Cited by 91Grief, Bereavement, and Mental HealthSuicide and Self-Harm StudiesDeath, Funerary Practices, and Mourning

Cognitive behaviour therapy to prevent complicated grief among relatives and spouses bereaved by suicide: cluster randomised controlled trial

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de Groot, Marieke, de Keijser, Jos, Neeleman, Jan, Kerkhof, Ad, Nolen, Willem, Burger, Huibert·2007·BMJ

Abstract

OBJECTIVE: To examine the effectiveness of a family based grief counselling programme to prevent complicated grief among first degree relatives and spouses of someone who had committed suicide. DESIGN: Cluster randomised controlled trial with follow-up at 13 months after the suicide. SETTING: General practices in the Netherlands. PARTICIPANTS: 122 first degree relatives and spouses of 70 people who committed suicide; 39 families (68 participants) were allocated to intervention, 31 families (54 participants) to control. INTERVENTION: A family based, cognitive behaviour counselling programme of four sessions with a trained psychiatric nurse counsellor between three to six months after the suicide. Control participants received usual care. MAIN OUTCOME MEASURES: Self report complicated grief. Secondary outcomes were the presence of maladaptive grief reactions, depression, suicidal ideation, and perceptions of being to blame for the suicide. RESULTS: The intervention was not associated with a reduction in complicated grief (mean difference -0.61, 95% confidence interval -6.05 to 4.83; P=0.82). Secondary outcomes were not affected either. When adjusted for baseline inequalities, the intervention reduced the risk of perceptions of being to blame (odds ratio 0.18, 0.05 to 0.67; P=0.01) and maladaptive grief reactions (0.39, 0.15 to 1.01; P=0.06). CONCLUSIONS: A cognitive behaviour grief counselling programme for families bereaved by suicide did not reduce the risk of complicated grief or suicidal ideation or the level of depression. The programme may help to prevent maladaptive grief reactions and perceptions of blame among first degree relatives and spouses. TRIAL REGISTRATION: Current Controlled Trials ISRCTN66473618.

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  1. Prigerson HG, Shear MK, Jacobs SC, Reynolds CF, Maciejewski PK, Davidson JR, et al. Consensus criteria for traumatic grief. Br J Psychiatry 1999;174:67-73.
  2. Huber PJ. Robust statistics: a review. Ann Stat 1972;43:1041.

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Authors
de Groot, M., de Keijser, J., Neeleman, J., Kerkhof, A., Nolen, W., & Burger, H.
Affiliations
  • University of Groningen (NL)
  • Vrije Universiteit Amsterdam (NL)
Venue
BMJ
Publisher
BMJ
Published
2007-04-20
Volume
334
Issue
7601
Pages
994
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
OpenAlex
W2152954500
Cited by
91
References
25
Citations by year
2026: 2 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 7 · 2021: 1 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 3 · 2013: 4 · 2012: 8
FWCI
7.28
Type
journal article
Language
en
Open access
Locations
  • BMJ (publishedVersion, other-oa)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (acceptedVersion, other-oa)
  • Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders
ZonMw
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
Keywords
complicated grief, suicide bereavement, family bereavement, cognitive behavioral therapy, grief counseling, suicidal ideation, depression
MeSH terms
Adult, Aged, Counseling, Female, Grief, Humans, Male, Middle Aged, Suicide, Cognitive Behavioral Therapy, Treatment Outcome, Spouses

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