Prolonged Grief: Psychotherapy vs. Control

Soledad Quero , Sara Fernández-Buendia , Jorge Grimaldos , Laura de la Coba-Cañizares , Clara Miguel

General Description

The grief-psyctr dataset is a meta-analytic research domain (MARD) which is part of the Metapsy project. The dataset contains study information and effect size data of randomized trials on psychological interventions for prolonged grief across all age groups. The date of the last search update is provided here.

This dataset includes psychological interventions (CBT, writing therapy, dual-process model treatment, psychoeducational interventions, etc) vs. control comparisons (e.g., waitlist, care as usual, other inactive controls). Effect sizes are provided for grief symptoms at post-test. When multiple instruments for complicated grief symptoms were reported within a study, one was selected based on the most frequently reported outcomes across the trials.

The dataset follows the Metapsy data standard. All included information has been independently extracted two researchers. Risk of bias ratings were conducted using the Cochrane Collaboration Risk of Bias Tool (Version 2).


Affiliated Institutions

Universitat Jaume I, Vrije Universiteit Amsterdam


Online Meta-Analysis Tool

A simplified version of this database can be analyzed at metapsy.org/database/grief.


Metadata

  • metapsyData Shorthand: grief-psyctr
  • Number of Studies: 35
  • Latest Version: 25.0.4
  • Last updated: May 28, 2025
  • Last search: September 1, 2023
  • Search String (Latest Version): ↗
  • Data Repository (Latest Version): ↗
  • Preregistration (Research Domain): ↗
  • License: ODC-By v1.0 ↗
  • Database DOI:

  • Version 25.0.4 (May 28, 2025):
  • Version 25.0.3 (May 28, 2025):
  • Version 25.0.2 (May 28, 2025):
  • Version 25.0.1 (May 28, 2025):

