Cited by 376Grief, Bereavement, and Mental HealthDigital Mental Health InterventionsDeath, Funerary Practices, and Mourning

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Internet-Based Cognitive-Behavioral Therapy for Complicated Grief: A Randomized Controlled Trial

Wagner, Birgit, Knaevelsrud, Christine, Maercker, Andreas·2006·Death Studies

DOI 10.1080/07481180600614385

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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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BackgroundSelf-citation
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“Weitere Studien liegen u. a. für Essstörungen (Carrard et al. 2011), pathologisches Glücksspiel (Carlbring und Smit 2008), komplizierte Trauer (Wagner et al. 2006), stoffgebundene Abhängigkeiten (Tossmann et al. 2011) und posttraumatische Belastungsstörungen (Kuester et al. 2016) sowie für…”
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Narrative Approaches with Older Adults
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“based intervention to complicated grief, (Wagner et al. 2006) offered clients (average age = 37 years old) carefully tailored writing assignments, with therapist feedback to assist them to embellish a self-narrative that assimilated and accommodated loss.”
Background
Complicated Grief in Rural Appalachia: Using Feminist Theory to Reconcile Grief
Darrow, N. E. T., & Gibbons, M. M. (2019) · Journal of Mental Health Counseling · doi:10.17744/mehc.41.4.02 · Cited by 3
Effectiveness and feasibility of internet-based and mobile-based interventions for individuals experiencing bereavement: a systematic review protocol
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The Relationship Between Working Alliance and Treatment Outcome in an Internet-Based Grief Therapy for People Bereaved by Suicide
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Bodner, E., Mikulincer, M., McMahon, E., & Rizzo, A. (2024) · Frontiers in Virtual Reality · doi:10.3389/frvir.2024.1438663 · Cited by 3
“…documented to be effective in decreasing avoidant behaviors due to traumatic memories related to losses, in increasing the expression of feelings and thoughts about the deceased (Simon, 2013), and in enhancing repeated exposures to the story of the death (Wagner et al., 2006; Boelen et al., 2007).”
Background
Family Bereavement Care in Pediatric Oncology
Lövgren, M., & Sveen, J. (2017) · Pediatric oncology · doi:10.1007/978-3-319-61391-8_12 · Cited by 3
Integrative kognitive Verhaltenstherapie für die anhaltende Trauerstörung: Vorstellung eines Behandlungsmanuals
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“Zum Schluss soll der Patient überlegen, was er einem konkreten oder imaginären Freund, der auch eine geliebte Person verloren hat, hinsichtlich seiner Trauer erzählen würde (Social Sharing [vgl. Wagner et al., 2006]).”
Background
New Technologies in the Treatment of Psychological Disorders – Overview, Potentials and Barriers for Conflict-Affected Populations
Stein, J., & Knaevelsrud, C. (2018) · Springer eBooks · doi:10.1007/978-3-319-97046-2_19 · Cited by 3
Self-citation
Grief
Papa, A., & Litz, B. T. (2010) · Springer eBooks · doi:10.1007/978-1-4419-6510-3_12 · Cited by 4
The End of All Tears: A Dynamic Interdisciplinary Analysis of Mourning and Complicated Grief With Suggested Applications for Clinicians
Goodwyn, E. D. (2015) · Journal of Spirituality in Mental Health · doi:10.1080/19349637.2015.1047919 · Cited by 5
Unravelling The Cause and Consequences of Post Traumatic Stress Disorder: A Comprehensive Review
-, A. V., Malik, P. R., & -, P. P. (2024) · International Journal For Multidisciplinary Research · doi:10.36948/ijfmr.2024.v06i04.24769 · Cited by 4
“Interventions designed specifically for PTSD patients have been proven to significantly reduce PTSD symptoms as well as related psychopathology, such as depression and anxiety (Wagner et al., 2006; Benight et al., 2008).”
Background
Perinatal Grief in the Indian Context: Conceptualizing and Companioning the Grieving Process
