Factors associated with outcome of cognitive–behavioural therapy for complicated grief: A preliminary study
Open accessAbstract
Complicated grief (CG), also called prolonged grief disorder, is a debilitating condition that can develop following a loss. There is growing evidence that cognitive–behavioural interventions are efficacious in the treatment of CG. The present preliminary study used data from 43 patients with CG who were randomly assigned to cognitive–behavioural therapy in an earlier treatment trial to explore (a) predictors of outcome of cognitive–behavioural therapy for CG and (b) the relationship between symptom improvement and changes in loss‐related negative cognitions and avoidance behaviours. Analyses showed that worse treatment outcome was associated with lower education attainment, loss of a partner/child (instead of some other relative), early treatment discontinuation, less patient motivation and more severe CG symptoms at pre‐treatment. As predicted, stronger reduction in CG severity was significantly associated with stronger reductions in negative cognitions and avoidance. Implications of these findings are discussed. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Greater effectiveness of cognitive–behavioural therapy (CGT) for complicated grief (CG) seems to be associated with higher educational level, being confronted with losses other than the loss of a partner or child, completion (and not early discontinuation) of treatment and stronger motivation. • Longer CBT treatment may be needed for CG patients bereaved by the loss of a partner or child and mourners with more severe levels of CG. • Seeking ways to enhance patient motivation and adherence to treatment seems important to improve the effectiveness of CBT for CG. • Reduction in CG severity during CGT is associated with reduction in negative cognitions and avoidance behaviours.
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Adding exposure therapy to cognitive restructuring enhances improvement more than adding cognitive restructuring to exposure therapy.
“and that adding exposure therapy to cognitive restructuring enhances improvement more than adding cognitive restructuring to exposure therapy (Boelen, de Keijser, van den Hout, & van den Bout, 2011).”
From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Boelen et al., 2011
The available passages labeled Abstract contain bibliographic information and topic keywords, but no treatment results. Searches for exposure, cognitive restructuring, and treatment order found no passage comparing the two sequences, so the claimed difference in improvement cannot be verified from our copy. (LLM, conf=0.69)
Experimental — accuracy not yet measuredIn the same comparison, exposure alone was more effective than cognitive restructuring alone.
“Comparing the cognitive behavioral conditions showed that exposure alone was more effective than cognitive restructuring alone”
From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Boelen et al., 2011
The available passages contain bibliographic metadata (labeled Abstract, no page), but no treatment results. Searches for exposure versus cognitive restructuring and comparisons of the treatment conditions found no passage stating which was more effective. (LLM, conf=0.70)
Experimental — accuracy not yet measuredIn a comparison of CBT with supportive therapy, the two CBT conditions achieved greater improvement in complicated grief and overall psychopathology than supportive therapy.
“The results showed that the two cognitive behavioral therapy conditions achieved greater improvement in complicated grief and overall psychopathology than supportive therapy.”
From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Boelen et al., 2011
The available indexed passages contain the paper’s title and bibliographic metadata (labelled Abstract, no page), but no results comparing two CBT conditions with supportive therapy. Searches for the comparison, complicated-grief improvement, and overall psychopathology found no passage that addresses the claimed finding. (LLM, conf=0.72)
Experimental — accuracy not yet measuredExposure techniques with behavioral and emotional elements are more effective than cognitive restructuring for mourning.
“Likewise, exposure techniques with behavioral and emotional elements were found to be more effective than cognitive restructuring for mourning (Boelen et al., 2011).”
From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Boelen et al., 2011
The indexed Abstract (no page number provided) reports associations between improvement in complicated grief and reductions in negative cognitions and avoidance. Searches for exposure, cognitive restructuring, and a comparison of their effectiveness found no passage in our copy addressing the claimed comparison. (LLM, conf=0.72)
Experimental — accuracy not yet measuredSupport therapy improves less than CBT in PGD patients.
“-They improve less than those receiving CBT (Boelen et al., 2011).”
From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Boelen et al., 2011
The available indexed passages contain the paper’s title and citation metadata, but no treatment results. Searches for supportive therapy or counselling compared with CBT found no passage addressing whether patients receiving support therapy improved less. (LLM, conf=0.74)
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Maraş, A. (2013) · DergiPark (Istanbul University)
- Authors
- Boelen, P. A., de Keijser, J., van den Hout, M. A., & van den Bout, J.
- Affiliations
- Utrecht University (NL)
- Corresponding author
- Boelen, Paul A.
- ORCID
- Boelen, Paul A.
- Venue
- Clinical Psychology & Psychotherapy
- Publisher
- Wiley
- Published
- 2010-08-30
- Volume
- 18
- Issue
- 4
- Pages
- 284-291
- ISSN
- 1063-3995 (ISSN-L)
- 1099-0879
- OpenAlex
- W2002585790
- Cited by
- 55
- References
- 22
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 5 · 2018: 6 · 2017: 4 · 2016: 2 · 2015: 6 · 2014: 3 · 2013: 3 · 2012: 1
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- Locations
- Clinical Psychology & Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- complicated grief, prolonged grief disorder, cognitive behavioral therapy, predictors of treatment outcome, avoidance behavior, medication adherence, patient motivation, educational attainment, bereavement, early treatment discontinuation
- MeSH terms
- Adult, Affective Symptoms, Attitude to Death, Educational Status, Female, Follow-Up Studies, Grief, Humans, Male, Middle Aged, Motivation, Netherlands, Patient Dropouts, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome
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