A new treatment for complicated grief

By the time any of us reaches a certain age, we'll have encountered losses - some small, some large. It's just part of the deal. With the wind behind us, we'll somehow manage not to be overwhelmed by the emotional fall-out; but not everyone is quite so lucky.

For some, a significant loss in later life, like a bereavement, will trigger an extreme grief reaction. It may be the first time ever in a person's life that grief has been consciously encountered. This may progress to complicated grief (CG).

The American Center for Complicated Grief describes the condition as 'a form of grief that takes hold of a person's mind and won't let go'. Sufferers may say they feel stuck; they know their loved one is gone, but still can't come to terms with it. Time moves on but they can't seem to.

A research group in the US has designed a treatment specifically to help older people process complicated grief after the loss of a significant other. Reported recently in JAMA Psychiatry, it appears to be more effective than standard talk therapy for depression. The model - still deploying talk therapy - is based on attachment theory and aims to facilitate natural mourning.

When compared with standard interpersonal psychotherapy (IPT) in which bereavement was discussed in terms of effect on mood, rational assessment of the deceased and enhancement of relationships in the present, the CG-specific talk therapy was more than twice as effective. Furthermore, participants in the CG-specific group experienced a significantly greater improvement in illness severity than the IPT group, who remained at least moderately depressed at the conclusion of treatment. Symptom reduction per week (sixteen sessions delivered weekly) was also greater in the CG-targeted group.

This is an important finding, given the incidence of complicated grief and its debilitating impact. The authors conclude:

"Our results strongly support the need for physicians and other health care providers to distinguish CG from depression. Given the growing elderly population, the high prevalence of bereavement in aging individuals, and the marked physical and psychological impact of CG, clinicians need to know how to treat CG in older adults."

What's your experience? How often do you encounter complicated grief? Are there other aspects to this discussion that need to be taken into account? As ever, we'd love to hear your views.

Written by Jacqui Hogan