An open trial of meaning-centered grief therapy: Rationale and preliminary evaluation

Abstract

Objectives: To determine the preliminary feasibility, acceptability, and effects of Meaning-Centered Grief Therapy (MCGT) for parents who lost a child to cancer. Methods: Parents who lost a child to cancer and who were between six months and six years post-loss and reporting elevated levels of prolonged grief were enrolled in open trials of MCGT, a manualized, one-on-one cognitive-behavioral-existential intervention that utilized psychoeducation, experiential exercises, and structured discussion to explore themes related to meaning, identity, purpose, and legacy. Parents completed 16 weekly sessions, 60–90 minute in length, either in person or through videoconferencing. Parents were administered measures of prolonged grief disorder symptoms, meaning in life, and other assessments of psychological adjustment pre-intervention (T1), mid-intervention (T2), post-intervention (T3), and at three months post-intervention (T4). Descriptive data from both the in-person and videoconferencing open trial were pooled. Results: Eight of 11 (72%) enrolled parents started the MCGT intervention, and 6 of 8 (75%) participants completed all 16 sessions. Participants provided positive feedback about MCGT. Results showed post-intervention longitudinal improvements in prolonged grief (d = 1.70), sense of meaning (d = 2.11), depression (d = 0.84), hopelessness (d = 1.01), continuing bonds with their child (d = 1.26), posttraumatic growth (ds = 0.29 – 1.33), positive affect (d = 0.99), and various health-related quality of life domains (ds = 0.46 – 0.71). Most treatment gains were either maintained or increased at the three-month follow-up assessment. Significance of Results: Overall, preliminary data suggest that this 16-session, manualized cognitive-behavioral-existential intervention is feasible, acceptable, and associated with transdiagnostic improvements in psychological functioning among parents who have lost a child to cancer. Future research should examine MCGT with a larger sample in a randomized controlled trial.

Regret and unfinished business in parents bereaved by cancer: A mixed methods study

“…11 As ruminative preoccupation has been found to exacerbate struggles to find meaning in the loss, which in turn prospectively predicts greater prolonged grief symptoms, 46 interventions that use imaginal work (e.g. letters, empty chair dialogues) and that focus on meaning reconstruction of events related to regrets, 69 such as Meaning-Centered Grief Therapy (MCGT), 70,71 may also have benefit. In MCGT, bereaved parents are encouraged to compassionately explore their motives for making various treatment decisions, acknowledging, and gently challenging the natural hindsight bias that commonly emerges.…”

Process of therapeutic changes in Meaning-Centered Group Psychotherapy adapted to the Portuguese language: A narrative analysis

“…Meaning-Centered Grief Therapy for parents who had lost a child was developed by Lichtenthal and Breitbart (2015); meaning reconstruction was the key to help manage prolonged grief symptoms. Studies supported its feasibility, acceptability, and effectiveness (Neimeyer, 2000; Lichtenthal, 2010; Lichtenthal et al, 2011, 2013, 2019; Lichtenthal and Breitbart, 2015).…”

Bereavement risk screening: A pathway to psychosocial oncology care

“…Family members at moderate risk could be provided referrals for counseling, support groups, and additional follow‐up. Those at high risk should be connected with providers either through the treating medical institution or in the community, specializing in grief and informed by evidence‐based grief practices 39,40 . Institutions may consider creating databases of local, trained mental health professionals who specialize in grief counseling as well as other community bereavement services.…”

“…Those at high risk should be connected with providers either through the treating medical institution or in the community, specializing in grief and informed by evidence-based grief practices. 39,40 Institutions may consider creating databases of local, trained mental health professionals who specialize in grief counseling as well as other community bereavement services. In addition, barriers to accessing bereavement services can be reduced by offering services virtually.…”