A co-designed systematic review and meta-analysis of the efficacy of grief interventions for anxiety and depression in young people

Worry and rumination as a transdiagnostic target in young people: a co-produced systematic review and meta-analysis

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PROSPERO (CRD42023408899).

A protocol for a pilot randomised controlled trial of unguided internet cognitive behaviour therapy for grief in adolescents

Grief is highly prevalent in adolescents, however, there have been no studies investigating internet delivered cognitive behaviour therapy for grief in adolescents (ICBT-G-A). In this paper, the co-design of an unguided ICBT-G-A intervention is described, and a protocol outlined for a pilot randomised controlled trial of the intervention. Participants will be randomised to the intervention (delivered via eight modules over a four-week period) or a four-week waitlist control. Intervention participants will complete a follow-up assessment at one-month post-intervention (eight weeks from the pre-intervention assessment). The intervention outcomes assessed at pre-intervention, post-intervention and follow-up include wellbeing and symptoms of anxiety, depression, post-traumatic stress, and prolonged grief. User feedback on experiences and acceptability of the intervention will be sought and feasibility assessed via programmatic data on recruitment and attrition.

Factors associated with posttraumatic stress severity and treatment response in a retrospective, naturalistic sample of homicidally bereaved children and young people

Background: Research on the mental health of homicidally bereaved children and young people is scarce. Despite the importance of timely referral of those at risk of developing severe mental health problems, few convincing risk factors have been identified. The effectiveness of current treatment models is unclear.Objective: This study examined factors associated with posttraumatic stress (PTS)symptom severity and treatment response in a naturalistic sample of homicidally bereaved children and young people who received traumatic grief-focused cognitive behavioural therapy (TGF-CBT); and assessed whether PTS-symptoms decreased between the start and termination of treatment.Method: Data was used from 222 children and young people aged between 8 and 25, who had completed therapy by July 2017, and for whom either start - or end scores on PTS-symptoms, or both, were available. PTS-symptoms were measured with the Children's Revised Impact of Event Scale-8 (CRIES-8). We explored associations of personal and loss-related variables with baseline symptom levels and symptom reduction during treatment, using latent growth modelling.Results: PTS-symptoms decreased significantly from pre- to posttreatment and with a large effect size. Higher age was associated with early treatment discontinuation. Female sex was associated with higher baseline scores, and having lost a parent or sibling with lower baseline scores. Higher baseline scores were associated with larger symptom reduction during treatment.Conclusions: TGF-CBT shows promise in reducing PTS-symptoms following homicidal bereavement, regardless of the individual differences in personal or loss-related characteristics included in this study. However, it is important to recognize the uniqueness of children and young people confronted with homicidal loss, and to tailor treatment to their individual needs and developmental stage. More research on risk and protective factors for adverse mental health outcomes and response to treatment in children and young people bereaved by homicide is urgently needed.

Supporting Adolescents Bereaved by Suicide or Other Traumatic Death: The Views of Counselors

Adolescents bereaved by suicide and other traumatic death may experience strong grief reactions and increased risks of mental health problems and suicidal behaviour. As timely access to professional help can be critical, it is essential to understand how counselors perceive suicide bereavement in adolescents and how they work with this population. This study aimed to examine the perspectives of counselors (N = 34). Eleven participated in an individual semi-structured interview and 23 others in group interviews. Thematic analysis yielded three themes: (1) Building a relationship with the bereaved adolescent, (2) Offering support tailored to the needs of the grieving adolescent, and (3) Offering strengths-based and sustainable support. Counselors' skills, attitudes, content-related expertise, and approaching the adolescent's grief within their developmental context were deemed essential for building a therapeutic relationship and offering viable support. The findings may inform good practices in counseling bereaved adolescents to facilitate positive mental health outcomes.

A pilot study of the perceptions and acceptability of guidance using artificial intelligence in internet cognitive behaviour therapy for perfectionism in young people

Perfectionism is a transdiagnostic process associated with a range of psychological disorders. Cognitive Behaviour Therapy for Perfectionism (CBT-P) has been demonstrated as efficacious across guided and unguided internet delivered interventions in reducing perfectionism and psychopathology. The aim of this pilot study was to understand perceptions and acceptability of an artificial intelligence supplemented CBT-P intervention (AI-CBT-P) in young people with lived experience of anxiety and depression (n = 8; age range 19-29 years, M = 24 years, SD = 3.77; 50 % female, 38 % male, 12 % non-binary). Young people reported that they were frequent users of artificial intelligence for study, work and general information, were positive about the intervention and using artificial intelligence for guidance in a self-help intervention, but also noted several concerns. Young people perceived numerous benefits to AI-CBT-P, including ease of access, low cost, lack of stigma and benefits for individuals with social anxiety. Overall, young people appear to be interested in, and have a positive view of, AI-CBT-P. Further research is now required to examine the feasibility and acceptability of the intervention.

Best Practice in Telephone Bereavement Support: A Thematic Analysis of Bereavement Support Providers' Perspectives

Telephone bereavement support is recommended in bereavement care policy and practice; however, little is known about what constitutes best practice. To explore how best practice in telephone bereavement support is conceptualized by those who provide the service, 26 healthcare professionals working in Australian hospitals, hospices, and other palliative care settings were interviewed. Thematic analysis was used to construct seven themes: A Valuable Service with Limited Resources, The First Call, The Dance of Rapport, A Space to Share, Identifying and Responding to Risk, Maintaining Contact, and Training and Development Needs. Participants viewed telephone bereavement support as an effective and accessible tool in supporting individuals' processing of and adaptation to loss; however, concerns remain regarding the quality and consistency of care provided. Greater resourcing of bereavement care is required, and telephone bereavement care providers' perspectives offer a foundation to ensure the service is evidence-based, pragmatic, and supported by quality training.

What we know about grief intervention: a bibliometric analysis

Background

Grief is a natural and individualized response to different losses, but if grief persists or becomes pathological, professional interventions are required. Grief and corresponding interventions have received increasing attention, as the related concepts have been incorporated into the DSM-5 and ICD-11. Therefore, we conducted a bibliometric analysis to explore the developments in the field of grief intervention research.

Methods

Articles on grief interventions were systematically searched and screened from the Web of Science Core Collection. The retrieved data were analyzed and visualized using VOSviewer and Bibliometrix software for journals, authors, institutions, countries, references, and keywords.

Results

A total of 9,754 articles were included. The number of articles on grief interventions has increased significantly each year since 1990. Death Studies was the journal that published the most articles in this field. We identified 25,140 authors contributed to this research area and these authors were from 123 countries and 6,630 institutions. Boelen PA secured the first position in article production, Columbia University emerged as the most productive affiliation and the United States was the foremost leading in grief intervention research. The prevalent keywords utilized in this field comprised bereavement, grief, death, depression, and palliative care.

Conclusion

The quantity of publications regarding grief interventions is increasing. Although most prior studies have focused on mortality, grief, and health, emerging themes such as COVID-19, grief among workers, and disfranchised grief have drawn increasing attention in recent years. Future studies may focus on investigating the complexities and challenges of grief, including its underlying mechanisms and impact on mental well-being.