An open trial of meaning-centered grief therapy: Rationale and preliminary evaluation

AbstractObjectiveTo determine the preliminary feasibility, acceptability, and effects of Meaning-Centered Grief Therapy (MCGT) for parents who lost a child to cancer.MethodParents who lost a child to cancer and who were between six months and six years after loss and reporting elevated levels of prolonged grief were enrolled in open trials of MCGT, a manualized, one-on-one cognitive-behavioral-existential intervention that used psychoeducation, experiential exercises, and structured discussion to explore themes related to meaning, identity, purpose, and legacy. Parents completed 16 weekly sessions, 60–90 minutes in length, either in person or through videoconferencing. Parents were administered measures of prolonged grief disorder symptoms, meaning in life, and other assessments of psychological adjustment preintervention, mid-intervention, postintervention, and at three months postintervention. Descriptive data from both the in-person and videoconferencing open trial were pooled.ResultEight of 11 (72%) enrolled parents started the MCGT intervention, and six of eight (75%) participants completed all 16 sessions. Participants provided positive feedback about MCGT. Results showed postintervention longitudinal improvements in prolonged grief (d = 1.70), sense of meaning (d = 2.11), depression (d = 0.84), hopelessness (d = 1.01), continuing bonds with their child (d = 1.26), posttraumatic growth (ds = 0.29–1.33), positive affect (d = 0.99), and various health-related quality of life domains (d = 0.46–0.71). Most treatment gains were either maintained or increased at the three-month follow-up assessment.Significance of resultsOverall, preliminary data suggest that this 16-session, manualized cognitive-behavioral-existential intervention is feasible, acceptable, and associated with transdiagnostic improvements in psychological functioning among parents who have lost a child to cancer. Future research should examine MCGT with a larger sample in a randomized controlled trial.

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A Mobile App for Prolonged Grief among Bereaved Parents: Study Protocol for a Randomized Controlled Trial

10.1101/2021.04.23.21256003 ◽

2021 ◽

Author(s):

Rakel Eklund ◽

Maarten Eisma ◽

Paul Boelen ◽

Filip Arnberg ◽

Josefin Sveen

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Controlled Trial ◽

Intervention Group ◽

Mobile App ◽

Cognitive Behavioral ◽

Ethical Review ◽

Depression Symptoms ◽

Prolonged Grief ◽

Bereaved Parents

Introduction: Bereaved parents have elevated risk to develop mental health problems, yet, few studies have evaluated the effect of psychosocial interventions developed for bereaved parents. Cognitive behavioral therapy (CBT), both face-to-face or digitally delivered, has shown to be an effective intervention for prolonged grief symptoms. Self-help mobile apps offer various advantages and studies show improved mental health after app interventions. No app has yet been evaluated targeting prolonged grief in bereaved parents. Therefore, the aim of this planned study is to develop and examine the effectiveness of a CBT-based mobile app, called My Grief, in reducing symptoms of prolonged grief, as well as other psychological symptoms, in bereaved parents. Another aim is to assess users experiences and adverse events of My Grief. Methods and analysis: We will conduct a two-armed randomized waitlist-controlled trial. Parents living in Sweden, who lost a child to cancer between one and ten years ago, with elevated symptoms of prolonged grief, will be recruited to participate in the trial. The content of My Grief covers four main domains (Learn: Self-monitoring: Exercises: Get support) and builds on principles of CBT and the proven-effective PTSD Coach app. Participants in the intervention group will fill out online questionnaires at baseline and at 3, 6 and 12-months follow-ups, and the waitlist-controls at baseline and at 3 months. The primary outcome will be prolonged grief symptoms at the 3 months follow-up. Secondary outcomes are posttraumatic stress and depression symptoms, quality of life, and cognitive behavioral variables (i.e., avoidance, rumination, negative cognitions). Ethics and dissemination: Ethical approval has been received from the Swedish Ethical Review Authority (project no. 2021-00770). If the app is shown to be effective, the app will be made publicly accessible on app stores, so that it can benefit other bereaved parents. Trial registration: Clinicaltrials.gov, identifier: NCT04552717.

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Couple Treatment for PTSD: Partner Outcomes and Partner and Patient Influences on Treatment Outcomes

10.32920/ryerson.14661672.v1 ◽

2021 ◽

Author(s):

Philippe Shnaider

Keyword(s):

Treatment Outcomes ◽

Psychological Functioning ◽

Controlled Trial ◽

Future Research ◽

Ptsd Symptoms ◽

Symptom Change ◽

Intimate Partners ◽

Interpersonal Factors ◽

Cognitive Behavioural ◽

Conjoint Therapy

A growing body of literature has documented interpersonal factors associated with the occurrence and treatment of posttraumatic stress disorder (PTSD). Among these factors, intimate partners’ psychological functioning has consistently been found to be associated with patients’ PTSD severity. The present study investigated intimate partners’ psychological functioning outcomes in a sample of 40 partners of individuals with PTSD within a randomized waitlist controlled trial of cognitive-behavioural conjoint therapy for PTSD. In addition, models of influence from partners to patients and vice versa were examined. More specifically, these models investigated the influence of pretreatment functioning and symptom change on treatment outcomes. There were no significant differences between active treatment and waitlist in intimate partners’ psychological functioning at posttreatment. Furthermore, neither partners’ psychological functioning, nor patients’ PTSD symptoms, influenced the others’ treatment outcomes. Findings are discussed with a focus on guiding future research on partners’ psychological functioning in the context of PTSD.

