Co-production of Spring PGD: a guided digital therapy for prolonged grief disorder (PGD)

Background: Prolonged Grief Disorder (PGD) affects a significant minority of bereaved individuals, leading to persistent emotional distress and functional impairment for six months or more. While cognitive behavioural therapy (CBT) with a grief specific focus is effective, access is limited due to the resource demands of in-person therapy. Guided digital therapies offer a promising alternative, but research on their use in the UK remains limited.Objective: This study aimed to develop a guided digital therapy for PGD using a co-production approach that engaged both individuals with relevant lived experience and professionals specialising in grief-related mental health. The goal was to design a user-centred, evidence-informed intervention to improve access to PGD treatment.Method: The development process followed a multi-stage approach. First, rapid literature reviews were conducted to assess existing evidence on in-person and digital therapies for PGD. Second, qualitative interviews were held with stakeholders, including individuals with lived experience of PGD and professionals in grief and/or digital interventions. The interviews gathered opinions on intervention content, structure, and delivery. Inductive thematic analysis was used to identify key themes, which informed the intervention design.Results: Five key themes emerged: (1) acceptability of digital interventions for PGD, (2) challenges in adjusting to loss and finding meaning, (3) optimal timing for therapy, (4) the need for simplicity in intervention delivery, and (5) strategies for effective user engagement. These insights guided the development of a practical, accessible, and engaging intervention.Conclusions: The co-production process led to the development of a guided digital therapy for PGD, incorporating perspectives from both individuals with lived experience and professionals. This study highlights the importance of cultural sensitivity, user engagement, and simplicity in digital intervention design. Findings will inform the next steps in evaluating and refining the intervention to enhance access to PGD treatment in the UK and beyond.