Online cognitive behavioral therapy for prolonged grief after traumatic loss : a randomized waitlist-controlled trial

Prolonged grief disorder, a condition characterized by severe, persistent, and disabling grief, is newly included in ICD-11 and DSM-5-TR. Prolonged grief symptoms can be effectively treated with face-to-face or internet-delivered cognitive behavioral therapy. Traumatic losses may elicit higher prevalence of severe grief reactions. While face-to-face cognitive behavioral therapy appears efficacious in treating prolonged grief symptoms in traumatically bereaved individuals, it is not yet clear if internet-based cognitive behavioral therapy is efficacious for this population.


Therefore, we investigated the efficacy of a 12-week internet-delivered cognitive behavioral therapy for people bereaved through traffic accidents in a randomized waitlist-controlled trial (registration number: NL7497, Dutch Trial Register). Forty adults bereaved though a traffic accident were randomized to internet-based cognitive behavioral therapy (n = 19) or a waitlist control condition (n = 21). Prolonged grief, post-traumatic stress, and depression symptoms were assessed at baseline, post-treatment, and 8-week follow-up. Dropout in the treatment condition was relatively high (42%) compared to the control condition (19%). Nevertheless, multilevel analyses showed that internet-based cognitive behavioral therapy strongly reduced prolonged grief, post-traumatic stress, and depression symptoms relative to the control condition at post-treatment and follow-up. We conclude that internet-based cognitive behavioral therapy appears a promising treatment for traumatically bereaved adults.

L.I.M. Lenferink, M.C. Eisma, M.Y. Buiter, J. de Keijser and P.A. Boelen | 2023
In: Cognitive Behaviour Therapy ; ISSN: 1651-2316
Online ahead of print doi: 10.1080/16506073.2023.2225744
Adults, Bereavement, Cognitive Behavioral Therapy, Computer Assisted Psychotherapy, Interventions, Netherlands, Posttraumatic Stress Disorder, Prolonged Grief Disorder, Psychotrauma, PTSD (DSM-5), PTSD (ICD-11), Research, Statistical Analysis, Traumatic Grief, Treatment, Treatment Effectiveness
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