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Cited by 107Grief, Bereavement, and Mental HealthDeath, Funerary Practices, and MourningSuicide and Self-Harm Studies

Grief interventions for people bereaved by suicide: a systematic review

Open access
Linde, Katja, Treml, Julia, Steinig, Jana, Nagl, Michaela, Kersting, Anette·2017·PLoS ONE
DOI 10.1371/journal.pone.0179496PMC PMC5482439
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Abstract

BACKGROUND: Adaption to the loss of a loved one due to suicide can be complicated by feelings of guilt, shame, responsibility, rejection, and stigmatization. Therefore people bereaved by suicide have an increased risk for developing complicated grief which is related to negative physical and mental disorders and an increased risk for suicidal behavior. Grief interventions are needed for this vulnerable population. The aim of this systematic review was to provide an overview of the current state of evidence concerning the effectiveness of interventions that focus on grief for people bereaved by suicide. METHODS: We conducted a systematic literature search using PubMed, Web of Science, and PsycINFO for articles published up until November 2016. Relevant papers were identified and methodological quality was assessed by independent raters. A narrative synthesis was conducted. RESULTS: Seven intervention studies met the inclusion criteria. Two interventions were based on cognitive-behavioral approaches, four consisted of bereavement groups, and one utilized writing therapy. As five of the seven interventions were effective in reducing grief intensity on at least one outcome measure, there is some evidence that they are beneficial. Bereavement groups tend to be effective in lowering the intensity of uncomplicated grief, as are writing interventions in lowering suicide-specific aspects of grief. Cognitive-behavioral programs were helpful for a subpopulation of people who had high levels of suicidal ideation. LIMITATION: On average, methodological quality was low so the evidence for benefits is not robust. The stability of treatment effects could not be determined as follow-up assessments are rare. Generalizability is limited due to homogeneous enrollments of mainly female, white, middle-aged individuals. CONCLUSIONS: People bereaved by suicide are especially vulnerable to developing complicated grief. Therefore, grief therapies should be adapted to and evaluated in this population. Prevention of complicated grief may be successful in populations of high risk individuals.

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Crossref · 10.1371/journal.pone.0179496

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  • Group therapy is effective in reducing the intensity of uncomplicated grief.

    “Group therapy is effective in reducing the intensity of uncomplicated grief”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Linde et al., 2017

    The Abstract (Results; page unavailable) says bereavement groups “tend to be effective” in lowering uncomplicated grief intensity among people bereaved by suicide. But Results (Study findings; page unavailable) describes mixed findings, including studies with no significant advantage over active comparison groups. The claim omits both that uncertainty and the population studied. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Cognitive behavioral programs proved useful for a subgroup of people with complicated grief with high levels of suicidal ideation.

    “Cognitive behavioral programs proved useful for a subgroup of people with complicated grief with high levels of suicidal ideation (Linde, Treml, Steinig, Nagl, & Kersting, 2017).”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Linde et al., 2017

    The Discussion reports that a cognitive-behavioral intervention helped prevent complicated grief in a subgroup of people bereaved by suicide who had high suicidal ideation. It does not show that the program treated people already experiencing complicated grief; the Discussion says none of the included studies evaluated interventions for that group. The finding also came from a preliminary post-hoc subgroup analysis, rather than evidence that cognitive-behavioral programs generally proved useful. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • CBT for PGT is effective for the subgroup of people with high levels of suicidal ideation.

    “-Effective for subgroup of people with high levels of suicidal ideation (Linde et al., 2017).”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Linde et al., 2017

    The Results and Discussion report that a CBT-based grief intervention reduced clinically diagnosed complicated grief among suicide-bereaved participants with suicidal ideation. The paper describes this as prevention of complicated grief, not established treatment for PGT, and cautions that the subgroup finding came from a post-hoc analysis requiring replication. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Bereavement groups are effective for de-escalating uncomplicated grief.

    “-They are effective for de-escalating uncomplicated grief (Linde et al., 2017).”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Linde et al., 2017

    The Abstract’s Results say bereavement groups *tend* to lower the intensity of uncomplicated grief among people bereaved by suicide. The Results > Study findings section calls the findings mixed, with two studies finding no significant difference from active comparison groups. The claim omits that uncertainty and states effectiveness categorically. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Intervention evidence suggests potential benefits of group-based and psychosocial approaches for some suicide-bereaved individuals, while the overall evidence base remains heterogeneous and methodologically uneven.

    “This dovetails with intervention evidence suggesting potential benefits of group-based and psychosocial approaches for some suicide-bereaved individuals, while also highlighting that the overall evidence base remains heterogeneous and methodologically uneven (Linde et al., 2017;McDaid et al., 2008).”

    From Relational and Institutional Disenfranchisement in Suicide Bereavement: A Qualitative Meta-Synthesis of Family Members' Experiences (2026) · cites this paper as Linde et al., 2017

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Research works printed but not linked: 1

  1. [59]Sanders CM, Mauger PA, Strong PN. A manual for the Grief Experience Inventory. Consulting Psychologists Press; 1985.

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Authors
Linde, K., Treml, J., Steinig, J., Nagl, M., & Kersting, A.
Affiliations
Leipzig University (DE)
Corresponding author
Kersting, Anette
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2017-06-23
Volume
12
Issue
6
Pages
e0179496
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0179496
PMC
PMC5482439
OpenAlex
W2702460881
Cited by
107
References
74
Citations by year
2026: 6 · 2025: 10 · 2024: 16 · 2023: 15 · 2022: 15 · 2021: 14 · 2020: 15 · 2019: 11 · 2018: 4 · 2017: 1
FWCI
1.30
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
Deutsche Forschungsgemeinschaft
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Keywords
complicated grief, suicide bereavement, grief intervention, bereavement groups, therapeutic writing, cognitive behavioral therapy, suicidal ideation, guilt and shame
MeSH terms
Grief, Humans, Social Support, Suicide, Writing, Cognitive Behavioral Therapy

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