A New Therapy to Help with "Complicated Grief"

Targeted therapy may help millions of older women afflicted with a kind of grief that could lead to suicide.

“Complicated grief,” as it’s known, affects an estimated 4 million women in the U.S. Beginning after the loss of a spouse or a close relationship, the condition can lead to an increased risk of suicide.

Symptoms of complicated grief, or CG, include prolonged acute grief and difficulty in accepting the reality and imagining a future with meaning.

The first full-scale randomized trial studying CG analyzed a targeted complicated grief treatment (CGT) to a grief-focused interpersonal psychotherapy (IPT).

Katherine Shear, the Marion E. Kenworthy Professor of Psychiatry in Social Work at the Columbia School of Social Work, developed the CGT program. It includes a technique in which patients repeatedly visualize the moment they learned their loved one died, and recount what happened after that. That exercise helps the patients come to grips with the reality they face. IPT, on the other hand, is less focused and involves patients discussing their moods with their therapist.

The participants in the study included 151 adults, mostly women, with an average age of 66. The median time since the loss of a loved one was three years. Over a four-and-a-half year period, half the group had CGT treatment and the other half had IPT.

The results showed that there was a 70 percent improvement of those who underwent CGT as compared to 32 percent for IPT.

“Our results strongly support the need for physicians and other health care providers to distinguish complicated grief from depression,” Shear said. “Given the growing elderly population, the high prevalence of bereavement in aging individuals, and the marked physical and psychological impact of CG, clinicians need to know how to treat CG in older adults.”
The results of the study were published in JAMA Psychiatry.

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