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Grief-Focused CBT May Be More Effective Than Mindfulness for Prolonged Grief Disorder

Jolynn Tumolo

Although both grief-focused cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy eased grief severity in adults with prolonged grief disorder, grief-focused CBT was associated with greater symptom reduction 6 months after treatment. Researchers published their findings in JAMA Psychiatry

“The findings indicate that both interventions may be considered for treating prolonged grief symptoms; with consideration of all relevant factors, grief-focused CBT appeared to be more effective in reducing grief severity,” wrote first author Richard A. Bryant, PhD, of the University of New South Wales and the Westmead Institute for Medical Research, Sydney, Australia, and study coauthors.

Related: Abnormal Experience of Positive Stimuli a Possible Intervention Target in Schizophrenia

The randomized clinical trial included 100 adults with prolonged grief disorder. Participants were randomly assigned to either individual 90-minute sessions of grief-focused CBT or mindfulness-based cognitive therapy at a traumatic stress clinic. Sessions occurred once weekly over 11 weeks.

Grief-focused CBT included recalling memories of the deceased, as well as cognitive restructuring and planning future social activities. Mindfulness-based cognitive therapy included mindfulness exercises aimed at tolerating grief-related distress.

At a follow-up 6 months after the intervention, the 50 patients in the grief-focused CBT group averaged a 7.1-point greater drop in Prolonged Grief−13 scale score than the 50 patients in the mindfulness-based cognitive therapy group, according to the study. Patients in the grief-focused CBT group also averaged a 6.6-point greater depression reduction, per the Beck Depression Inventory, and improvements in grief-related cognition compared with the mindfulness-based cognitive therapy group.

The study identified no differences in adverse events between treatments.

“In this study, grief-focused CBT conferred more benefit for core prolonged grief disorder symptoms and associated problems 6 months after treatment than mindfulness-based cognitive therapy,” researchers wrote. “Although both treatments may be considered for prolonged grief disorder, grief-focused CBT might be the more effective choice, taking all factors into consideration.”

 

Reference

Bryant RA, Azevedo S, Yadav S, et al. Cognitive behavior therapy vs mindfulness in treatment of prolonged grief disorder: a randomized clinical trial. JAMA Psychiatry. Published online April 24, 2024. doi:10.1001/jamapsychiatry.2024.0432