Devendran, Y., Saravanan, V., Satyanarayana, V. A., S., S. C., Devi, G., & Desai, G. (2025) · Journal of Psychiatry Spectrum · doi:10.4103/jopsys.jopsys_85_24 · Cited by 2
Expressive Writing for Grief: A Meta-Analysis of Randomized Controlled Trials
Yao, D., Xu, S., Liu, J., Gai, Y., & Li, J. (2025) · Research on Social Work Practice · doi:10.1177/10497315251371566 · Cited by 3
“…studies report con ﬂ icting results: while several studies report moderate to high effects of EW (Kaiser et al., 2022; Kersting et al., 2013; Wagner et al., 2006), others indicate small or no signi ﬁ cant effect (Lichtenthal & Cruess, 2010; O ’ Connor et al., 2003; van der Houwen et al.,…”
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Neue Medien für die Intervention bei Traumafolgestörungen
Wagner, B., & Maercker, A. (2009) · Springer eBooks · doi:10.1007/978-3-211-72015-8_7 · Cited by 4
Self-citation
Systems Engineering and Health Informatics
Pasupathy, K. S. (2011) · IGI Global eBooks · doi:10.4018/978-1-60960-561-2.ch606 · Cited by 2
Klinisch-psychologische Intervention im Internet Review zu empirischen Befunden störungsspezifischer Angebote
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O’Day, E. B., & Goetter, E. M. (2017) · Springer eBooks · doi:10.1007/978-3-319-65241-2_12 · Cited by 3
Wirksamkeit von Trauerinterventionen
Wagner, B. (2013) · Springer eBooks · doi:10.1007/978-3-642-37359-6_4 · Cited by 1
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Belastungs- und Traumafolgestörungen
Maercker, A. R. A. (2014) · Springer eBooks · doi:10.1007/978-3-642-54723-2_9 · Cited by 2
Self-citation
Unguided online treatment of disturbed grief, posttraumatic stress, and depression in adults bereaved during the COVID-19 pandemic: a randomized controlled trialPreprint
Reitsma, L., Boelen, P. A., de Keijser, J., & Lenferink, L. I. M. (2022) · doi:10.31234/osf.io/8xb5h · Cited by 2
Influence of Coping Styles on Social Support Seeking Among Cancer Patient Family Caregivers
Rankin, S. R. (2011) · ProQuest Demo Repository · Cited by 2
Yas Sürecinde Uygulanan Psikolojik Müdahale Yaklaşımlarının Doküman Analizi İle İncelenmesi
KIZILTAN, E., & ULUSOY, Y. (2022) · Humanistic Perspective · doi:10.47793/hp.998187 · Cited by 1
The change of working alliance and the association to treatment outcome in an internet-based therapy after pregnancy loss
Kramuschke, M., Reinhardt, J., Dölemeyer, R., Kaiser, J., & Kersting, A. (2024) · BMC Psychology · doi:10.1186/s40359-024-01751-4 · Cited by 2
“The internet-based intervention was later adapted for prolonged grief [52] and could achieve a reduction of prolonged grief within a medium effect size (Cohen’s d = 0.52).”
BackgroundInfluential
Grief and Posttraumatic Growth in Individuals Who Have Experienced the Death of a Loved One From Six Latin American Countries: The Moderating Role of Gender and Age
Caycho‐Rodríguez, T., Sánchez‐Villena, A. R., Baños-Chaparro, J., Ventura‐León, J., Vilca, L. W., Carbajal‐León, C., Valencia, P. D., Reyes-Bossio, M. A., Yupanqui-Lorenzo, D. E., Travezaño-Cabrera, A., et al. (2025) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228251333838 · Cited by 1
Spring PGD versus waiting list control in the treatment of prolonged grief disorder (PGD): protocol for a feasibility randomised controlled trial (RCT)
Lewis, C., Smalley, M., Phillips, D. M., Snell, G. D., Thomas, B., Yun, J. W. S., & Bisson, J. I. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2554031 · Cited by 1

Authors: Wagner, B., Knaevelsrud, C., & Maercker, A.
Affiliations: University of Zurich (CH)
Corresponding author: Wagner, Birgit
ORCID: Wagner, Birgit
Knaevelsrud, Christine
Venue: Death Studies
Publisher: Informa UK Limited
Published: 2006-06
Volume: 30
Issue: 5
Pages: 429-453
ISSN: 0748-1187 (ISSN-L)
1091-7683
DOI: 10.1080/07481180600614385
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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Internet-Based Cognitive-Behavioral Therapy for Complicated Grief: A Randomized Controlled Trial

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