An online grief intervention to improve well-being and reduce clinical symptoms: a randomized controlled trial

The COVID-19 pandemic amplified the emotional impact of losing a loved one, deteriorating well-being, and increasing dysphoric symptoms in mourners. This study evaluated the efficacy of COVID Grief, a self-applied online cognitive-behavioral intervention for Mexican adults facing grief during the pandemic. We conducted a randomized clinical trial, enrolling 1,109 participants, 45 of whom completed the full intervention, and 69 of whom completed the waiting list control (WLC). Between-subject analysis showed that intervention group (IG) participants reported significantly higher satisfaction with life and quality of life and a reduction in depression, anxiety and stress levels compared to those in the WLC. Within-subjects analysis showed that IG presented no significant changes in satisfaction with life, whereas the quality of life was increased, and levels of depression, anxiety, and stress were reduced after treatment. For WLC, satisfaction with life and quality of life were significantly decreased, and symptoms of depression and anxiety -but not stress symptoms- increased after the waitlist. Completer's opinions of the treatment were highly positive, although they only represent 5% of participants who accessed the intervention. High dropout rates should be addressed in future studies.