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Cognitive behavioral therapy may improve outcomes in children and adolescents with prolonged grief disorder | 2 Minute Medicine

1. In this randomized control study, individualized cognitive behavioral therapy (CBT) was superior to supportive therapy in reducing symptoms in both 6 and 12 month follow-up in persistent grief disorder.

2. Participants in the CBT grief aid group also showed fewer symptoms of depression, post-traumatic stress disorder (PTSD), and fewer internalizing problems compared to the supportive therapy group.

Evidence rating level: 2 (good)

Persistent grief disorder occurs after loss and is typically treated with CBT in adults. Treatment practices for children and adolescents usually include supportive counseling; The current literature does not address the effectiveness of CBT for persistent grief disorder in this population.

This randomized control study compared an individualized CBT program, CBT Trauerhilfe, with supportive therapy in children and adolescents with persistent grief disorder. The primary endpoint was childhood prolonged grief (IPG-C) inventory score at follow-up at 3, 6, and 12 months. Secondary endpoints included Children’s Depression Inventory (CDI), Child PTSD Symptom Scale (CPSS), and Child Behavior Checklist (CBCL) scores. The enrolled participants were between 8 and 18 years old, had lost a close relative, and suffered from distressing / debilitating symptoms of persistent grief disorder. Participants with a history of simultaneous psychological or psychopharmacological treatment and those with a previous diagnosis of intellectual disability, developmental disorders or severe behavioral disorders were excluded.

134 participants were randomly assigned to either the supportive counseling group (n = 60) or the CBT group (n = 74). The participants in the CBT and supportive groups showed an improvement in IPG-C values ​​of 78.6% and 60%, respectively, at the follow-up examination after 12 months compared to the measurements before treatment. In addition, there was a greater reduction in CDI, CPSS, and CBCL scores in the CBT group. However, this study had several limitations. For example, multiple therapists were used to deliver the therapies and no independent assessments of treatment integrity were made. In addition, the home environment and the level of care provided by the caregivers to the participants were not taken into account. The results of this study suggest that CBT may be superior to supportive therapy in treating persistent grief disorder in children and adolescents.

Click here to read the study in the American Journal of Psychiatry

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