Effects of the Integrated Grief Therapy on Psychological Resilience, Post-Traumatic Growth, Traumatic Stress, and Grief Processes in Earthquake Survivors

June 8, 2026 updated by: Burçin Çakır, Sakarya University

Effects of the Integrated Grief Therapy on Earthquake Survivors

This study evaluates the effectiveness of an Integrated Grief Therapy (IGT) group program for adults affected by the February 6, 2023 earthquake in Türkiye. Many earthquake survivors experience psychological difficulties such as traumatic stress, grief, and reduced resilience after losing loved ones, homes, and a sense of safety. This study aims to determine whether a structured group-based therapy program can help improve psychological well-being and reduce distress.

A total of 190 adult participants who experienced the earthquake were included in the study. Participants were randomly assigned to either an experimental group or a waitlist control group. The experimental group participated in an 8-session Integrated Grief Therapy program delivered face-to-face by trained mental health professionals. The program included psychoeducation about grief, emotional expression, cognitive and behavioral coping strategies, and activities designed to support meaning-making and adaptation after loss. The control group continued to receive routine psychosocial support services available in the community but did not participate in the structured therapy during the study period.

All participants completed standardized psychological assessments before and after the intervention. These assessments measured psychological resilience, post-traumatic growth, grief-related difficulties, and traumatic stress symptoms.

The study aims to determine whether participants who receive the Integrated Grief Therapy program show greater improvements in resilience and post-traumatic growth, and greater reductions in traumatic stress and grief symptoms, compared to those who do not receive the intervention during the same period.

The findings from this study may help inform the development of effective, scalable mental health interventions for individuals affected by large-scale disasters.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

190

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Mersin, Turkey (Türkiye)
        • Psychosocial Support and Grief Therapy Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18 to 45 years
  • Individuals who were present in Hatay, Türkiye during the 2023 Türkiye-Syria earthquakes
  • Individuals directly affected by the earthquake
  • Ability to provide informed consent
  • Willingness to participate in group-based psychological intervention sessions

Exclusion Criteria:

  • Current diagnosis of a psychotic disorder or severe mental disorder
  • Severe cognitive impairment or neurological condition
  • Acute suicidal risk requiring immediate intervention or hospitalization
  • Currently receiving intensive psychiatric or psychological treatment
  • Substance use disorder in an acute or severe phase
  • Inability to commit to attending the full intervention program
  • Declined or withdrew informed consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Integrated Grief Therapy (IGT)
Participants receiving 8-session group-based Integrated Grief Therapy program
Behavioral: Integrated Grief Therapy (IGT)
Integrated Grief Therapy (IGT) is a structured, 8-session group intervention developed to support individuals coping with loss after a disaster. The program integrates elements of cognitive-behavioral therapy, humanistic approaches, and grief-focused techniques. It includes psychoeducation about grief, identification and restructuring of maladaptive thoughts, emotional expression, interpersonal sharing, and meaning-making activities such as memory exercises and completion letters. The intervention aims to enhance psychological resilience, promote post-traumatic growth, and reduce traumatic stress and grief symptoms.
No Intervention: Waitlist Control / Treatment as Usual
Participants receiving routine psychosocial support only

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Psychological Resilience Score
Time Frame: 8 week
Psychological resilience will be assessed using the Psychological Resilience Scale for Adults. Total scores range from 33 to 165, with higher scores indicating greater psychological resilience.
8 week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Depression Score
Time Frame: 8 week
Depression symptoms will be assessed using the Depression subscale of the Depression Anxiety Stress Scales, a self-report instrument. The subscale consists of 7 items with total scores ranging from 0 to 42. Higher scores indicate greater depression severity.
8 week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sakarya University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 12, 2024

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

September 30, 2026

Study Registration Dates

First Submitted

April 11, 2026

First Submitted That Met QC Criteria

June 8, 2026

First Posted (Actual)

June 11, 2026

Study Record Updates

Last Update Posted (Actual)

June 11, 2026

Last Update Submitted That Met QC Criteria

June 8, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 67000

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Group Therapy Intervention Plan

Title of the intervention:

Structured Group Therapy Program for Individuals Exposed to Trauma and Loss

Purpose of the intervention:

The purpose of this group therapy program is to reduce psychological distress among individuals who have experienced traumatic events and loss, provide a safe environment for emotional sharing, strengthen coping skills, enhance perceived social support, and improve overall psychosocial functioning.

Target group:

Adults experiencing psychological distress following earthquake exposure, displacement, bereavement, uncertainty, grief, and trauma-related experiences.

A separate protocol may be developed for adolescents if needed.

Mode of delivery:

Face-to-face, closed-group format

Group structure:

Each group will consist of 8-12 participants. Each group will be facilitated by one group therapist and one co-facilitator/observer.

Facilitators:

Psychologists or mental health professionals trained in trauma, grief, crisis inter

IPD Sharing Time Frame

Understanding trauma and grief reactions

Objective:

To normalize participants' reactions and provide psychoeducation regarding trauma and grief.

Content:

Common emotional, cognitive, and physical reactions after trauma The individual and variable nature of grief Addressing the question: "Are my reactions normal?" Increasing awareness of symptoms and stress responses

Techniques:

Psychoeducation, group sharing, emotion-awareness exercises

IPD Sharing Access Criteria

Inclusion Criteria Age 18 years or older Exposure to trauma, loss, displacement, or related distressing experiences Self-reported psychological distress related to these experiences Willingness to participate in group sessions Ability to attend sessions regularly Provision of informed consent Exclusion Criteria Active psychotic symptoms Severe cognitive impairment Acute suicide risk Severe substance intoxication during participation Clinical instability that would significantly impair participation in a group setting

Participants meeting exclusion criteria will be referred to appropriate mental health services when necessary.

Safety and Ethical Considerations Written or verbal informed consent will be obtained from all participants. Confidentiality will be emphasized at the beginning of the group process. Participants may withdraw from the study/intervention at any time without penalty.

Individuals who experience significant emotional distress during sessions will be assessed individ

IPD Sharing Supporting Information Type

  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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