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To determine the preliminary feasibility, acceptability, and effects of Meaning-Centered Grief Therapy (MCGT) for parents who lost a child to cancer.
Method
Parents who lost a child to cancer and who were between six months and six years after 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 used psychoeducation, experiential exercises, and structured discussion to explore themes related to meaning, identity, purpose, and legacy. Parents completed 16 weekly sessions, 60–90 minutes 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 preintervention, mid-intervention, postintervention, and at three months postintervention. Descriptive data from both the in-person and videoconferencing open trial were pooled.
Result
Eight of 11 (72%) enrolled parents started the MCGT intervention, and six of eight (75%) participants completed all 16 sessions. Participants provided positive feedback about MCGT. Results showed postintervention 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 (d = 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.
This review was undertaken to analyze the research to date and identify areas for future research regarding the associations between parental grief after the death of a child and the subsequent health of the parents, including both their mortality and morbidity risks.
Methods:
Relevant literature was identified through a search of OVID-Medline, CINAHL, and PsycINFO using variations of the terms “parental grief and bereaved parents” combined with “health,” “illness,” “morbidity,” and “mortality.” Additionally, bibliographies of selected articles were reviewed to identify additional sources. The final sample includes 17 articles.
Results:
The literature search revealed a paucity of publications on the topic. However, it also showed that the studies that have been done examining the relationship between parental grief and health outcomes have produced conflicting results in almost every disease state examined. Additionally, several concerns with the quality of existing studies came to light that may bring their results into question. Three primary areas of concern surfaced including lack of consistency in measurement for psychological variables and “soft” self-report health outcomes, questionable methodologies in bereavement research in general, and the lack of a uniform definition of bereaved parents.
Significance of results:
Based on these findings, it is clear that more methodologically sound research is necessary to clarify the relationship between parental grief after the death of a child and the parents' subsequent morbidity and mortality risks.
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