Variable Description

VariableDescription
studyAuthor and year of publication
Comparisonall are psychotherapy vs control (psy vs ctr)
condition_arm1cbt = Cognitive Behavior Therapy. In CBT the therapists focus on the impact that a patient’s present dysfunctional thoughts have on current behavior and future functioning. CBT is aimed at evaluating, challenging and modifying a patient’s dysfunctional beliefs (cognitive restructuring). It also includes behavioral techniques such as exposure or problem solving. In this form of treatment, the therapist mostly emphasizes homework assignments and outside-of-session activities. Therapists exert an active influence over therapeutic interactions and topics of discussion, use a psycho educational approach, and teach patients new ways of coping with stressful situations. The most used subtypes are CBT according to Beck’s manual (Beck et al., 1979) and the “Coping with Depression” course (Lewinsohn et al., 1984).; Writ = Writing therapy. Telling stories and writing narratives are seen as acceptable ways of reporting experiences in many cultures, and both are key elements of well-established interventions for PTSD and PG in children and adolescents (Cohen & Mannarino, 2004; Cohen, Mannarino, & Deblinger, 2006; Neuner et al., 2008). Writing is also one treatment strategy for PGD in adults (Rosner, Pfoh, & Kotoučová, 2011). According to Pennebaker (1997), writing therapy is based on the theory of inhibition and disclosure which indicates that disclosing stress emotionally reduces stress and improves the person’s well-being. Moreover, it enables thoughts and feelings to be integrated, leading to a reduction in the negative feelings associated with the stressful experience (Barbosa et al., 2014). It consists of writing narratives to relate experiences. One example is INTHERAPY (Lange et al., 2002).; dpm = Dual-Process Model treatment. This treatment is based on the Dual-Process Model of coping with bereavement (Stroebe and Shut, 1999, 2015) and has two main axes of intervention: loss and restoration coping. These interventions suggest that bereavement should not only address emotional distress and other factors associated with the loss (e.g. coping with painful emotions and acceptance of the loss) but also aspects associated with the person's recovery (e.g. return to work, coping with legal difficulties, financial difficulties, acquiring new roles, social relationships...). other psy = other types of psychological interventions that did not fit in the previous categories and did not have enough presence to form a subgroup
condition_arm2wl= waiting list control; tau= treatment as usual control; other ctrl= other types of (inactive) control conditions
multi_arm1In multiarm trials, this variable provides a specification of the type of treatment used in the first arm. This variable is set to NA (missing) when the study was not a multiarm trial. For example, if a multiarm trial employed two types of CBT interventions, face-to-face and Internet-based, this variable would be set to f2f and Internet, respectively.
multi_arm2In multiarm trials, this variable provides a specification of the type of treatment used in the second arm. This variable is set to NA (missing) when the study was not a multiarm trial. For example, if a multiarm trial employed two types of control groups, waitlist and placebo, this variable would be set to wl and plac, respectively. Typically, multiarm trials employ two or more active treatments (e.g. CBT and problem-solving therapy), which are compared to the same control group (e.g. a waitlist). This means that values in multi_arm2 do not differ (e.g. they are always wl for this specific multiarm trial); nevertheless, the variable should be specified in the dataset.
other psy specifiedMore detailed description of "other psy"
instrumentThis variable describes the instrument through which the relevant outcome was measured.
outcome_typeThis variable encodes the type of outcome that builds the basis of the comparison, e.g. response, remission or deterioration. This is variable is particularly relevant for dichotomous effect size data, because it indicates what the event counts refer to. The msd factor level is typically used for outcomes expressed in means and standard deviations.
mean_arm1Mean of the outcome in the first arm at the measured time point.
sd_arm1Standard deviation of the outcome in the first arm at the measured time point.
