Boelen Paul A, de Keijser Jos, van den Hout Marcel A, van den Bout Jan
Department of Clinical and Health Psychology, Utrecht University, Utrecht, Netherlands.
J Consult Clin Psychol. 2007 Apr;75(2):277-84. doi: 10.1037/0022-006X.75.2.277.
Few studies have examined treatments for complicated grief--a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive-behavioral therapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of complicated grief were allocated to 1 of 3 treatment conditions: (a) a condition of 6 sessions of cognitive restructuring (CR) and 6 sessions of exposure therapy (ET; CR + ET), (b) a condition in which these interventions were applied in reversed order (ET + CR), and (c) 12 sessions of SC. Outcomes showed that the 2 cognitive-behavioral therapy conditions produced more improvement in complicated grief and general psychopathology than SC in the completers and intention-to-treat groups. Comparison of the cognitive-behavioral conditions showed that "pure" exposure was more effective than "pure" cognitive restructuring, that adding ET to CR led to more additional improvement than adding CR to ET, and that ET + CR was more efficacious than CR + ET. Effect sizes of ET + CR were encouraging and compare favorably with those found in earlier bereavement intervention studies.
很少有研究探讨过针对复杂性哀伤（一种在失去亲人后可能出现的使人衰弱的状况）的治疗方法。本研究比较了认知行为疗法与支持性咨询（SC）这种非特异性治疗方法的效果。采用最小化法，将54名具有临床显著水平复杂性哀伤的哀悼者分配到3种治疗条件中的一种：（a）6次认知重构（CR）和6次暴露疗法（ET；CR + ET）的条件；（b）这些干预措施以相反顺序应用的条件（ET + CR）；以及（c）12次SC。结果表明，在完成治疗者和意向性治疗组中，两种认知行为疗法条件在复杂性哀伤和一般精神病理学方面的改善比SC更多。认知行为疗法条件的比较表明，“单纯”暴露比“单纯”认知重构更有效，在CR基础上加用ET比在ET基础上加用CR带来更多额外改善，且ET + CR比CR + ET更有效。ET + CR的效应量令人鼓舞，与早期丧亲干预研究中的效应量相比具有优势。
