What Is the Treatment for Prolonged Grief Disorder?

Complicated grief treatment is a psychotherapeutic approach that has been shown to be effective in alleviating the symptoms of complicated grief. This type of therapy is similar to psychotherapy techniques used for PTSD or depression, but it is specifically designed to address symptoms associated with complicated or prolonged grief disorder. Attachment theory, cognitive-behavioral therapy, or CBT, and other methods are used to help someone better adapt to and process their loss. A 16-session intervention utilizes a combination of these varied approaches in individual or group settings. 

Complicated grief treatment takes patients through phases of healing techniques that include seven core themes:

1.      Guiding patients to accept grief

2.      Monitoring and managing emotional pain

3.      Encouraging future-oriented thinking

4.      Reconnecting with others

5.      Mastering an ability to tell the story about the death

6.      Learning to live with reminders of the deceased

7.      Making a connection to memories about the deceased

Through these theme-oriented treatments, participants learn to better recognize their grief reactions while adjusting to the loss. Patients may be asked to hold imagined conversations with their loved one to reduce stress caused by thoughts about them. In some cases, they also may be asked to imagine and recount to the therapist the details of the death and revisit those details over a period of weeks. Similar to something called imaginative exposure where patients with phobias imagine a situation when they would experience anxiety from a specific trigger, this process may be too upsetting for some clients and does not yield a favorable outcome for everyone.

Some researchers believe more studies are needed to better understand the value of individual techniques related to complicated grief treatment. Aside from ensuring their efficacy, experts believe this could also help to drive more affordable options for patients, who may only need portions of therapy related to certain aspects of their grief.

For instance, cognitive-behavioral strategies can be used alone or in conjunction with other interpersonal psychotherapies to help those who suffer from prolonged grief disorder. CBT can address underlying symptoms associated with the disorder including sleep disturbances or insomnia. A pilot study shows promise for CBT-inclusive therapies as participants reengaged in positive self-care and with social resources. Improvement was also noted for symptoms of grief, depression, anxiety, and posttraumatic stress that often accompany complicated or prolonged grief disorder.

Pharmacological intervention is only used as an adjunct treatment option for complicated grief. It is most effective in treating underlying symptoms of depression when combined with other therapies. Studies show that support groups may help to reduce intensity of periods of acute grief, but do not address the long-term scope of grief.

Robert Neimeyer, professor emeritus of psychology at the University of Memphis, director of the Portland Institute for Loss and Transition and co-editor of “Grief and Bereavement in Contemporary Society,” recently told The Washington Post, “the most important goals of complicated grief therapy are to develop a narrative of what happened, to revise and re-create one’s relationship with the loved one, and to reinvent oneself.”

The bottom line is that patients who suffer from complicated grief or prolonged grief disorder should seek out treatment. The American Psychological Association warns that without treatment, the condition can persist indefinitely, leading to problems such as substance abuse, suicidal thinking, sleep disturbances and impaired immune function.

If you believe you have symptoms of complicated grief, or prolonged grief disorder, The Center for Prolonged Grief has a list of psychotherapists who specialize in many types of therapies specifically designed to address symptoms, or you can ask your healthcare provider to recommend someone.

Sources

“Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment”. Psychiatry Online. https://psychiatryonline.org/doi/10.1176/appi.focus.20200052 

“All About Cognitive Behavioral Therapy (CBT)”. PsychCentral. https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy 

“Exposure Therapy: How Imaginal Exposure Techniques Help with Phobias”. Dr. Joseph S Weiss. https://www.theanxietydocseattle.com/exposure-therapy-imaginal-exposure-techniques-help-phobias/ 

“A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder”. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/25113524/ 

“Grief interventions for people bereaved by suicide: A systematic review”. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/28644859/ 

“Grief and Bereavement in Contemporary Society (Routledge Mental Health Classic Editions)”. https://www.amazon.com/Bereavement-Contemporary-Society-Routledge-Editions-dp-1032058919/dp/1032058919/ref=mt_other?_encoding=UTF8&me=&qid= 

“Prolonged grief disorder recognized as official diagnosis. Here’s what to know about chronic mourning.” Washington Post. https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/ 

“Find a Therapist”. The Center for Prolonged Grief. https://prolongedgrief.columbia.edu/find-a-therapist-contact-us/