n_arm1Sample size in the first trial arm.
mean_arm2Mean of the outcome in the second arm at the measured time point.
sd_arm2Standard deviation of the outcome in the second arm at the measured time point.
n_arm2Sample size in the second trial arm.
event_arm1Number of events (responders, remission, deterioration cases) in the first trial arm
event_arm2Number of events (responders, remission, deterioration cases) in the second trial arm
totaln_arm1Total number of participants arm 1 (event data)
totaln_arm2Total number of participants arm 2 (event data)
precalc_gThe pre-calculated value of Hedges' g (small-sample bias corrected standardized mean difference; Hedges, 1981).
precalc_g_seStandard error of g
dropout_arm1Attrition arm 1
rand_arm1Randomized participants arm 1
dropout_arm2Attrition arm 2
rand_arm2Randomized participants arm 2
other_statOther statistics used for calculating the effect size
Grief measureDescription of instrument in detail
yearYear of study publication
age_group1 = children/adolescents; 2= adults; 3= older adults
meanageAverage age
propwomen% of women at baseline
recr1 = Community (If (a part of) the participants are recruited through announcements in newspapers, radio, tv, social media, flyers, etc., and participate as volunteers in the study, the study is rated as “community recruitment”. Basically, people have to take action themselves for participating in the study. This type of recruitment can be conducted in the general population, but also in more selected populations, such as university students, or patient groups.); 2= Other/NR (Other recruitment methods (which are not community), such as clinical recruitment, systematic screening, recruitment from known patients in general medical settings, etc. If the recruitment method is not described in the paper (which happens occasionally) that is also rated as “other”)
diag1= Grief symptoms (hgh baseline grief symptomatology); 2= Cut-off score (Participants score above a cut-off score on a self-rating grief questionnaire, such as the ICG or the PG-13.); 3= Other (1) Temporal criteria (e. g. X months since the loved one has died), 2) there is no information on any criteria, 3) another measure other than grief is used (depression, anxiety, etc.). (Specify the criteria in comments). 4) PGD according to ICD-11 criteria (minimum 6 months post-loss). 5) If the diagnosis method is not described in the paper).
type_death1= natural death; 2= unnatural death; 3= Both natural/unnatural or not specified
relation_deceased1= parents; 2= couple; 3= mixed (2 or more of: family, friends, child, parents, couple and other relatives)/ a single category that is neither a (1) parents or (2) couple (for example only children)/ relation to the deceased is not described in the paper
time since loss (months)Time since loss in months
format1= Individual treatment; 2= Group; 3= Guided self-help; 4= Unguided self-help; 5= Other formats or mixed formats
nsess_contThe number of sessions is the number of planned sessions, but when the realized number of sessions is given this is preferred. Only full numbers are given (no decimals).
country1= US; 2= Europe; 3= Other
rob1= low risk; 2= some concerns; 3= high risk
ratingThis variable encodes if the measured outcome was self-reported ("self-report") or clinician-rated ("clinician").
timeThe measurement point at which the outcome was obtained (e.g. post or follow-up).
time_weeksThe measurement point at which the outcome was obtained, in weeks after randomization (set to NA if this information was not available).
.idmetapsyTools generated variable: Unique identifier for a trial arm comparison/row.
full_refFull reference of the study
.gmetapsyTools generated variable: Calculated effect size (Hedges' g).
.g_semetapsyTools generated variable: Standard error of Hedges' g.
.log_rrmetapsyTools generated variable: Calculated effect size (logeRR).
.log_rr_semetapsyTools generated variable: Standard error of logeRR.
.event_arm1metapsyTools generated variable: Number of events (responders, remission, deterioration cases) in the first trial arm.
.event_arm2metapsyTools generated variable: Number of events (responders, remission, deterioration cases) in the second trial arm.
.totaln_arm1metapsyTools generated variable: Total sample size in the first trial arm.
.totaln_arm2metapsyTools generated variable: Total sample size in the second trial arm.


