ABSTRACT
Objective This randomized-waitlist controlled trial is the first study examining short-term effects of a self-guided online grief-specific cognitive behavioral therapy (CBT) in reducing early persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression symptoms in adults bereaved during the COVID-19 pandemic. Method Sixty-five Dutch adults, bereaved at least three months earlier during the pandemic, with clinically-relevant PCBD, PTSD, and/or depression symptoms, were allocated to a treatment (n = 32) or waitlist condition (n = 33). Telephone interviews were conducted to assess PCBD, PTSD, and depression symptoms (using validated instruments) at baseline, post-treatment, and post-waiting period. Participants received an eight-week self-guided online grief-specific CBT including exposure, cognitive restructuring, and behavioral activation assignments. Analyses of covariance were performed. Results Intention-to-treat analyses indicated that people in the intervention condition showed significantly lower PCBD (d = 0.90), PTSD (d = 0.71), and depression (d = 0.57) symptom-levels post-treatment relative to waitlist controls post-waiting, while taking baseline symptom-levels and use of professional psychological co-intervention into account. Conclusions The online CBT proved to be an effective intervention, reducing PCBD, PTSD, and depression symptoms. Pending replication of these findings, early online interventions may be widely implemented in practice to improve treatments for distressed bereaved people.
ABSTRACT
OBJECTIVE: This randomized-waitlist controlled trial is the first study examining short-term effects of a self-guided online grief-specific cognitive behavioral therapy (CBT) in reducing early persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression symptoms in adults bereaved during the COVID-19 pandemic. METHOD: Sixty-five Dutch adults, bereaved at least three months earlier during the pandemic, with clinically-relevant PCBD, PTSD, and/or depression symptoms, were allocated to a treatment (n = 32) or waitlist condition (n = 33). Telephone interviews were conducted to assess PCBD, PTSD, and depression symptoms (using validated instruments) at baseline, post-treatment, and post-waiting period. Participants received an eight-week self-guided online grief-specific CBT including exposure, cognitive restructuring, and behavioral activation assignments. Analyses of covariance were performed. RESULTS: Intention-to-treat analyses indicated that people in the intervention condition showed significantly lower PCBD (d = 0.90), PTSD (d = 0.71), and depression (d = 0.57) symptom-levels post-treatment relative to waitlist controls post-waiting, while taking baseline symptom-levels and use of professional psychological co-intervention into account. CONCLUSIONS: The online CBT proved to be an effective intervention, reducing PCBD, PTSD, and depression symptoms. Pending replication of these findings, early online interventions may be widely implemented in practice to improve treatments for distressed bereaved people.
Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Adult , Stress Disorders, Post-Traumatic/psychology , Pandemics , Depression/psychology , GriefABSTRACT
Background Losing a loved one during the COVID-19 pandemic is a potentially traumatic loss that may result in symptoms of persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression. To date, grief-specific cognitive-behavioural therapy (CBT) has mostly been delivered through individual face-to-face formats, while studies have shown that online treatment also yields promising results. Offering treatment online is now more than ever relevant during the pan demic and may offer important benefits compared with face-to-face CBT, such as lower costs and higher accessibility. Our expectation is that grief-specific online CBT is effective in reducing PCBD, PTSD, and depression symptoms. Objective Our aim is to evaluate the short-term and long-term effectiveness of grief-specific online CBT in reducing PCBD, PTSD, and depression symptom-levels for adults who lost a loved one during the COVID-19 pandemic. Method This study consists of two parts. In part 1, a two-armed (unguided online CBT versus waitlist controls) randomized controlled trial will be conducted. In part 2, a two-armed (guided online CBT versus unguided online CBT) controlled trial will be conducted. Symptoms of PCBD, PTSD, and depression will be assessed via telephone interviews at pre-treatment/pre-waiting period, post-treatment/post-waiting period, and six months post-treatment. Potential participants are people who lost a loved one at least three months earlier during the COVID-19 pandemic with clinically relevant levels of PCBD, PTSD, and/or depression. Analysis of covariance and multilevel modelling will be performed. Discussion This is one of the first studies examining the effectiveness of online grief-specific CBT. More research is needed before implementing online grief-specific CBT into clinical practice. HIGHLIGHTS This is the first study examining the effectiveness of online treatment in reducing psychopathology levels in people who lost loved ones during the COVID-19 pandemic.
