None listed
Conditions
Brief summary
Recent research has demonstrated that 16% of the bereaved population experience a complicated form of grief called Prolonged Grief Disorder (PGD), that causes extreme disruption to daily functioning (Prigerson, Vanderwerker, & Maciejewski, 2008). Based on these findings, it is estimated that out of the 140,000 deaths registered in Australia per year (Australian Bureau of Statistics, 2012) each conservatively affecting approximately 5 people, around 112,000 people could develop prolonged grief disorder. Despite the prevalence of this disorder, studies of psychotherapy for individuals suffering from the effects of prolonged grief are scarce. The purpose of this research project is to test the efficacy of Metacognitive Therapy on traumatic grief-related effects for individuals with PGD. Male and female participants (N=50; aged 18 or over) will be randomly assigned to either a waiting list or an intervention condition (Metacognitive Therapy), which promotes new ways of relating to their thoughts and beliefs about the loss. Measures of prolonged grief, anxiety, depression, rumination, metacognition and quality of life will be taken pre and post treatment and at the 3-month follow-up for both groups and at the 6-month follow-up for the intervention group. Multi-level mixed effects linear regression will be used to assess treatment efficacy. It is hypothesised that compared to participants in the wait-list condition, the intervention group will have lower levels of PGD symptoms and better quality of life at completion of the study. A greater awareness of the treatments that support the return to pre-loss levels of functioning for bereaved individuals is required.
Interventions
The Metacognitive Group Therapy program targets maladaptive coping strategies by eliminating worry/rumination, maladaptive attention strategies, and enhancing metacognitive flexibility, which in turn allows natural processing and normal cognitions to occur. The manual comprises three components: engagement in therapy, metacognitive therapy, and maintenance (Rees & van Koesveld, 2009). Each of the 10 modules of the manual will be reviewed and modified by Associate Professor Clare Rees, Dr Moi
The Metacognitive Group Therapy program targets maladaptive coping strategies by eliminating worry/rumination, maladaptive attention strategies, and enhancing metacognitive flexibility, which in turn allows natural processing and normal cognitions to occur. The manual comprises three components: engagement in therapy, metacognitive therapy, and maintenance (Rees & van Koesveld, 2009). Each of the 10 modules of the manual will be reviewed and modified by Associate Professor Clare Rees, Dr Moira O’Connor, Dr Lauren Breen, and I to produce a MCT program for PGD. Chambless and Ollendick (2001) argue treatment manulisation is important in evaluating the effects of a specific treatment, as it allows treatment fidelity assessment and an operational definition of the treatment. The MCT group intervention will be delivered to the intervention group (groups of no less than 10 participants) face-to-face once a week for 2 hours over 6 weeks. Each group session will contain a module overview, the key message, and materials needed. Participants will be asked to complete homework activities between sessions. Participant attendance will be recorded, to certify treatment is received in its entirety, ensuring internal validity. Each group session will be run at the School of Psychology and Speech Pathology (Curtin University), or a more geographically appropriate community centre if required. Refreshments will be provided. The chief investigator and psychology graduate trainee will run the intervention. A program implementation effectiveness checklist will be completed by the chief investigator and graduate psychology student at completion of each session, to control for protocol adherence. Clinical supervision will be provided by Associate Professor Clare Rees with a minimum of 10% of session videotapes checked for adherence to the MCT protocol.
Sponsors
Dr Moira O'Connor
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participant inclusion criteria will be: 1) provision of written informed consent; 2) intense symptoms of grief or PGD (as determined by PG-13) 6 months post the loss of a significant other; 3) if taking medication (namely, antidepressants or other mood stabilisers), the medication must be stable for one month prior to baseline assessment. Participants need to remain on the same dosage and medication throughout the treatment period including follow-up.
Exclusion criteria
Participant exclusion criteria will be: 1) a high suicidal risk as measured by the suicidality section of the MINI (Sheehan et al., 1997); 2) participants currently undergoing other psychological treatment; and 3) a pre-existing psychiatric (excluding: anxiety & depression) or neurological history, according to the DSMIV-TR diagnostic criteria, as measured by the SCID. Participants that do not meet the inclusion criteria/or meet the exclusion criteria will be excluded from the study and will be provided referral information (such as Lifeline or Crisis Care), or for those identified with high suicidality we will consult with their psychiatrist or local general practitioner.
Outcome results
None listed