 76.1% of those in the CBT group versus 57.4% in the supportive counseling group. These results remained consistent at three months and six months. At 12 months, IPG-C scores suggested improvement in 78.6% of those in the CBT group versus 60.0% in the supportive counseling group.
“Although mechanisms of change are still to be researched, it is conceivable that CBT Grief-Help more effectively alleviates prolonged grief disorder by yielding positive changes in negative thinking patterns, decreasing maladaptive coping, increasing pleasant activities, and strengthening social problem-solving skills,” the researchers wrote. “In addition, whereas supportive counseling leaves room to avoid the reality of the loss and associated feelings, CBT Grief-Help encourages emotional processing of this reality.”
For related information, see the American Journal of Psychiatry article “Persistent Impairment: Life After Losing a Parent.”
(Image: iStock/fizkes)
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