Does grief treatment work, honestly

Treatment offered to bereaved people in general produced very small benefits that mostly faded, while treatment aimed at people in serious difficulty worked. Grief is not a thing to be treated by default, and getting stuck in it is.

The finding this review is known for is a difference between two groups. Treatment offered to bereaved people in general produced very small benefits that largely faded by follow up, while treatment aimed at people with complicated or prolonged grief produced meaningfully larger ones. We have not read the effect sizes off the paper itself, so none are printed here, and this is cited for the direction of the result only.

Currier JM, Neimeyer RA, Berman JS (2008). The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review. Psychological Bulletin, 134(5), 648 to 661 doi

Across 31 trials and 4,760 bereaved adults, the overall benefit of treatment was small to moderate and faded somewhat over time. Real, modest, and worth knowing honestly before you decide whether to seek it.

31 randomised trials and 4,760 bereaved adults, 73 in every 100 of them women. The overall benefit was small to moderate, Hedges g 0.41 straight after treatment and 0.45 at follow up, falling to 0.31 once the tendency to publish positive results was adjusted for. Larger effects appeared for one to one rather than group work, where symptoms were high to begin with, and where people were at least six months past the death. The authors state their own limitations: the studies varied a great deal in quality, there was evidence of publication bias, the effects are small and of unclear practical meaning, and there is not enough detail about who benefits. The identifier for this paper has not been confirmed by us, so none is published.

Johannsen M, Damholdt MF, Zachariae R, Lundorff M, and others (2019). Psychological interventions for grief in adults: a systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders, 253, 69 to 86

The standard source for how common prolonged grief disorder is points to a minority of bereaved adults rather than a majority. We are not printing the pooled percentage, because a number here would invite you to check yourself against it.

This is the standard source for how common prolonged grief disorder is among bereaved adults, and it points to a minority rather than a majority. We are not printing the pooled percentage, because we verified the citation and not the number, and a figure like that should not be repeated on trust.

Lundorff M, Holmgren H, Zachariae R, Farver-Vestergaard I, O'Connor M (2017). Prevalence of prolonged grief disorder in adult bereavement: a systematic review and meta-analysis. Journal of Affective Disorders, 212, 138 to 149 doi

A randomised trial of a treatment built specifically for complicated grief, which is the evidence that targeted help for this group works. It is delivered by trained clinicians following a protocol, which is why this course points you to one rather than imitating it.

A randomised trial of a structured treatment designed specifically for complicated grief, which is the evidence that targeted treatment for this group works. It is delivered by trained clinicians following a protocol, and it contains exposure based components, which is exactly why nothing resembling it appears in this course.

Shear MK, Reynolds CF, Simon NM, and others (2016). Optimizing treatment of complicated grief: a randomized clinical trial. JAMA Psychiatry, 73(7), 685 to 694 doi