Grief is best alleviated by psychotherapy
What really helps with grief
Talk therapy is the most effective way to reduce grief and depression after the death of a loved one. This is the conclusion of a new review of scientific evidence published in Annals of Internal Medicine.
The researchers note that psychotherapy has a "strong evidence base", while there is much less evidence of effectiveness for many other common support methods - self-help groups, spiritual counselling, peer support, antidepressants and self-help books.
The team, led by Suzanne Hempel of the Southern California Evidence Review Centre at the University of Southern California, emphasises: while a wide range of interventions are available to practitioners, there needs to be a better understanding of how to tailor them to the specific circumstances of bereaved people, including patients with prolonged grief disorder.
What the researchers studied
The review included data from 169 clinical trials testing different ways of helping people facing bereavement. Studies on so-called protracted g rief (previously often called 'complicated grief') - a condition in which grief remains intense, persistent and disruptive to daily life for longer than would normally be expected after a loss - were analysed separately.
Of the papers reviewed, 76 studies evaluated whether psychotherapy helps with grief.
The main finding: psychotherapy helps resilience more than other methods
According to the review, psychotherapy generally showed positive effects in reducing symptoms of grief disorder. The researchers also found evidence of benefit from:
support groups run by professionals,
increased contact from the medical team (where doctors and nursing staff are more active in accompanying the patient/family after the loss).
However, the strength of evidence for these areas was lower than for psychotherapy.
The authors of the review emphasise that evidence for other interventions - as well as for help for children and for outcomes beyond the common symptoms of grief, grief disorder and depression - is still lacking.
"Knowledge gaps": children, culture, and spiritual support
Psychologist and bereavement trauma specialist Sherry Cormier (Annapolis, Maryland), commenting on the findings, called the review a "clear map" of what works and what is not yet proven.
Among the unexpected gaps, the authors highlight:
a lack of research on how best to help grieving children,
a lack of data on how effective psychotherapy is for culturally diverse groups,
the inability to conclude on the effect of spiritual counselling, despite the fact that many people turn to religious and community organisations in times of loss.
Why therapy may be especially important
Experts remind us that grief is often experienced as isolation: a person is stuck in pain while "the rest of the world goes on." In therapy, Cormier says, the person receives empathy and validation for the experience, which reduces feelings of loneliness. In addition, loss changes attachments and one's sense of identity - and working with these "shifts" in therapy can facilitate recovery.