Complicated grief in older adults: a randomized controlled trial of complicated grief group therapy

Purpose: This study compared the efficacy of complicated grief therapy (CGT; Shear, K. [2003]. Complicated grief: A guidebook for therapists [Liberty Version]. New York State Office of Mental Heath; Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F. 3rd [2005]. Treatment of complicated grief: A randomized controlled trial. The Journal of the American Medical Association, 293, 2601-2608) administered as group therapy (CGGT) with standard group therapy (treatment as usual [TAU]) in older adults presenting with complicated grief (CG).

Methods: The design was a 2×4, prospective, randomized controlled clinical trial. The independent variable was group type, with 1 group receiving experimental methods based on the work of Shear et al. (Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F. 3rd. [2005]. Treatment of complicated grief: a randomized controlled trial. The Journal of the American Medical Association, 293, 2601-2608), CGGT versus. TAU. The dependent variable was treatment response.

Results: CGGT participants demonstrated higher treatment response than TAU participants. Although participants in both groups showed improvement in CG measures, CGGT participants realized significantly greater improvement. More importantly, when CG was measured on Prolonged Grief Disorder Scale, nearly half of CGGT participants realized clinically significant improvement. All CGGT completers had Brief Grief Questionnaire scores upon follow-up that, had they scored at that level at pretest, would have disqualified them for study enrollment.

Implications: The high level of clinical significance suggests that CGGT participants were effectively treated for CG. This study offers evidence that CGGT holds promise for treatment of CG in older adults and merits inquiry in other populations.