Study References

  • Andrade et al. (2016): Andrade, A. S., Moreira, M., Sá, M., Pacheco, D., Almeida, V., & Rocha, J. C. (2017). Randomized controlled trial of a cognitive narrative crisis intervention for bereavement in primary healthcare. Behavioural and Cognitive Psychotherapy, 45(1), 85-90.
  • Barbosa et al. (2014): Barbosa, V., Sá, M., & Carlos Rocha, J. (2014). Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood. Aging & Mental Health, 18(3), 354-362.
  • Buck et al. (2020): Buck, H. G., Cairns, P., Emechebe, N., Hernandez, D. F., Mason, T. M., Bell, J., ... & Tofthagen, C. (2020). Accelerated resolution therapy: Randomized controlled trial of a complicated grief intervention. American Journal of Hospice and Palliative Medicine®, 37(10), 791-799.
  • Dominick et al. (2009): Dominick, S. A., Irvine, A. B., Beauchamp, N., Seeley, J. R., Nolen-Hoeksema, S., Doka, K. J., & Bonanno, G. A. (2010). An internet tool to normalize grief. OMEGA-Journal of Death and Dying, 60(1), 71-87.
  • Eisma et al. (2015): Eisma, M. C., Boelen, P. A., van den Bout, J., Stroebe, W., Schut, H. A., Lancee, J., & Stroebe, M. S. (2015). Internet-based exposure and behavioral activation for complicated grief and rumination: A randomized controlled trial. Behavior therapy, 46(6), 729-748.
  • García et al. (2014): García, J. A., Landa, V., Grandes, G., Pombo, H., & Mauriz, A. (2013). Effectiveness of “primary bereavement care” for widows: a cluster randomized controlled trial involving family physicians. Death Studies, 37(4), 287-310.
  • Goodkin et al. (1999): Goodkin, K., Blaney, N. T., Feaster, D. J., Baldewicz, T., Burkhalter, J. E., & Leeds, B. (1999). A randomized controlled clinical trial of a bereavement support group intervention in human immunodeficiency virus type 1–seropositive and–seronegative homosexual men. Archives of General Psychiatry, 56(1), 52-59.
  • Groot et al. (2007): de Groot, M., de Keijser, J., Neeleman, J., Kerkhof, A., Nolen, W., & Burger, H. (2007). Cognitive behaviour therapy to prevent complicated grief among relatives and spouses bereaved by suicide: cluster randomised controlled trial. Bmj, 334(7601), 994.
  • Johansen et al. (2022): Johannsen, M., Schlander, C., Farver-Vestergaard, I., Lundorff, M., Wellnitz, K. B., Komischke-Konnerup, K. B., & O'Connor, M. (2022). Group-based compassion-focused therapy for prolonged grief symptoms in adults–Results from a randomized controlled trial. Psychiatry Research, 314, 114683.
  • Kaiser et al. (2022): Kaiser, J., Nagl, M., Hoffmann, R., Linde, K., & Kersting, A. (2022). Therapist-assisted web-based intervention for prolonged grief disorder after cancer bereavement: Randomized controlled trial. JMIR mental health, 9(2), e27642.
  • Kalantari et al. (2012): Kalantari, M., Yule, W., Dyregrov, A., Neshatdoost, H., & Ahmadi, S. J. (2012). Efficacy of writing for recovery on traumatic grief symptoms of Afghani refugee bereaved adolescents: A randomized control trial. OMEGA-Journal of death and dying, 65(2), 139-150.
  • Kovac & Lilian (2000).: Kovac, S. H., & Range, L. M. (2000). Writing projects: Lessening undergraduates' unique suicidal bereavement. Suicide and Life‐Threatening Behavior, 30(1), 50-60.
  • Lenferink et al. (2020): Lenferink, L. I. M., Eisma, M. C., Buiter, M. Y., de Keijser, J., & Boelen, P. A. (2023). Online cognitive behavioral therapy for prolonged grief after traumatic loss: a randomized waitlist-controlled trial. Cognitive behaviour therapy, 52(5), 508-522. doi:doi:10.1080/16506073.2023.2225744
  • Lenferink et al. (2023): Lenferink, L. I., de Keijser, J., Smid, G. E., & Boelen, P. A. (2020). Cognitive therapy and EMDR for reducing psychopathology in bereaved people after the MH17 plane crash: Findings from a randomized controlled trial. Traumatology, 26(4), 427.
  • Lichtenthal & Cruess (2010): Lichtenthal, W. G., & Cruess, D. G. (2010). Effects of directed written disclosure on grief and distress symptoms among bereaved individuals. Death Studies, 34(6), 475-499.
  • Litz et al. (2014): Litz, B. T., Schorr, Y., Delaney, E., Au, T., Papa, A., Fox, A. B., ... & Prigerson, H. G. (2014). A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder. Behaviour research and therapy, 61, 23-34.
  • Mawson et al. (1981): Mawson, D., Marks, I. M., Ramm, L., & Stern, R. S. (1981). Guided mourning for morbid grief: A controlled study. The British Journal of Psychiatry, 138(3), 185-193.
  • McGuiness et al. (2015): McGuinness, B., Finucane, N., & Roberts, A. (2015). A hospice-based bereavement support group using creative arts: an exploratory study. Illness, Crisis & Loss, 23(4), 323-342.
  • Mutedzi et al. (2023): Mutedzi, B., Nkhoma, K., Langhaug, L., Hunt, J., & Harding, R. (2023). Improving bereavement outcomes in Zimbabwe: results of a feasibility cluster trial of the 9-cell bereavement tool. Pilot and feasibility studies, 9(1). doi:doi:10.1186/s40814-023-01313-2
  • O'Connor et al. (2003): O'Connor, M., Nikoletti, S., Kristjanson, L. J., Loh, R., & Willcock, B. (2003). Writing therapy for the bereaved: Evaluation of an intervention. Journal of palliative medicine, 6(2), 195-204.
