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Internet-Based Exposure and Behavioral Activation for Complicated Grief and Rumination: A Randomized Controlled Trial
Maarten C Eisma1, Paul A Boelen1, Jan van den Bout1
1Utrecht University.
Behavior Therapy
|November 2, 2015
Summary
Online exposure therapy effectively reduced complicated grief and rumination. Behavioral activation showed promise but had higher dropout rates, suggesting online exposure is more feasible for these conditions.
Area of Science:
- Psychology
- Mental Health
- Clinical Research
Background:
- Complicated grief and rumination are significant issues following bereavement.
- Internet-delivered interventions offer accessible treatment options.
Purpose of the Study:
- To evaluate the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination.
- To compare EX and BA against a waiting-list control group.
Main Methods:
- Forty-seven bereaved individuals with complicated grief and rumination were randomized into EX, BA, or waiting-list groups.
- Participants received 6 homework assignments over 6-8 weeks.
- Intention-to-treat and completers analyses were conducted, with follow-up at 3 months.
Main Results:
- Exposure therapy significantly reduced complicated grief, posttraumatic stress, depression, and rumination compared to the control.
- Behavioral activation reduced complicated grief, posttraumatic stress, and rumination, but had a high dropout rate (59%).
- Effects of EX were maintained at 3-month follow-up; BA effects were partially maintained.
Conclusions:
- Internet-delivered exposure therapy is a potentially applicable online intervention for decreasing complicated grief and rumination.
- Behavioral activation appears less feasible due to high dropout rates.
- Further research may explore optimizing BA for this population or utilizing EX as a primary online treatment.
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