Cognitive behaviour therapy may be more effective than mindfulness in treatment of prolonged grief

In a world first, Professor Richard Bryant and his team at WIMR have discovered that grief-focused cognitive behaviour therapy is relatively more effective than mindfulness-based cognitive therapy in reducing prolonged grief six months after treatment.

Prolonged grief disorder affects between 4% and 10% of bereaved people. It represents a major public health issue because it is associated with increased suicidal risk, cancer, immunological dysfunction, cardiac events, and functional impairment.

Professor Richard Bryant explained, “Although grief-focused cognitive behavior therapies are the most empirically supported treatment for prolonged grief disorder, many people find this treatment difficult.”

Evidence suggests that a pivotal component of this treatment is actively engaging with memories of the death and associated emotions.

However, up to 22% of patients report that this is excessively difficult. One key obstacle may be the difficulty in tolerating the distress associated with engaging with memories of the death.

A viable alternative for treatment is mindfulness-based cognitive therapy which does not explicitly evoke distress through loss-focused strategies. Rather, it involves learning strategies that promote awareness of emotions and sensory states in a nonjudgmental manner to manage thoughts and emotions that contribute to the psychological disorder.

The study led by Professor Bryant, and published in leading journal, JAMA Psychiatry, is the first to test the relative efficacy of grief-focused cognitive behavior therapy and mindfulness-based cognitive therapy in reducing prolonged grief disorder severity.

Professor Bryant says, “Both interventions were associated with reduced grief severity.  Grief-focused cognitive behavior therapy demonstrated greater reduction in prolonged grief symptoms six months after treatment, compared to mindfulness-based cognitive therapy.”

This discovery suggests that although both treatments may be considered for prolonged grief disorder, grief-focused cognitive behavior therapy might be the more effective choice.

Professor Bryant was recently interviewed by Dr Norman Swan on the ABC’s Health Report.  You can listen to this interview here.