Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.
Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
Clin Psychol Psychother. 2017 Nov;24(6):O1512-O1523. doi: 10.1002/cpp.2113. Epub 2017 Aug 29.
This controlled, longitudinal investigation tested the effectiveness of a bereavement counselling model for adults on reducing complicated grief (CG) symptoms. Participants (N = 344; 79% female; mean age: 49.3 years) were adult residents of Scotland who were bereaved of a close relation or partner, experiencing elevated levels of CG, and/or risks of developing CG. It was hypothesized that participants who received intervention would experience a greater decline in CG levels immediately following the intervention compared to the control participants, but the difference would diminish at follow-up (due to relapse). Data were collected via postal questionnaire at 3 time points: baseline (T), post-intervention (T + 12 months), and follow-up (T + 18 months). CG, post-traumatic stress, and general psychological distress were assessed at all time points. Multilevel analyses controlling for relevant covariates were conducted to examine group differences in symptom levels over time. A stepwise, serial gatekeeping procedure was used to correct for multiple hypothesis testing. A main finding was that, contrary to expectations, counselling intervention and control group participants experienced a similar reduction in CG symptoms at postmeasure. However, intervention participants demonstrated a greater reduction in symptom levels at follow-up (M = 53.64; d = .33) compared to the control group (M = 62.00). Results suggest community-based bereavement counselling may have long-term beneficial effects. Further longitudinal treatment effect investigations with extensive study intervals are needed.
本对照性纵向研究旨在检验丧亲辅导模式对成年人减轻复杂性悲伤(CG)症状的有效性。研究对象为苏格兰的成年丧亲者(79%为女性,平均年龄 49.3 岁),他们经历了亲人或伴侣的离世,CG 症状明显或有 CG 风险。研究假设接受辅导的参与者与对照组相比,在辅导结束后 CG 水平会有更大的下降,但在随访时(因复发)会有所减少。数据通过邮寄问卷在三个时间点收集:基线(T)、干预后(T+12 个月)和随访(T+18 个月)。在所有时间点评估 CG、创伤后应激和一般心理困扰。采用多层次分析控制相关协变量,以检验随时间症状水平的组间差异。采用逐步、串行的门控程序对多重假设检验进行校正。主要发现是,与预期相反,辅导干预组和对照组在随访时 CG 症状的减轻程度相似。然而,与对照组(M=62.00)相比,干预组在随访时(M=53.64;d=.33)症状水平的降低更为显著。结果表明,基于社区的丧亲辅导可能具有长期的有益效果。需要进一步进行具有广泛研究间隔的纵向治疗效果研究。