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Internet-Based Cognitive-Behavioral Therapy for Complicated Grief: A Randomized Controlled Trial
Abstract
The present study investigates the efficacy of an Internet-based cognitive-behavioral therapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology--therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n = 55) were randomly assigned to either the treatment group or a waiting list control condition. The 5-week intervention consisted of three modules: (1) exposure to bereavement cues; (2) cognitive reappraisal; and (3) integration and restoration. The Impact of Event Scale (IES), a failure to adapt scale, and the depression and anxiety subscales of the Brief Symptom Inventory (BSI) were used to assess treatment outcomes. Participants in the treatment group (n = 26) improved significantly relative to participants in the waiting condition on symptoms of intrusion, avoidance, maladaptive behavior, and general psychopathology, and showed a large treatment effect. Follow-up results show that this improvement was maintained after 3 months.
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“A further recent study examining the efficacy of an Internet-based cognitive behavioral therapy for mothers after pregnancy loss67 showed positive treatment effects, with the intervention group showing significantly reduced symptoms of grief, PTSD, and depression after treatment relative to the waiting-list group, and this symptom reduction was maintained at 3-month followup.68,69”
From Complicated grief after perinatal loss (2012) · cites this paper as [67]
In the citing paper
“Currently, data on the efficacy of ICBT are available for a wide range of psychological disorders, including stress-related disorders [19–23].”
From An internet-based intervention for adjustment disorder (TAO): Study protocol for a randomized controlled trial (2018) · cites this paper as [22]
In the citing paper
“The treatment group was found to have improved significantly in relation to subjects on the waitlist as regards symptoms such as intrusion, advoidance, maladaptive behavior, and psychopathology in general (Wagner, Knaevelsrud, & Maercker, 2006).”
From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Wagner et al., 2006
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“Although studies of indicated interventions were more encouraging in their results, only five such studies could be identified that assessed outcomes at posttreatment (Denny & Lee, 1984; A. W. Forrest, 1990; Kleber & Brom, 1987; Reynolds et al., 1999; Wagner et al., 2006) and only two that did so at follow-up (Parkes,…”
MethodResultComplicated grief after perinatal loss
Kersting, A., & Wagner, B. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/akersting · Cited by 419
Self-citationKnaevelsrud, C., & Maercker, A. (2007) · BMC Psychiatry · doi:10.1186/1471-244x-7-13 · Cited by 398
Self-citationThe prevention and treatment of complicated grief: a meta-analysis
Wittouck, C., Van Autreve, S., De Jaegere, E., Portzky, G., & van Heeringen, K. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.09.005 · Cited by 361
Predictors of grief following the death of one's child: the contribution of finding meaning
Keesee, N. J., Currier, J. M., & Neimeyer, R. A. (2008) · Journal of Clinical Psychology · doi:10.1002/jclp.20502 · Cited by 358
“As randomized controlled trials of therapies for complicated grief that feature such methods have begun to support their clinical efficacy (Shear, Frank, Houck & Reynolds, 2005; Wagner, Knaevelsrud & Maercker, 2006 ), clinicians can begin to draw upon evidence-based procedures to assist bereaved parents in a frequentl…”
BackgroundOptimizing Treatment of Complicated Grief: A Randomized Clinical Trial
Shear, M. K., Reynolds, C. F., Simon, N. M., Zisook, S., Wang, Y., Mauro, C., Duan, N., Lebowitz, B., & Skritskaya, N. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.0892 · Cited by 349
Wagner, B., Horn, A. B., & Maercker, A. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.06.032 · Cited by 311
“The online intervention was given as a guided intervention with intensive therapist contact, based on the principles applied in a number of previous studies (Lange et al., 2003; Ruwaard et al., 2007; Ruwaard et al., 2009; Wagner et al., 2006).”
MethodSelf-citationGrief therapy and the reconstruction of meaning: From principles to practice
Neimeyer, R. A., Burke, L. A., Mackay, M. M., & van Dyke Stringer, J. G. (2010) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-009-9135-3 · Cited by 310
“Controlled research on the efficacy of expressive writing underscores its effectiveness (Wagner et al. 2006), especially when it explicitly prompts meaning-based processing of the loss experience (Lichtenthal and Cruess 2010).”
