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An Open Trial of ‘Grief-Help’: A Cognitive–Behavioural Treatment for Prolonged Grief in Children and Adolescents

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Abstract

In the past years, there is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). Although mostly studied in adults, clinically significant PGD symptoms have also been observed in children and adolescents. To date, no effective treatment for childhood PGD yet exists. We recently developed a nine-session cognitive–behavioural treatment for childhood PGD combined with five sessions of parental counselling. In the current article, we present outcomes of treatment of 10 consecutive children and adolescents turning to our university clinic with elevated PGD symptoms as their primary problem and main reason to seek therapy. Patients were significantly improved at post-treatment, with large improvements in self-rated PGD and post-traumatic stress (effect sizes > 0.8) and small to moderate improvement in depression and parent-rated internalizing and externalizing problems (0.2 < effect sizes < 0.8). Additional predictor analysis of outcomes suggested that, among other things, this treatment approach is less efficacious for children and adolescents further removed from loss and those confronted with suicidal loss. That said, the treatment appears promising, and controlled evaluation is clearly indicated. Copyright © 2013 John Wiley & Sons, Ltd.

Key Practitioner Message

  • We developed ‘Grief-Help’, a nine-session cognitive–behavioural treatment for childhood prolonged grief combined with five sessions of parental counselling.
  • Results of the treatment of 10 consecutive children and adolescents are reported in this article.
  • Patients were significantly improved at post-treatment, with large improvements in prolonged grief and post-traumatic stress (effect sizes > 0.8) and small to moderate improvement in depression and internalizing and externalizing problems (0.2 < effect sizes < 0.8).
  • Predictor analysis, using data from 16 patients, suggested that this treatment is less efficacious for children and adolescents further removed from loss and those confronted with suicidal loss.
  • This study provides further evidence that ‘Grief-Help’ is a promising approach to the treatment of childhood prolonged grief.

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