Group Vs Individual Grief-Focused Cognitive Behavioral Therapy for Older Adults: A Randomized Clinical Trial

Area of Science:

• Psychiatry
• Clinical Psychology
• Gerontology

Background:

• Prolonged grief disorder (PGD) significantly impacts older adults.
• Grief-focused cognitive behavioral therapies (GF-CBTs) are effective for PGD.
• The comparative efficacy of group versus individual GF-CBT delivery formats remains unclear.

Purpose of the Study:

• To determine if group GF-CBT is non-inferior to individual GF-CBT in alleviating PGD symptoms in older adults.
• To compare the effectiveness of two GF-CBT delivery formats on secondary outcomes like PTSD, depression, and anxiety.

Main Methods:

• A non-inferiority randomized clinical trial involving 113 older adults (≥65 years) with PGD.
• Participants were randomized to 12 weekly sessions of either group GF-CBT (2 hours) or individual GF-CBT (1 hour).
• Outcomes, including PGD, PTSD, depression, and anxiety symptoms, were assessed at multiple time points up to 6 months post-treatment.

Main Results:

• Both group and individual GF-CBT significantly reduced PGD symptoms over time (large effect sizes).
• Group GF-CBT demonstrated non-inferiority to individual GF-CBT in reducing PGD symptoms at 6-month follow-up.
• Non-inferiority was also observed for secondary outcomes, including PTSD, depression, and anxiety symptoms, with comparable dropout rates.

Conclusions:

• Group GF-CBT is a viable and effective alternative to individual GF-CBT for treating PGD in older adults.
• Both formats show significant and lasting benefits for PGD and associated symptoms post-bereavement.
• These findings support the use of group GF-CBT in clinical practice for older adults experiencing grief and related disorders.