Richardson, T., Stallard, P., & Velleman, S. (2010) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-010-0069-9 · Cited by 272
“…2004), tinnitus (Andersson et al. 2002; Andersson and Kaldo 2004), insomnia (Strom et al. 2004), stress (Grime 2004; Ruwaard et al. 2007), grief (Wagner et al. 2006, 2007), problem drinking (Riper et al. 2008) drug dependence (Carroll et al. 2008), and alcohol or cannabis use with co-morbid…”
BackgroundSuicide bereavement and complicated grief
Tal Young, I., Iglewicz, A., Glorioso, D., Lanouette, N., Seay, K., Ilapakurti, M., & Zisook, S. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/iyoung · Cited by 291
Internet Methods for Delivering Behavioral and Health-Related Interventions (eHealth)
Strecher, V. J. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091428 · Cited by 284
Kuester, A., Niemeyer, H., & Knaevelsrud, C. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.11.004 · Cited by 261
Self-citationGrief in Children and Adolescents Bereaved by Sudden Parental Death
Melhem, N. M. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.101 · Cited by 231
Prolonged grief disorder: Diagnostic, assessment, and treatment considerations.
Jordan, A. H., & Litz, B. T. (2014) · Professional Psychology: Research and Practice · doi:10.1037/a0036836 · Cited by 234
“; Wagner et al., 2006).”
Bereavement and Complicated Grief
Shear, M. K., Ghesquiere, A., & Glickman, K. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-013-0406-z · Cited by 268
Johannsen, M., Damholdt, M. F., Zachariae, R., Lundorff, M., Farver-Vestergaard, I., & O'Connor, M. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.04.065 · Cited by 214
Sijbrandij, M., Kunovski, I., & Cuijpers, P. (2016) · Depression and Anxiety · doi:10.1002/da.22533 · Cited by 213
Holland, J. M., Currier, J. M., & Neimeyer, R. A. (2006) · OMEGA - Journal of Death and Dying · doi:10.2190/fkm2-yjty-f9vv-9xwy · Cited by 222
“…with past longitudinal research (e.g., Davis et al., 1998; McIntosh et al., 1993) and experimental studies of cognitive and meaning-based therapies (Shear et al., 2005; Wagner et al., 2006) provide preliminary evidence for the central role of meaning reconstruction in the aftermath of loss.”
BackgroundSupport for mothers, fathers and families after perinatal death
Koopmans, L., Wilson, T., Cacciatore, J., & Flenady, V. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000452.pub3 · Cited by 216
A Cognitive Attachment Model of prolonged grief: Integrating attachments, memory, and identity
Maccallum, F., & Bryant, R. A. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.05.001 · Cited by 214
Kersting, A., Dölemeyer, R., Steinig, J., Walter, F., Kroker, K., Baust, K., & Wagner, B. (2013) · Psychotherapy and Psychosomatics · doi:10.1159/000348713 · Cited by 210
Self-citationMusiat, P., & Tarrier, N. (2014) · Psychological Medicine · doi:10.1017/s0033291714000245 · Cited by 188
“Similar fi gures were reported in an intervention for complicated grief (Wagner et al. 2006), depression (Ruwaard et al. 2009) and bulimia nervosa (Ruwaard et al. 2013).”
BackgroundAmstadter, A. B., Broman-Fulks, J., Zinzow, H., Ruggiero, K. J., & Cercone, J. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.04.001 · Cited by 189
Knaevelsrud, C., Brand, J., Lange, A., Ruwaard, J., & Wagner, B. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3582 · Cited by 183
“In particular, interventions developed for patients with PTSD have been shown to produce significant reductions in PTSD symptoms and in associated psychopathology, such as depression and anxiety [12-17].”
Self-citationEisma, M. C., Boelen, P. A., van den Bout, J., Stroebe, W., Schut, H. A. W., Lancee, J., & Stroebe, M. S. (2015) · Behavior Therapy · doi:10.1016/j.beth.2015.05.007 · Cited by 185
“As mentioned, exposure is an integral part of many effective contemporary CBT interventions (e.g., Boelen et al., 2007; Shear et al., 2005; Wagner et al., 2006).”
InfluentialSimon, N. M. (2013) · JAMA · doi:10.1001/jama.2013.8614 · Cited by 198
The Effectiveness of Online Cognitive Behavioral Treatment in Routine Clinical Practice
Ruwaard, J., Lange, A., Schrieken, B., Dolan, C. V., & Emmelkamp, P. (2012) · PLoS ONE · doi:10.1371/journal.pone.0040089 · Cited by 173
Preschl, B., Maercker, A., & Wagner, B. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-189 · Cited by 158
“For the online condition, the CBT treatment manual for depression [29] was adapted for use as an internetbased intervention, based on the principles applied in a number of previous studies [3,41-43].”