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REPRINTED WITH PERMISSION OF IASP - PAIN 158 (2017) 868–878: A tailored-guided internet-based cognitive-behavioral intervention for patients with rheumatoid arthritis as an adjunct to standard rheumatological care: results of a randomized controlled trial

Ból ◽

10.5604/01.3001.0012.0656 ◽

2017 ◽

Vol 18 (4) ◽

pp. 20-34

Author(s):

Maaike Ferwerda ◽

Sylvia van Beugen ◽

Henriët van Middendorp ◽

Saskia Spillekom-van Koulil ◽

A. Rogier T. Donders ◽

...

Keyword(s):

Physical Functioning ◽

Psychological Functioning ◽

Daily Life ◽

Controlled Trial ◽

Intervention Group ◽

Cognitive Behavioral ◽

Control Group ◽

Cognitive Behavioral Intervention ◽

Randomized Controlled ◽

The Impact

For patients with chronic pain conditions such as rheumatoid arthritis (RA), who experience elevated levels of distress, tailored guided internet-based cognitive-behavioral treatment may be effective in improving psychological and physical functioning, and reducing the impact of RA on daily life. A multicenter, randomized controlled trial was conducted for RA patients with elevated levels of distress as assessed by a disease-specific measure. The control group (n=71) received standard care and the intervention group (n = 62) additionally received an internet-based tailored cognitive-behavioral intervention. Main analyses were performed using a linear mixed model estimating differences between the intervention and control groups in scores of psychological functioning, physical functioning, and impact of RA on daily life at preassesment and postassessment, and at 3, 6, 9, and 12 months. Patients who received the internet-based intervention reported a larger improvement in psychological functioning compared with the control group, indicating less depressed mood (P < 0.001, d = 0.54), negative mood (P = 0.01, d = 0.38), and anxiety (P < 0.001, d = 0.48) during the course of the 1-year follow-up period. Regarding physical functioning, a trend was found for the intervention group reporting less fatigue than the control group (P = 0.06, d= 0.24), whereas no effect was found on pain. No effects were found for the impact of RA on daily life, except for the intervention group experiencing fewer role limitations due to emotional problems (P < 0.001, d = 0.53). Offering guided internet-based cognitive-behavioral therapy is a promising development to aid patients with psychological distress particularly in improving psychological functioning. Further research on adherence and specific intervention ingredients is warranted.

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Treating prolonged grief disorder with prolonged grief-specific cognitive behavioral therapy: study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-018-2618-3 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Rita Rosner ◽

Eline Rimane ◽

Anna Vogel ◽

Jörn Rau ◽

Maria Hagl

Keyword(s):

Randomized Controlled Trial ◽

Cognitive Behavioral Therapy ◽

Study Protocol ◽

Behavioral Therapy ◽

Controlled Trial ◽

Cognitive Behavioral ◽

Prolonged Grief Disorder ◽

Prolonged Grief ◽

Randomized Controlled

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Depression prevention via digital cognitive behavioral therapy for insomnia: a randomized controlled trial

SLEEP ◽

10.1093/sleep/zsz150 ◽

2019 ◽

Vol 42 (10) ◽

Cited By ~ 16

Author(s):

Philip Cheng ◽

David A Kalmbach ◽

Gabriel Tallent ◽

Christine Lm Joseph ◽

Colin A Espie ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Controlled Trial ◽

Relative Rate ◽

Cognitive Behavioral ◽

Future Research ◽

Depression Prevention ◽

Randomized Controlled

Abstract Study Objectives Insomnia is a common precursor to depression; yet, the potential for insomnia treatment to prevent depression has not been demonstrated. Cognitive behavioral therapy for insomnia (CBT-I) effectively reduces concurrent symptoms of insomnia and depression and can be delivered digitally (dCBT-I); however, it remains unclear whether treating insomnia leads to sustained reduction and prevention of depression. This randomized controlled trial examined the efficacy of dCBT-I in reducing and preventing depression over a 1-year follow-up period. Methods Patients with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) insomnia disorder were randomly assigned to receive dCBT-I or an attentional control. The follow-up sample included 358 patients in the dCBT-I condition and 300 patients in the online sleep education condition. The primary outcome measure was relative rate ratios for depression at 1-year follow-up. Insomnia responses to treatment were also tested as predictors of incident depression at the 1-year follow-up. Results At 1-year follow-up, depression severity continued to be significantly lower in the dCBT-I condition relative to control. In addition, the number of individuals who reported no depression at 1-year follow-up was 51% higher in the dCBT-I condition relative to control. In those with minimal to no depression at baseline, the incident rate of moderate-to-severe depression at 1-year follow-up was reduced by half in the dCBT-I condition relative to the control condition. Conclusion dCBT-I showed robust effects as an intervention that prevents depression. Future research should examine dose–response requirements and further characterize mechanisms of action of dCBT-I for depression prevention. Clinical Trial Sleep to Prevent Evolving Affective Disorders; NCT02988375.

