Exposure-Based Therapy Best for Complicated Grief

By Karon, Amy | Clinical Psychiatry News, February 2015 | Go to article overview

Exposure-Based Therapy Best for Complicated Grief


Karon, Amy, Clinical Psychiatry News


About 70% of older adults with complicated grief improved with targeted exposure-based counseling, compared with 32% who underwent interpersonal therapy, a randomized trial shows.

Response rates were sustained 6 months later, reflecting positive results from an earlier study of complicated grief therapy (CGT) in middle-aged patients, reported Dr. Katherine Shear of Columbia University College of Physicians and Surgeons, New York.

"Complicated grief is an under-recognized public health problem that likely affects millions of people in the United States, many of them elderly," the investigators wrote. Symptoms often resemble depression but do not benefit from interpersonal therapy to the extent that depression does (JAMA Psychiatry 2014 Sept. 23 [doi: 10.1001/ jamapsychiatry.2014.1242]).

In the study, 151 bereaved adults with scores of at least 30 on the Inventory of Complicated Grief had 16 individual weekly sessions of either CGT or interpersonal therapy. About 81% of patients were women; the average age was 66 years. The CGT intervention included work with grief-monitoring diaries, memories, and photographs; discussions of goals; and imaginary conversations with the deceased; while patients in interpersonal therapy discussed the death, positive and negative aspects of their relationships with the deceased, and how to develop satisfying relationships in the present. …

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