MethodSelf-citationBereavement theory: recent developments in our understanding of grief and bereavement
Hall, C. (2014) · Bereavement Care · doi:10.1080/02682621.2014.902610 · Cited by 150
Maercker, A. R. A., Forstmeier, S., Enzler, A., Krüsi, G., Hörler, E., Maier, C., & Ehlert, U. (2007) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2007.07.002 · Cited by 149
Self-citationRuminative coping as avoidance
Stroebe, M., Boelen, P. A., van den Hout, M., Stroebe, W., Salemink, E., & van den Bout, J. (2007) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-007-0746-y · Cited by 157
“Recent randomized clinical trials have found convincing evidence for the efficacy of the widely used CBTtechniques of exposure and cognitive restructuring for the alleviation of complicated grief [8, 63, 72 ].”
BackgroundBell, V. (2007) · Journal of Mental Health · doi:10.1080/09638230701482378 · Cited by 140
“…small) randomized controlled trials for stress-management (Zetterqvist et al., 2003), tinnitus (Andersson et al., 2002; Kaldo-Sandstrom et al., 2004), headache (Andersson et al., 2003; Devineni & Blanchard, 2005) chronic back pain (Buhrman et al., 2004) and complicated grief (Wagner et al., 2006).”
BackgroundLitz, B. T., Schorr, Y., Delaney, E., Au, T., Papa, A., Fox, A. B., Morris, S., Nickerson, A., Block, S., & Prigerson, H. G. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.07.005 · Cited by 139
“The therapist contact in HEAL is supportive and limited e the therapist neither provides intervention content nor delivers feedback on specific assignments completed by the participants (in contrast to Kersting et al., 2011, 2013; Wagner et al., 2006; Wagner & Maercker, 2008).”
BackgroundTreatment of complicated grief
Rosner, R., Pfoh, G., & Kotoučová, M. (2011) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v2i0.7995 · Cited by 137
“…different methods: Shear et al. (2005) used a confrontational method they called ‘‘revisiting’’ that is similar to Foa and Rothbaum’s prolonged exposure (1998), Wagner et al. (2006) used a writing task in their internet-based intervention and Boelen et al. (2007) used again prolonged exposure.”
MethodResultPostdisaster psychological intervention since 9/11.
Watson, P., Brymer, M. J., & Bonanno, G. A. (2011) · American Psychologist · doi:10.1037/a0024806 · Cited by 142
Integration of palliative care into COVID-19 pandemic planning
Fadul, N. A., Elsayem, A. F., & Bruera, E. D. (2020) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2020-002364 · Cited by 132
Rosner, R., Pfoh, G., Kotoučová, M., & Hagl, M. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.05.035 · Cited by 133
“…complicated grief treatment with interpersonal therapy (Shear et al., 2005); (2) a trial comparing an internet-based intervention with an untreated control (Wagner et al., 2006); and (3) a trial comparing cognitive behavioural therapy (CBT) with supportive counselling (Boelen et al., 2007).”
BackgroundInfluentialHolland, J. M., & Neimeyer, R. A. (2010) · OMEGA - Journal of Death and Dying · doi:10.2190/om.61.2.b · Cited by 123
Disturbed grief: prolonged grief disorder and persistent complex bereavement disorder
Boelen, P. A., & Smid, G. E. (2017) · BMJ · doi:10.1136/bmj.j2016 · Cited by 138
Neimeyer, R. A., & Currier, J. M. (2009) · Current Directions in Psychological Science · doi:10.1111/j.1467-8721.2009.01666.x · Cited by 122
Kersting, A., Kroker, K., Schlicht, S., Baust, K., & Wagner, B. (2011) · Archives of Women's Mental Health · doi:10.1007/s00737-011-0240-4 · Cited by 118
“Based on this rationale, an internet-based cognitive behavioral treatment program for complicated grief (Wagner et al. 2005, 2006) was specifically adapted to the needs of mothers after loss of a child during pregnancy (see Kersting et al. 2011 for further details of the treatment protocol.)”
