Factors associated with outcome of cognitive-behavioural therapy for complicated grief: A preliminary study.

Complicated grief (CG), also called prolonged grief disorder, is a debilitating condition that can develop following a loss. There is growing evidence that cognitive-behavioural interventions are efficacious in the treatment of CG. The present preliminary study used data from 43 patients with CG who were randomly assigned to cognitive-behavioural therapy in an earlier treatment trial to explore (a) predictors of outcome of cognitive-behavioural therapy for CG and (b) the relationship between symptom improvement and changes in loss-related negative cognitions and avoidance behaviours. Analyses showed that worse treatment outcome was associated with lower education attainment, loss of a partner/child (instead of some other relative), early treatment discontinuation, less patient motivation and more severe CG symptoms at pre-treatment. As predicted, stronger reduction in CG severity was significantly associated with stronger reductions in negative cognitions and avoidance. Implications of these findings are discussed. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Greater effectiveness of cognitive-behavioural therapy (CGT) for complicated grief (CG) seems to be associated with higher educational level, being confronted with losses other than the loss of a partner or child, completion (and not early discontinuation) of treatment and stronger motivation. • Longer CBT treatment may be needed for CG patients bereaved by the loss of a partner or child and mourners with more severe levels of CG. • Seeking ways to enhance patient motivation and adherence to treatment seems important to improve the effectiveness of CBT for CG. • Reduction in CG severity during CGT is associated with reduction in negative cognitions and avoidance behaviours. [ABSTRACT FROM AUTHOR]