The prevention and treatment of complicated grief: A meta-analysis

BackgroundBereaved individuals are at increased risk of mental and physical disorders, and prevention and treatment of complicated grief is indicated. Earlier quantitative reviews have not focused on the effect of bereavement interventions on (complicated) grief. Therefore the main objective of this meta-analysis was to determine the short-term and long-term effect of both preventive and treatment interventions on complicated grief.MethodsRandomized controlled trials for prevention or treatment of complicated grief were identified through a systematic literature search. Electronic databases and reference lists of earlier review articles served as data sources. Data were analyzed with REVMAN 5.0.14.ResultsFourteen randomized controlled trials met the inclusion criteria. Study quality differed among the trials. Contrary to preventive interventions, treatment interventions yielded significant pooled standardized mean differences in favor of the (specific) grief intervention at post-test and follow-up. During the follow-up period, the positive effect of treatment interventions for complicated grief even increased.ConclusionsTreatment interventions can effectively diminish complicated grief symptoms. Preventive interventions, on the other hand, do not appear to be effective. Limitations of the meta-analysis and future research options are discussed.

Research Highlights
► Preventive grief interventions show inconsistent support for their effectiveness.
► Treatment grief interventions appear to be efficacious in the short-term and long-term alleviation of complicated grief symptoms.
► Professional assistance is indicated for only a subgroup of the bereaved.
► Preventive grief interventions may be more problematic to conduct and need further elaboration.
► Treatment studies should be replicated using larger samples and long-term follow-up periods.