BackgroundResultInfluentialSelf-citationWeb-Based Bereavement Care: A Systematic Review and Meta-Analysis
Wagner, B., Rosenberg, N., Hofmann, L., & Maaß, U. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00525 · Cited by 129
“Study Eisma et al. (43) Kersting et al. (46) Kersting et al. (45) Litz et al. (48) van der Houwen et al. (47) Wagner et al. (18) Wagner and Maercker (44)a Country Netherlands Germany Germany USA USA, UKb Germanyc Germanyc Population GP GP GP GP GP GP GP Subjects Subjects with elevated levels of complicated griefd and…”
BackgroundMethodInfluentialSelf-citationPapa, A., Sewell, M. T., Garrison‐Diehn, C., & Rummel, C. (2013) · Behavior Therapy · doi:10.1016/j.beth.2013.04.009 · Cited by 117
The efficacy of a brief internet-based self-help intervention for the bereaved
van der Houwen, K., Schut, H., van den Bout, J., Stroebe, M., & Stroebe, W. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.12.009 · Cited by 106
“This could explain – in part – why Wagner et al. (2006, 2007) who focused on persons suffering from complicated grief, did find effects, whereas studies that used the traditional Pennebaker paradigm and included all bereaved did not.”
BackgroundMethodResultInfluentialGrief interventions for people bereaved by suicide: a systematic review
Linde, K., Treml, J., Steinig, J., Nagl, M., & Kersting, A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0179496 · Cited by 107
Comparison of two diagnostic systems for Complicated Grief
Forstmeier, S., & Maercker, A. R. A. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.09.013 · Cited by 110
“criteria have shown that (a) CG symptoms can be classified into intrusion, avoidance, and failure-to-adapt categories; (b) CG has proven to be distinct from depression; (c) the CG diagnosis showed a meaningful correlational pattern to measures of psychopathology and normal grief reactions (Langner and Maercker, 2005);…”
ResultSelf-citationHuang, T.-T., Liu, C.-B., Tsai, Y.-H., Chin, Y.-F., & Wong, C.-H. (2015) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2015.05.013 · Cited by 96
Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis
Sloan, D. M., Gallagher, M. W., Feinstein, B. A., Lee, D. J., & Pruneau, G. M. (2011) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2010.550058 · Cited by 99
Wagner, B., Knaevelsrud, C., & Maercker, A. R. A. (2007) · Cognitive Behaviour Therapy · doi:10.1080/16506070701339713 · Cited by 98
“Failure to adapt was measured by a newly developed scale (Wagner et al., 2006).”
BackgroundMethodInfluentialSelf-citationNakajima, S., Ito, M., Shirai, A., & Takako, K. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/snakajima · Cited by 95
Efficacy of an internet-based intervention for posttraumatic stress disorder in Iraq: a pilot study
Wagner, B., Schulz, W., & Knaevelsrud, C. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.07.026 · Cited by 91
de Groot, M., de Keijser, J., Neeleman, J., Kerkhof, A., Nolen, W., & Burger, H. (2007) · BMJ · doi:10.1136/bmj.39161.457431.55 · Cited by 91
“Several studies have shown that such therapy has beneficial effects in the treatment of complicated grief.”
BackgroundWagner, B., Brand, J., Schulz, W., & Knaevelsrud, C. (2012) · Depression and Anxiety · doi:10.1002/da.21962 · Cited by 84
Self-citationFeatures and benefits of online counselling: Trinity College online mental health community
Richards, D. (2009) · British Journal of Guidance and Counselling · doi:10.1080/03069880902956975 · Cited by 96
Mortazavi, S. S., Shahbazi, N., Taban, M., Alimohammadi, A., & Shati, M. (2021) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228211032736 · Cited by 86
“According to research, methods such as writing stories about losing the loved ones on the Internet can reduce the symptoms of people with unresolved grief and provide an opportunity to express their emotions (Wagner et al., 2006).”
MethodZuelke, A. E., Luppa, M., Löbner, M., Pabst, A., Schlapke, C., Stein, J., & Riedel-Heller, S. G. (2021) · JMIR Mental Health · doi:10.2196/29661 · Cited by 75
“Participants mainly reported the loss of a parent [38], relatives other than their partner (ie, child, sibling, or parent) [35], a child during pregnancy [33,34], a spouse [40,41], or a child [36,37,39].”
BackgroundMethodResultInfluentialA 1.5‐year follow‐up of an internet‐based intervention for complicated grief
Wagner, B., & Maercker, A. (2007) · Journal of Traumatic Stress · doi:10.1002/jts.20230 · Cited by 93
“625 Not much is known about the long-term outcomes of treatments for complicated grief or, more specifically, of Internet-based interventions.”
