A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder

Behav Res Ther. 2014 Oct:61:23-34. doi: 10.1016/j.brat.2014.07.005. Epub 2014 Jul 24.

Abstract

This trial assessed the feasibility, acceptability, tolerability, and efficacy of an Internet-based therapist-assisted cognitive-behavioral indicated prevention intervention for prolonged grief disorder (PGD) called Healthy Experiences After Loss (HEAL). Eighty-four bereaved individuals at risk for PGD were randomized to either an immediate treatment group (n = 41) or a waitlist control group (n = 43). Assessments were conducted at four time-points: prior to the wait-interval (for the waitlist group), pre-intervention, post-intervention, 6 weeks later, and 3 months later (for the immediate group only). Intent-to-treat analyses indicated that HEAL was associated with large reductions in prolonged grief (d = 1.10), depression (d = .71), anxiety (d = .51), and posttraumatic stress (d = .91). Also, significantly fewer participants in the immediate group met PGD criteria post-intervention than in the waitlist group. Pooled data from both groups also yielded significant reductions and large effect sizes in PGD symptom severity at each follow-up assessment. The intervention required minimal professional oversight and ratings of satisfaction with treatment and usability of the Internet interface were high. HEAL has the potential to be an effective, well-tolerated tool to reduce the burden of significant pre-clinical PGD. Further research is needed to refine HEAL and to assess its efficacy and mechanisms of action in a large-scale trial.

Keywords: Cognitive behavior therapy; Internet-based intervention; Prevention; Prolonged grief.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Grief*
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Remote Consultation*
  • Stress Disorders, Post-Traumatic / prevention & control*
  • Stress Disorders, Post-Traumatic / psychology
  • Treatment Outcome