ABSTRACT
Background: Losing a loved one during the COVID-19 pandemic is a potentially traumatic loss that may result in symptoms of persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression. To date, grief-specific cognitive-behavioural therapy (CBT) has mostly been delivered through individual face-to-face formats, while studies have shown that online treatment also yields promising results. Offering treatment online is now more than ever relevant during the pan demic and may offer important benefits compared with face-to-face CBT, such as lower costs and higher accessibility. Our expectation is that grief-specific online CBT is effective in reducing PCBD, PTSD, and depression symptoms. Objective: Our aim is to evaluate the short-term and long-term effectiveness of grief-specific online CBT in reducing PCBD, PTSD, and depression symptom-levels for adults who lost a loved one during the COVID-19 pandemic. Method: This study consists of two parts. In part 1, a two-armed (unguided online CBT versus waitlist controls) randomized controlled trial will be conducted. In part 2, a two-armed (guided online CBT versus unguided online CBT) controlled trial will be conducted. Symptoms of PCBD, PTSD, and depression will be assessed via telephone interviews at pre-treatment/pre-waiting period, post-treatment/post-waiting period, and six months post-treatment. Potential participants are people who lost a loved one at least three months earlier during the COVID-19 pandemic with clinically relevant levels of PCBD, PTSD, and/or depression. Analysis of covariance and multilevel modelling will be performed. Discussion: This is one of the first studies examining the effectiveness of online grief-specific CBT. More research is needed before implementing online grief-specific CBT into clinical practice.
Antecedentes: Perder a un ser querido durante la pandemia de COVID-19 es una pérdida potencialmente traumática que puede resultar en síntomas de trastorno de duelo complejo persistente (PCBD en su sigla en inglés), trastorno de estrés postraumático (TEPT) y depresión. Hasta la fecha, la terapia cognitivo-conductual (TCC) específica para el duelo se ha proporcionado principalmente a través de formatos individuales cara a cara, mientras que los estudios han demostrado que el tratamiento en línea también produce resultados prometedores. Ofrecer tratamiento en línea es ahora más relevante que nunca durante la pandemia y puede ofrecer importantes beneficios en comparación con la TCC presencial, como menores costos y mayor accesibilidad. Nuestra expectativa es que la TCC en línea específica para el duelo sea eficaz para reducir el PCBD, el TEPT y los síntomas de depresión.Objetivo: Nuestro objetivo es evaluar la efectividad a corto y largo plazo de la TCC en línea específica para el duelo en la reducción de los niveles de PCBD, TEPT y síntomas de depresión en adultos que perdieron a un ser querido durante la pandemia de COVID-19.Método: Este estudio consta de dos partes. En la parte 1, se llevará a cabo un ensayo controlado aleatorio de dos brazos (TCC en línea no guiado versus controles con la lista de espera). En la parte 2, se llevará a cabo un ensayo controlado de dos brazos (TCC en línea guiada versus TCC en línea no guiada). Los síntomas de PCBD, TEPT y depresión se evaluarán mediante entrevistas telefónicas en el período de pretratamiento/pre-espera, post-tratamiento/post-período de espera y seis meses post-tratamiento. Los participantes potenciales son personas que perdieron a un ser querido al menos tres meses antes durante la pandemia de COVID-19 con niveles clínicamente relevantes de PCBD, TEPT y/o depresión. Se realizarán análisis de covarianza y modelado multinivel.Discusión: Este es uno de los primeros estudios que examinan la efectividad de la TCC en línea específica para el duelo. Se necesita más investigación antes de implementar la TCC en línea específica para el duelo en la práctica clínica.