BackgroundMethodInfluentialSelf-citationRini, C. K., Williams, D. A., Broderick, J. E., & Keefe, F. J. (2012) · Translational Behavioral Medicine · doi:10.1007/s13142-011-0107-2 · Cited by 79
Efficacy of an integrative CBT for prolonged grief disorder: A long-term follow-up
Rosner, R., Bartl, H., Pfoh, G., Kotoučová, M., & Hagl, M. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.04.051 · Cited by 76
“Summarizing the above, our results reflect clinical reality, considering that patients were, on average, ten years older than for example those participating in trials with Internet-based interventions (e.g., Kersting et al., 2013; Wagner et al., 2006).”
BackgroundResultInfluentialEbert, D. D., Harrer, M., Apolinário-Hagen, J., & Baumeister, H. (2019) · Advances in Experimental Medicine and Biology · doi:10.1007/978-981-32-9721-0_29 · Cited by 76
Prolonged grief disorder: clinical utility of ICD-11 diagnostic guidelines
Mauro, C., Reynolds, C. F., Maercker, A. R. A., Skritskaya, N. A., Simon, N. M., Zisook, S., Lebowitz, B. D., Cozza, S. J., & Shear, M. K. (2018) · Psychological Medicine · doi:10.1017/s0033291718001563 · Cited by 80
“Diagnosis of persistent impairing grief is important because there is a strong evidence that this condition responds to targeted treatment (e.g. Wagner et al., 2006; Boelen et al., 2007; Rosner et al., 2011; Kersting et al., 2013; Bryant et al., 2014); summarized in (Shear, 2015).”
Self-citationSimblett, S. K., Birch, J., Matcham, F., Yágüez, L., & Morris, R. G. (2017) · JMIR Mental Health · doi:10.2196/mental.5558 · Cited by 74
“Of the six studies that were not included in the meta-analysis, four studies found a significant difference on all subscales representing dimensional symptoms of PTSD, including intrusions, avoidance, and hyperarousal, in favor of the treatment intervention [42,45,46,61].”
BackgroundMethodInfluentialComplicated grief therapy as a new treatment approach
Wetherell, J. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/jwetherell · Cited by 48
“The four interventions that were more efficacious than the comparison condition were all based, at least in part, on cognitive-behavioral principles.(14,24,45) An interpretive intervention focused on increasing clients’ insight about conflict and trauma related to their loss was not efficacious.”
BackgroundComplicated grief: recent developments in diagnostic criteria and treatment
Nakajima, S. (2018) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2017.0273 · Cited by 69
Complicated grief therapy for clinicians: An evidence‐based protocol for mental health practice
Iglewicz, A., Shear, M. K., Reynolds, C. F., Simon, N. M., Lebowitz, B. D., & Zisook, S. (2019) · Depression and Anxiety · doi:10.1002/da.22965 · Cited by 69
Herbst, N., Voderholzer, U., Thiel, N., Schaub, R., Knaevelsrud, C., Stracke, S., Hertenstein, E., Nissen, C., & Külz, A. K. (2014) · Psychotherapy and Psychosomatics · doi:10.1159/000357570 · Cited by 69
Self-citationWagner, B., Nagl, M., Dölemeyer, R., Klinitzke, G., Steinig, J., Hilbert, A., & Kersting, A. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.01.006 · Cited by 68
“This is comparable with other Internet-based mental health interventions (Kersting et al., 2013; Knaevelsrud & Maercker, 2007; Wagner et al., 2006).”
ResultRumination and implicit avoidance following bereavement: An approach avoidance task investigation
Eisma, M. C., Rinck, M., Stroebe, M. S., Schut, H. A. W., Boelen, P. A., Stroebe, W., & van den Bout, J. (2015) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2014.11.010 · Cited by 68
“…aimed at confronting bereaved individuals with emotionally over-whelming aspects of the loss, have been proven effective in reducing prolonged grief symptoms (e.g., Boelen, de Keijser, van den Hout, & van den Bout, 2007; Shear, Frank, Houck, & Reynolds, 2005; Wagner, Knaevelsrud, & Maercker, 2006).”
