Prolonged grief disorder in people who have lost a loved one during the COVID-19 pandemic: risk factors and the effectiveness of unguided online cognitive behavioural therapy.

Abstract

After nearly 7 million deaths during the COVID-19 pandemic an increased risk of developing prolonged grief disorder (PGD) was predicted. By using a randomized waitlist-controlled trial this study investigated the association between saying goodbye to a loved one and PGD symptom-levels, and to study the effect of unguided online cognitive behavioural treatment (CBT) on PGD symptoms when compared to a waitlist condition. The participant group consisted of 65 adults who had lost a loved one at least three months ago during the COVID-19 pandemic. They were divided over an intervention (N=32) and waitlist condition (N=33). Telephone interviews were conducted prior to the intervention or waitlist period (T1) and after (T2), acquiring background information of each candidate and assessing PGD symptoms with the TGI-CA. The intervention consisted of an eight-week online, unguided, grief-specific CBT consisting of exposure, cognitive restructuring and behavioural activation. A Pearson’s r correlation analysis and analysis of covariance (ANCOVA) have been performed. The Pearson’s r correlation analysis showed no significant relationship between saying goodbye and PGD symptom-levels (r(63) = -.16, p = .21). The ANCOVA showed a significant decrease in PGD symptoms at T2 in the intervention condition compared to the waitlist condition (F(1,51) = 26.80, p = <.001) with baseline PGD symptoms and additional psychological aid as covariates. The online unguided CBT appears promising for lowering PGD symptoms; with additional research into online unguided CBT’s effectiveness, this treatment could be implemented in clinical practice to accessibly treat a larger population of people experiencing PGD symptoms.