The Effectiveness of an Unguided Online Grief Intervention in Reducing PTSD-Levels in Bereaved People During the COVID-19 Pandemic: a Randomized Controlled Trial

Abstract

The ongoing COVID-19 pandemic has led to an increase of traumatic losses worldwide. The increased risk these traumatic losses bring on mental health problems, stresses the need for research on suitable bereavement care for people bereaved during the pandemic. This randomized controlled trial (RCT) evaluated differences between causes of death (COVID-19 vs. other causes) in baseline levels of posttraumatic stress disorder (PTSD) in people bereaved during the COVID-19 pandemic. Furthermore, the effectiveness of unguided online grief-specific cognitive behavioural therapy (CBT) was examined in reducing PTSD-levels in people bereaved during the pandemic. The sample consisted of adults bereaved during the pandemic for at least three months, with clinically relevant levels of persistent complex bereavement disorder (PCBD), PTSD, and-/or depression. Participants were randomized to an intervention- (n = 19) or waitlist condition (n = 33). Intervention consisted of eight-week unguided online grief-specific CBT. Using the PTSD Checklist for DSM-5 (PCL-5), PTSD symptoms were assessed through telephone interviews at pre-treatment/pre-waiting (T1) and post-treatment/post-waiting (T2). First, an independent samples t-test showed no significant differences in baseline PTSD-levels between people bereaved due to COVID-19 and people bereaved during the pandemic due to other causes of death. Second, an analysis of covariance (ANCOVA) revealed that participants in the intervention condition showed significantly lower PTSD-levels than participants in the waitlist condition, indicating a treatment effect of the online CBT. However, a meaningful statement about implementation of the online CBT in clinical practice can be made when future research replicates the results and examines the long-term effects.