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Peaceful mind: an open trial of cognitive-behavioral therapy for anxiety in persons with dementia

International Psychogeriatrics ◽

10.1017/s1041610210000694 ◽

2010 ◽

Vol 22 (6) ◽

pp. 1012-1021 ◽

Cited By ~ 39

Author(s):

Amber L. Paukert ◽

Jessica Calleo ◽

Cynthia Kraus-Schuman ◽

Lynn Snow ◽

Nancy Wilson ◽

...

Keyword(s):

Behavioral Activation ◽

Negative Impact ◽

Behavioral Therapy ◽

Controlled Trial ◽

Open Trial ◽

Cognitive Behavioral ◽

Self Awareness ◽

Significant Negative Impact ◽

New Treatment ◽

Assessment Procedures

ABSTRACTBackground: Anxiety has a high prevalence among individuals with dementia, and it has a significant negative impact on their functioning; yet intervention studies are lacking. We developed Peaceful Mind, a cognitive-behavioral intervention for persons with dementia. In this paper, we describe the intervention and results of an open trial evaluating the feasibility and utility of the intervention and assessment procedures.Methods: Peaceful Mind is implemented over a period of three months in the participant's home with involvement of a caregiver or “collateral.” Dyads are followed for an additional three months via telephone. An assortment of simplified skills is offered, including self-awareness, breathing, behavioral activation, calming thoughts, and sleep skills.Results: Nine participants were enrolled, eight completed the three-month assessment, and seven completed the six-month assessment. Overall, participants and collaterals were satisfied with the intervention and reported that they benefited in terms of anxiety, depression, and collateral distress.Conclusions: A randomized controlled trial would help determine whether this promising new treatment has a statistically significant impact on anxiety in this population.

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The Role of Posttraumatic Growth in a Randomized Controlled Trial of Cognitive-Behavioral Conjoint Therapy for PTSD

Journal of Traumatic Stress ◽

10.1002/jts.22122 ◽

2016 ◽

Vol 29 (4) ◽

pp. 379-383 ◽

Cited By ~ 9

Author(s):

Anne C. Wagner ◽

Lindsey Torbit ◽

Tiffany Jenzer ◽

Meredith S. H. Landy ◽

Nicole D. Pukay-Martin ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Posttraumatic Growth ◽

Controlled Trial ◽

Cognitive Behavioral ◽

Randomized Controlled ◽

Conjoint Therapy

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Couple Treatment for PTSD: Partner Outcomes and Partner and Patient Influences on Treatment Outcomes

10.32920/ryerson.14661672 ◽

2021 ◽

Author(s):

Philippe Shnaider

Keyword(s):

Treatment Outcomes ◽

Psychological Functioning ◽

Controlled Trial ◽

Future Research ◽

Ptsd Symptoms ◽

Symptom Change ◽

Intimate Partners ◽

Interpersonal Factors ◽

Cognitive Behavioural ◽

Conjoint Therapy

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Investigating Posttraumatic Growth in Midlife Using an Intensive Longitudinal Research Design: Posttraumatic Growth Is Not as Prevalent as Previously Considered

European Journal of Personality ◽

10.1177/08902070211041852 ◽

2021 ◽

pp. 089020702110418

Author(s):

Frank J. Infurna ◽

Suniya S. Luthar ◽

Kevin J. Grimm

Keyword(s):

Life Satisfaction ◽

Posttraumatic Growth ◽

Psychological Functioning ◽

Multilevel Models ◽

Longitudinal Research ◽

Meaning Making ◽

Future Research ◽

Major Life ◽

Cross Sectional ◽

Life Stressor

The notion that adversity leads to enduring improvements in psychological functioning carries promise given the diverse adversities individuals confront over their life course. However, research on posttraumatic growth (PTG) has relied on cross-sectional research designs, which severely limit the ability to discern whether growth transpires following adversity. Our goal was to examine whether PTG is possible across a diverse array of outcomes and identify factors that promote PTG. We analyzed data from a longitudinal, prospective study that assessed midlife participants monthly for a period of 2 years. Over the study period, 276 participants experienced a major life stressor, and multiphase multilevel models were used to examine whether PTG transpired in life satisfaction, gratitude, compassion, generativity, meaning-making, and religiosity/spirituality. On average, life satisfaction, generativity, and meaning-making declined following adversity; substantial between-person differences were observed across all outcomes. Our multidimensional approach revealed that, on average, individuals experienced PTG in less than one outcome. More anticipated support and less interpersonal strain were consistently associated with positive functioning in each outcome. Our discussion focuses on how multidimensional approaches to studying PTG promise to disentangle which outcomes potentially grow following adversity and illuminate best research practices for examining PTG, laying the groundwork for future research.

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