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Targeted treatment improved complicated grief vs. interpersonal psychotherapy

Therapy that specifically targeted complicated grief in older adults based on an attachment theory model was more effective in reducing symptoms than interpersonal psychotherapy, according to researchers from Columbia University and the Hunter College of the City University of New York.

A randomized clinical trial was conducted with 151 patients who screened positive for complicated grief. Participants were aged 50 years or older and randomly assigned to 16 sessions of interpersonal psychotherapy or a more targeted, complicated grief-specific therapy using combined techniques from interpersonal psychotherapy, prolonged exposure and motivational interviewing. Complicated grief treatment sessions focused on “facilitating natural mourning” and contained both loss-focused and restoration-focused components. Therapy was provided by licensed clinical social workers, doctoral social workers, psychology doctoral students and doctoral-level psychologists without any prior experience with grief counselling.

Participants completed self-reported questionnaires and were also assessed by independent evaluators at 8, 12, 16 and 20 weeks.

Treatment completion rates were 81% for interpersonal psychotherapy and 82% for complicated grief therapy. Of those who received complicated grief therapy, 70.5% (95% CI, 60.3% to 82.6%) responded to treatment compared with 32% (95% CI, 22.7% to 45.2%) of those who received interpersonal psychotherapy. At 20 weeks, 35.2% of participants in the complicated grief treatment group were remained ill vs. 64.1% in the interpersonal psychotherapy treatment group.

“Results strongly support the need for physicians and other health care providers to distinguish complicated grief from depression,” the researchers wrote. “Given the growing elderly population, the high prevalence of bereavement in aging individuals, and the marked physical and psychological impact of complicated grief, clinicians need to know how to treat complicated grief in older adults.”

Disclosure: Please see the full study for a complete list of relevant financial disclosures.