Internet Cognitive Therapy for Prolonged Grief Disorder (iCT-PG): a developmental case series.
iCT-PG showed promising results in reducing symptoms of Prolonged Grief Disorder in a small group of participants, but further research is needed to confirm these findings.
Where it sits
this study against the rest of the 5-amino-1mq corpusSummary and findings
This study evaluated Internet Cognitive Therapy for Prolonged Grief (iCT-PG) in eight adults diagnosed with Prolonged Grief Disorder (PGD) over 14 weeks. Participants completed a 12-session program, and outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up. Results indicated large reductions in PGD symptoms and comorbid conditions.
Abstract
<b>Background:</b> Prolonged Grief Disorder (PGD) affects a significant minority of bereaved individuals and is associated with persistent distress, comorbidity, and functional impairment. Access to evidence-based treatment remains limited. This study introduces and evaluates Internet Cognitive Therapy for Prolonged Grief (iCT-PG), a therapist-assisted digital intervention adapted from iCT-PTSD.<b>Objective:</b> To assess preliminary feasibility, acceptability, and clinical outcomes of iCT-PG, and to examine changes in key cognitive maintenance mechanisms of PGD (memory characteristics, negative appraisals, unhelpful coping strategies, and a sense of social disconnection).<b>Methods:</b> Eight adults assessed at interview to meet diagnostic criteria for PGD completed the 12-session iCT-PG programme remotely (e.g. browser, tablet, smartphone) over 14 weeks. The intervention targeted loss-related memory characteristics, negative grief appraisals, a sense of social disconnection, and unhelpful coping strategies, and used a personalised digital modular approach and therapist support through weekly calls and messages. Outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up using validated measures.<b>Results:</b> All participants completed treatment. Large reductions in PGD symptoms and comorbid symptoms of PTSD, depression, anxiety, and functional impairment were observed. At post-treatment, 87.5% (7/8) demonstrated both reliable improvement in PGD symptoms on the Reliable Change Index, and recovery below clinical cut-offs. There was no reliable deterioration on any measure. Process measures showed large pre-post treatment effect sizes (<i>d</i> = 1.29-1.64), with the strongest improvements in loss-related memory characteristics (<i>d</i> = 2.61). Therapeutic gains were maintained at 3-month follow-up. Average therapist time was approximately 10 h per participant.<b>Conclusions:</b> iCT-PG was feasible, well-accepted, and associated with substantial clinical improvement. The intervention successfully targeted mechanisms known to maintain PGD, supporting its theoretical foundation. Though uncontrolled and small in sample size, findings support further evaluation in larger trials to determine efficacy and scalability.
Background
Prolonged Grief Disorder (PGD) significantly impacts bereaved individuals, leading to distress and functional impairment. Existing treatments are limited, necessitating innovative approaches. This study evaluates Internet Cognitive Therapy for Prolonged Grief (iCT-PG), adapted from iCT-PTSD, to assess its feasibility and preliminary outcomes.
Methods
The study involved eight adults diagnosed with PGD who completed a 12-session iCT-PG program remotely over 14 weeks. The intervention included therapist support and targeted cognitive maintenance mechanisms of PGD. Outcomes were measured at pre-treatment, post-treatment, and 3-month follow-up using validated scales.
Results
At post-treatment, 87.5% (7/8) of participants showed reliable improvement in PGD symptoms, with effect sizes ranging from d = 1.29 to d = 1.64. The most significant improvement was in loss-related memory characteristics with an effect size of d = 2.61. All participants completed the treatment without deterioration in any measure.
Interpretation
The findings indicate substantial improvements in PGD symptoms, with effect sizes suggesting meaningful change. However, the small sample size and uncontrolled design limit the conclusions that can be drawn. These results warrant further investigation in larger, controlled trials to assess the efficacy of iCT-PG.
Key findings
- 87.5% (7/8) demonstrated reliable improvement in PGD symptoms on the Reliable Change Index at post-treatment.
- Effect sizes ranged from d = 1.29 to d = 1.64 for various symptoms.
- The strongest improvement in loss-related memory characteristics was d = 2.61.
- All participants completed treatment with no reliable deterioration on any measure.
- Average therapist time was approximately 10 hours per participant.
Limitations
- small n=8 study
- uncontrolled design
- short follow-up period
- no long-term efficacy data