  • Park & Cha (2023): Park, S. R., & Cha, Y. J. (2023). Effects of online group art therapy on psychological distress and quality of life after family bereavement: In COVID-19 pandemic. Arts in Psychotherapy, 82. doi:doi:10.1016/j.aip.2022.101972
  • Range et al. (2000): Range, M., Stacey H. Kovac, Michelle S. Marion, L. (2000). Does writing about the bereavement lessen grief following sudden, unintentional death?. Death studies, 24(2), 115-134.
  • Reitsma et al. (2023): Reitsma, L., Boelen, P. A., de Keijser, J., & Lenferink, L. I. M. (2023). Self-guided online treatment of disturbed grief, posttraumatic stress, and depression in adults bereaved during the COVID-19 pandemic: A randomized controlled trial. Behaviour Research and Therapy, 163. doi:doi:10.1016/j.brat.2023.104286
  • Rosner et al. (2014): Rosner, R., Pfoh, G., Kotoučová, M., & Hagl, M. (2014). Efficacy of an outpatient treatment for prolonged grief disorder: A randomized controlled clinical trial. Journal of Affective Disorders, 167, 56-63.
  • Sandler et al. (2010): Sandler, I. N., Ma, Y., Tein, J. Y., Ayers, T. S., Wolchik, S., Kennedy, C., & Millsap, R. (2010). Long-term effects of the family bereavement program on multiple indicators of grief in parentally bereaved children and adolescents. Journal of consulting and clinical psychology, 78(2), 131.
  • Shear et al. (2016): Shear, M. K., Reynolds, C. F., Simon, N. M., Zisook, S., Wang, Y., Mauro, C., ... & Skritskaya, N. (2016). Optimizing treatment of complicated grief: A randomized clinical trial. JAMA psychiatry, 73(7), 685-694.
  • Sikkema et al. (2004, 2006): Sikkema, K. J., Hansen, N. B., Kochman, A., Tate, D. C., & Difranceisco, W. (2004). Outcomes from a randomized controlled trial of a group intervention for HIV positive men and women coping with AIDS-related loss and bereavement. Death studies, 28(3), 187-209.
  • Supiano & Luptak (2013): Supiano, K. P., & Luptak, M. (2014). Complicated grief in older adults: A randomized controlled trial of complicated grief group therapy. The Gerontologist, 54(5), 840-856.
  • Thurman et al. (2017): Thurman, T. R., Luckett, B. G., Nice, J., Spyrelis, A., & Taylor, T. M. (2017). Effect of a bereavement support group on female adolescents' psychological health: a randomised controlled trial in South Africa. The Lancet Global Health, 5(6), e604-e614.
  • Treml et al. (2021): Treml, J., Nagl, M., Linde, K., Kündiger, C., Peterhänsel, C., & Kersting, A. (2021). Efficacy of an Internet-based cognitive-behavioural grief therapy for people bereaved by suicide: a randomized controlled trial. European journal of psychotraumatology, 12(1), 1926650.
  • Unterhitzenberger & Rosner (2014): Unterhitzenberger, J., & Rosner, R. (2014). Lessons from writing sessions: A school-based randomized trial with adolescent orphans in Rwanda. European Journal of Psychotraumatology, 5(1), 24917.
  • Van der Houwen et al. (2010): van der Houwen, K., Schut, H., van den Bout, J., Stroebe, M., & Stroebe, W. (2010). The efficacy of a brief internet-based self-help intervention for the bereaved. Behaviour research and therapy, 48(5), 359-367.
  • Wagner et al. (2006, 2007): Wagner, B., Knaevelsrud, C., & Maercker, A. (2006). Internet-based cognitive-behavioral therapy for complicated grief: a randomized controlled trial. Death studies, 30(5), 429-453.
  • Wagner et al. (2022): Wagner, B., Grafiadeli, R., Schäfer, T., & Hofmann, L. (2022). Efficacy of an online-group intervention after suicide bereavement: A randomized controlled trial. Internet Interventions, 28, 100542.
  • Wittouck et al. (2014): Wittouck, C., Van Autreve, S., Portzky, G., & van Heeringen, K. (2014). A CBT-based psychoeducational intervention for suicide survivors. Crisis.


Database Flowchart

Studies in the grief-psyctr dataset were extracted from the larger “psychological interventions for prolonged grief” database. The study flow of this database can be found below.

(n=2292)Records identified through database searches (n=0)Records identified through other sources (n=1273)Records after duplicate removal (n=1273)Records screened (n=1092)Records excluded (n=181)Full-text articles assessed for eligibility (n=146)Full-text excluded (n=35)Studies included in database (n=35)Studies included in dataset
  • Companion papers: n=0
  • Depression is not an inclusion criterion: n=0
  • Dissertations: n=0
  • Effect sizes cannot be estimated: n=0
  • Maintenenance trial: n=0
  • No control condition: n=0
  • No psychotherapy for depression: n=0
  • No random assignment: n=0
  • Full-text not available: n=0
  • Other: n=0
  • Other language: n=0
  • Protocol paper: n=0


Citation

Soledad Quero , Sara Fernández-Buendia , Jorge Grimaldos , Laura de la Coba-Cañizares , Clara Miguel (2025) . Database of prolonged grief trials comparing psychological interventions with control conditions. Part of the Metapsy project (Version 25.0.4 ). URL docs.metapsy.org/databases/grief-psyctr. DOI https://doi.org/10.5281/zenodo.15538811 .

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