A Randomized Open Trial Assessing the Feasibility of Behavioral Activation for Pathological Grief Responding

•Examined feasibility of using Behavioral Activation to treat postbereavement grief, posttraumatic stress, and depression•BA was associated with large reductions in PGD, PTSD, and depression symptoms in completer and intent-to-treat analyses•70% of the completer sample at posttreatment and 75% at follow-up responded to treatment•45% at posttreatment and 40% at follow-up were classified as evidencing high-end state functioning

This study investigated the feasibility of using behavioral activation to treat enduring postbereavement mental health difficulties using a two-arm, multiple baseline design comparing an immediate start group to a delayed start group at baseline, 12-, 24-, and 36-weeks postrandomization. Participants received 12–14 sessions of behavioral activation within a 12-week intervention period starting immediately after the first assessment or after 12 weeks for the delayed start group. Prolonged grief, posttraumatic stress, and depression symptoms were assessed as outcomes. Compared with no treatment, behavioral activation was associated with large reductions in prolonged, complicated, or traumatic grief; posttraumatic stress disorder; and depression symptoms in the intent-to-treat analyses. Seventy percent of the completer sample at posttreatment and 75 percent at follow-up responded to treatment with 45 percent at posttreatment and 40 percent at follow-up being classified as evidencing high-end state functioning at 12-week follow-up.