Richard A Bryant 1,2 , Lucy Kenny 2 , Amy Joscelyne 2 , Natasha Rawson 2 , Fiona Maccallum 2 , Catherine Cahill 2 , Sally Hopwood 2 , Angela Nickerson 2 Show Affiliations »
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BACKGROUND: Prolonged grief disorder (PGD ) causes significant impairment in approximately 7% of bereaved people. Although cognitive-behavioral therapy (CBT ) has been shown to effectively treat PGD , there is no evidence of long-term effects of CBT. OBJECTIVE: To determine the long-term efficacies of CBT with exposure or CBT without exposure in treating PGD by assessing outcome at 2 years. METHODS: A randomized controlled trial of PGD patients (N = 80) attending an outpatient clinic took place between September 2007 and June 2010, and a 2-year follow-up occurred between December 2009 and October 2012 . All patients received 10 weekly 2-hour group therapy sessions that comprised CBT techniques. Patients also received 4 individual sessions in which they were randomly allocated to receive exposure therapy (CBT/Exposure) for memories of the death or supportive counseling (CBT ). Prolonged grief disorder was assessed by clinical interview using the Complicated Grief Assessment. Severity of PGD , the primary outcome, was assessed using the Inventory of Complicated Grief . RESULTS: Intent-to-treat analyses indicated a significant linear time × treatment condition interaction effect at 2 years (B = -0.63; SE = 0.26; t₂₂₅ = -2.44; P = .02; 95% CI, -1.14 to -0.12), indicating that CBT/Exposure led to greater reductions in PGD than CBT. Further, the linear between-group effect size at the 2-year follow-up was 1.15. CONCLUSIONS: Exposure therapy in the course of CBT leads to greater reduction in symptoms of PGD than CBT without exposure, and this additive gain extends 2 years after treatment is complete. To achieve optimal treatment gains in patients with PGD , therapists should encourage some form of exposure therapy to memories of the death. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry identifier: ACTRN12609000229279. © Copyright 2017 Physicians Postgraduate Press, Inc.
RCT Entities: Population
Interventions
Outcomes
BACKGROUND: Prolonged grief disorder (PGD ) causes significant impairment in approximately 7% of bereaved people . Although cognitive-behavioral therapy (CBT) has been shown to effectively treat PGD , there is no evidence of long-term effects of CBT. OBJECTIVE: To determine the long-term efficacies of CBT with exposure or CBT without exposure in treating PGD by assessing outcome at 2 years. METHODS: A randomized controlled trial of PGD patients (N = 80) attending an outpatient clinic took place between September 2007 and June 2010, and a 2-year follow-up occurred between December 2009 and October 2012. All patients received 10 weekly 2-hour group therapy sessions that comprised CBT techniques. Patients also received 4 individual sessions in which they were randomly allocated to receive exposure therapy (CBT/Exposure) for memories of the death or supportive counseling (CBT). Prolonged grief disorder was assessed by clinical interview using the Complicated Grief Assessment. Severity of PGD , the primary outcome, was assessed using the Inventory of Complicated Grief. RESULTS: Intent-to-treat analyses indicated a significant linear time × treatment condition interaction effect at 2 years (B = -0.63; SE = 0.26; t₂₂₅ = -2.44; P = .02; 95% CI, -1.14 to -0.12), indicating that CBT/Exposure led to greater reductions in PGD than CBT. Further, the linear between-group effect size at the 2-year follow-up was 1.15. CONCLUSIONS: Exposure therapy in the course of CBT leads to greater reduction in symptoms of PGD than CBT without exposure, and this additive gain extends 2 years after treatment is complete. To achieve optimal treatment gains in patients with PGD , therapists should encourage some form of exposure therapy to memories of the death . TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry identifier: ACTRN12609000229279. © Copyright 2017 Physicians Postgraduate Press, Inc.
Entities: Chemical
Disease
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Year: 2017
PMID： 28445631 DOI： 10.4088/JCP.16m10729
Source DB: PubMed Journal: J Clin Psychiatry ISSN： 0160-6689 Impact factor: 4.384