David Baxter PhD
Late Founder
CBT fails to alleviate complicated grief in families affected by suicide
23 April 2007
Brit Med J 2007
Cognitive behavior therapy (CBT) does not reduce the risk for complicated grief, suicidal thoughts, or depression among families bereaved by suicide, say investigators.
However, this therapy may help prevent maladaptive grief reactions and perceptions of blame among first-degree relatives and spouses.
"The mild beneficial effect of our counseling program on maladaptive grief reactions and blame might be the result of reduced negative cognitions and avoidant behaviors," say Marieke de Groot, from the University of Groningen in The Netherlands, and colleagues.
"This might, in turn, have improved family problem solving," they add.
The researchers followed-up 122 first-degree relatives and spouses of 70 people who committed suicide over a 13-year period.
Thirty-nine families were randomly assigned to receive CBT, while the remaining 31 received usual care.
CBT was conducted by experienced psychiatric nurses who helped relatives to reference their grief reactions, engage in emotional processing, interact effectively, and problem solve.
CBT did not affect complicated grief. At the 13-month follow-up, average traumatic grief scores were 69.96 for those receiving CBT and 66.5 for the control group.
The two groups also had similar levels of depression, with Center for Epidemiologic Studies Depression scale scores of 14.2 for participants receiving CBT and 13.3 for controls.
Maladaptive grief reactions, however, were substantially rarer among relatives and spouses in the CBT group, at 22%, compared with 32% among controls.
The intervention also strongly reduced feelings of blame, with 15% of participants receiving CBT feeling they were to blame for the suicide, compared with 22% of controls.
"Having a chance in counseling to reflect on and acknowledge their loved one's difficulties before the suicide may have helped relatives to realize that they did nothing wrong," de Groot et al write in an advance online publication by the British Medical Journal.
"Informing relatives of the psychiatric context of suicidal behavior might have challenged their perceptions of guilt and self blame," they add.
"Thus, this counseling program can help to relieve the burdens associated with bereavement after suicide."
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23 April 2007
Brit Med J 2007
Cognitive behavior therapy (CBT) does not reduce the risk for complicated grief, suicidal thoughts, or depression among families bereaved by suicide, say investigators.
However, this therapy may help prevent maladaptive grief reactions and perceptions of blame among first-degree relatives and spouses.
"The mild beneficial effect of our counseling program on maladaptive grief reactions and blame might be the result of reduced negative cognitions and avoidant behaviors," say Marieke de Groot, from the University of Groningen in The Netherlands, and colleagues.
"This might, in turn, have improved family problem solving," they add.
The researchers followed-up 122 first-degree relatives and spouses of 70 people who committed suicide over a 13-year period.
Thirty-nine families were randomly assigned to receive CBT, while the remaining 31 received usual care.
CBT was conducted by experienced psychiatric nurses who helped relatives to reference their grief reactions, engage in emotional processing, interact effectively, and problem solve.
CBT did not affect complicated grief. At the 13-month follow-up, average traumatic grief scores were 69.96 for those receiving CBT and 66.5 for the control group.
The two groups also had similar levels of depression, with Center for Epidemiologic Studies Depression scale scores of 14.2 for participants receiving CBT and 13.3 for controls.
Maladaptive grief reactions, however, were substantially rarer among relatives and spouses in the CBT group, at 22%, compared with 32% among controls.
The intervention also strongly reduced feelings of blame, with 15% of participants receiving CBT feeling they were to blame for the suicide, compared with 22% of controls.
"Having a chance in counseling to reflect on and acknowledge their loved one's difficulties before the suicide may have helped relatives to realize that they did nothing wrong," de Groot et al write in an advance online publication by the British Medical Journal.
"Informing relatives of the psychiatric context of suicidal behavior might have challenged their perceptions of guilt and self blame," they add.
"Thus, this counseling program can help to relieve the burdens associated with bereavement after suicide."
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