Psychological Interventions for Individuals Bereaved by Homicide: A Systematic Review

Abstract

Research has demonstrated that approximately 45–50% of individuals show healthy levels of psychological and physical functioning in the first 12 months post-loss. Homicidal bereavement (loss due to murder or manslaughter) does not appear to follow this pattern. Homicide-related mental health difficulties are a serious problem worldwide, displaying high rates of lifetime incidence, high chronicity, and role impairment. Individuals are at increased risk to develop symptoms of post-traumatic stress disorder (PTSD), complicated grief (CG), and depression. Nevertheless, a systematic review specifically on the efficacy of psychological interventions following homicidal loss has not yet been conducted. The current systematic review (registered via PROSPERO) aimed to review the psychological interventions available and report their effectiveness. Of 77 records, 7 met predefined inclusion criteria. Studies presented different methodologies, tested different clinical models, and treatment conditions. Thus, a narrative systematic review was conducted. Studies included manualized interventions to deliver 1:1 and group sessions. Cognitive behavioral therapy, restorative retelling, and eye movement desensitization and reprocessing were the main models used together with psychoeducational elements about trauma and grief responses. Overall, symptoms of PTSD, CG, and depression decreased significantly postintervention. Sustained improvements were reported for PTSD and depressive symptoms at the follow-up measurements. Mixed results were found regarding how individual (age, gender) and external factors (time since loss, relationship with the deceased) impact on symptom progression. As a result of differences in methodologies, categorization of therapies, methodological differences, and small sample sizes, important questions remain unanswered. Further randomized controlled trials and expert consensus could be considered.

The UK National Homicide Therapeutic Service: A Retrospective Naturalistic Study Among 929 Bereaved Individuals

“…We tentatively expected that higher symptom severity at the start of treatment would be associated with larger symptom reduction during treatment. We did not expect to find any effects for gender, age and recentness of the loss on symptom change during treatment (26). Because of the exposure-oriented nature of the therapy, we expected clients who were direct witnesses to the homicide to show a larger reduction in PTS, PG, and anxiety symptoms than those who were not.…”

“…Although the TG-CBT is tailored to the client’s needs, it follows a systematic approach and includes the same therapeutic ingredients for all patients. These include an initial 15 sessions that can be extended depending on individual circumstances, the duration of legal and court proceedings and higher complexity of the case; implementation of evidence-based trauma-focused CBT [National Collaborating Centre for Mental Health (NICE) ( 26 )] and grief-focused CBT ( 26 – 28 ); provision of an outreach model of care with the sessions taking place at the office of ASSIST or at the homes of the clients; individual sessions with possibilities of involvement of supporting others; deployment of qualified and experienced therapists receiving regular training and supervision (from the Oxford Cognitive Therapy Centre); and close collaboration with caseworkers of Victim Support to provide practical and judicial support throughout the process.…”

A Comprehensive Analysis of Factors Associated with Intimate Partner Femicide: A Systematic Review

“…In addition, it includes a four-phase flow diagram that synthesizes the identification, screening, eligibility, and inclusion to exhibit the systematic review process [ 46 ]. Even though the guide was initially used in the health framework [ 45 ], it has been adapted and applied to other areas of research such as violence [ 47 , 48 , 49 ]. A meta-analysis has not been performed because the statistical outcomes in the publications included in the current study are not sufficiently homogeneous for comparison.…”

An Ecological Review of Homicide Bereavement’s Risk Factors: Implications for Future Research

“…Previous reviews dealt with various aspects of HB, such as coping strategies (Edwards et al, 2021), prevalence of pathogenic symptoms (Djelantik et al, 2020), effects of homicide on victims’ families (Connolly & Gordon, 2015; da Costa et al, 2017), children’s HB (Alisic et al, 2015; Menezes & Borsa, 2020), interventions for HB treatment (Alves-Costa, Hamilton-Giachristis, Christie, et al, 2021; Pastrana et al, 2022), and the influence of informal support on HB (Scott et al, 2020). Given the noted gravity of HB and the fact that its risk factors have yet been systematically reviewed, this paper aimed to contribute to current knowledge on HB risk factors, that is, antecedents that might have a causal role in the increase in homicide survivors’ risk for developing severe posttraumatic sequelae.…”