Pavlacic, J. M., Buchanan, E. M., Maxwell, N. P., Hopke, T. G., & Schulenberg, S. E. (2019) · Review of General Psychology · doi:10.1177/1089268019831645 · Cited by 81
Danaher, B. G., Milgrom, J., Seeley, J. R., Stuart, S., Schembri, C., Tyler, M. S., Ericksen, J., Lester, W., Gemmill, A. W., & Lewinsohn, P. (2012) · JMIR Research Protocols · doi:10.2196/resprot.2329 · Cited by 67
“It is important to note that encouraging results have also been reported for using Web-based CBT interventions for other mental health disorders including the treatment of panic disorder [43,44], post-traumatic stress disorder [45,46], and complicated grief [47].”
Smid, G., Kleber, R., de la Rie, S., Bos, J., Gersons, B., & Boelen, P. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.27324 · Cited by 62
“Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss.”
BackgroundMethodDiagnostic and clinical considerations in prolonged grief disorder
Maercker, A., & Lalor, J. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/amaercker · Cited by 52
“This involves a Web-based approach for eligible patients.(50) Demonstrating the association between PGD and PTSD, this approach also begins with a technique of self-confrontation similar to that used in Internet-based therapy of PTSD.”
MethodSelf-citationReitsma, L., Boelen, P. A., de Keijser, J., & Lenferink, L. I. M. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104286 · Cited by 64
“These findings are in line with prior RCTs demonstrating that online grief-specific CBT-based interventions lead to a significant decrease in disturbed grief, PTSD, and depression symptoms relative to waiting for treatment (Eisma et al., 2015; Kersting et al., 2013; Litz et al., 2014; Treml et al., 2021; Wagner et al.…”
BackgroundResultInfluentialBrodbeck, J., Berger, T., Biesold, N., Rockstroh, F., & Znoj, H. J. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.04.008 · Cited by 64
Complicated grief treatment: an evidence-based approach to grief therapy
Shear, M. K., & Gribbin Bloom, C. (2017) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-016-0242-2 · Cited by 69
“…demonstrated in three clinical trials as well as several studies using a closely related treatment (Boelen et al. 2007; Wagner and Maercker 2007; Wagner et al. 2006; Asukai et al. 2011; Rosner et al. 2011; Acierno et al. 2012; Kersting et al. 2013; Barbosa et al. 2014; Bryant et al. 2014;…”
Lechner‐Meichsner, F., Theurer, C., & Wilz, G. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22739 · Cited by 65
A Psychodynamic Perspective on a Systematic Review of Online Psychotherapy for Adults
Machado, D. D. B., Laskoski, P. B., Severo, C. T., Bassols, A. M. S., Sfoggia, A., Kowacs, C., Krieger, D. V., Torres, M. B., Gastaud, M. B., Wellausen, R. S., et al. (2016) · British Journal of Psychotherapy · doi:10.1111/bjp.12204 · Cited by 65
Treml, J., Nagl, M., Linde, K., Kündiger, C., Peterhänsel, C., & Kersting, A. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1926650 · Cited by 66
“…as confrontation and cognitive restructuring, which were demonstrated to be efficacious in reducing PGD symptoms (e.g. Boelen, De Keijser, Van Den Hout, & Van Den Bout, 2007; Shear, Frank, Houck, & Reynolds, 2005; Wagner et al., 2006), and could be especially helpful for people bereaved by suicide.”
BackgroundMethodInfluentialRisks for Complicated Grief in Family Caregivers
Ghesquiere, A., Haidar, Y. M. M., & Shear, M. K. (2011) · Journal of Social Work in End-of-Life & Palliative Care · doi:10.1080/15524256.2011.593158 · Cited by 62
“Wagner, Knaevelsrud, and Maercker ( 2006 ) compared an individualized 5-week Internet-based cognitive behavioral therapy for CG to a wait list control group.”
BackgroundEffectiveness of an inpatient group therapy for comorbid complicated grief disorder
Rosner, R., Lumbeck, G., & Geissner, E. (2011) · Psychotherapy Research · doi:10.1080/10503307.2010.545839 · Cited by 61
“However, they reported that 45% of patients met criteria for a current depressive episode and 49% of patients met criteria for PTSD. Wagner et al. (2006) likewise excluded patients with suicidality, severe depression, severe dissociative symptoms, and substance abuse.”
BackgroundResultInfluentialBoelen, P. A., de Keijser, J., van den Hout, M. A., & van den Bout, J. (2011) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.720 · Cited by 55
Complicated grief in patients with unipolar depression
Kersting, A., Kroker, K., Horstmann, J., Ohrmann, P., Baune, B. T., Arolt, V., & Suslow, T. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.01.033 · Cited by 55
How the Internet is changing the experience of bereavement by suicide: A qualitative study in the UK
Chapple, A., & Ziébland, S. (2010) · Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine · doi:10.1177/1363459309360792 · Cited by 55
Comparing the Effects of Three Online Cognitive Reappraisal Trainings on Well-Being
Ranney, R. M., Bruehlman-Senecal, E., & Ayduk, Ö. N. (2016) · Journal of Happiness Studies · doi:10.1007/s10902-016-9779-0 · Cited by 61
Wojtkowiak, J., Lind, J., & Smid, G. E. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.623835 · Cited by 69
Johansen, M. A., Berntsen, G., Schuster, T., Henriksen, E. K. K., & Horsch, A. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2216 · Cited by 56
“Patients receiving email therapy for complicated grief improved significantly relative to participants in the waiting list condition, and were quite satisfied with the treatment [65].”
BackgroundGrief Before and After Bereavement in the Elderly: An Approach to Care
Lechner‐Meichsner, F., O'Connor, M., Skritskaya, N. A., & Shear, M. K. (2020) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2019.12.010 · Cited by 60
An internet tool to normalize grief
Dominick, S. A., Irvine, A. B., Beauchamp, N., Seeley, J. R., Nolen-Hoeksema, S., Doka, K. J., & Bonanno, G. A. (2010) · OMEGA - Journal of Death and Dying · doi:10.2190/om.60.1.d · Cited by 53
Johansen, M. A., Henriksen, E. K. K., Horsch, A., Schuster, T., & Berntsen, G. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2214 · Cited by 54
“Table 3 presents the location of the patient at the time of communication and who the patient’s main communication partner was [44-75,78-80].”
BackgroundInnovative Moments in Grief Therapy: Reconstructing Meaning Following Perinatal Death
Alves, D., Mendes, I., Gonçalves, M. M., & Neimeyer, R. A. (2012) · Death Studies · doi:10.1080/07481187.2011.608291 · Cited by 51
Maercker, A., & Znoj, H. (2010) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v1i0.5558 · Cited by 57
“Results of a randomized treatment trial of web-based cognitive-behavioral therapy of CGD (Wagner et al., 2006; Wagner & Maercker, 2008).”
BackgroundSelf-citationRecent trends in the treatment of prolonged grief
Mancini, A., Griffin, P., & Bonanno, G. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32834de48a · Cited by 51
Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood
Barbosa, V., Sá, M., & Carlos Rocha, J. (2014) · Aging & Mental Health · doi:10.1080/13607863.2013.833164 · Cited by 47
Anxious and depressive avoidance behavior in post-loss psychopathology: a longitudinal study
Boelen, P. A., & Eisma, M. C. (2015) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2015.1004054 · Cited by 54
“…loss and revisiting scenes of the death as a means to curb anxious avoidance combined with graded activation to counter depressive avoidance have proven to be efficacious in the treatment of post-loss psychopathology (Boelen et al., 2007; Papa et al., 2013; Shear et al., 2005; Wagner et al., 2006).”
Background
Metadata
- Authors
- Wagner, B., Knaevelsrud, C., & Maercker, A.
- Affiliations
- University of Zurich (CH)
- Corresponding author
- Wagner, Birgit
- Venue
- Death Studies
- Publisher
- Informa UK Limited
- Published
- 2006-06
- Volume
- 30
- Issue
- 5
- Pages
- 429-453
- ISSN
- 0748-1187 (ISSN-L)
- 1091-7683
- OpenAlex
- W2018552270
- Cited by
- 376
- References
- 63
- Citations by year
- 2026: 5 · 2025: 17 · 2024: 18 · 2023: 18 · 2022: 17 · 2021: 20 · 2020: 25 · 2019: 13 · 2018: 16 · 2017: 25 · 2016: 19 · 2015: 24 · 2014: 18 · 2013: 21 · 2012: 22
- FWCI
- 16.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Death Studies (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Keywords
- complicated grief, internet-based cognitive behavioral therapy, bereavement, cognitive reappraisal, avoidance, depression, anxiety, maintenance of treatment effects
- MeSH terms
- Adaptation, Psychological, Austria, Behavior Therapy, Germany, Grief, Humans, Switzerland, Therapy, Computer-Assisted, Treatment Outcome, Internet, Electronic Mail
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