Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Adults with Prolonged Grief Disorder (PGD): A Study Protocol for a Randomized Feasibility Trial

Cintia Tur, Daniel Campos, Rocio Herrero, Sonia Mor, Alba López-Montoyo, Diana Castilla, Soledad Quero, Cintia Tur, Daniel Campos, Rocio Herrero, Sonia Mor, Alba López-Montoyo, Diana Castilla, Soledad Quero

Abstract

Introduction: Grief is an emotional reaction to the loss of a loved one with a natural recovery. Approximately 10% of people who lose a loved one develop prolonged grief disorder (PGD). Internet-based and computer-based interventions (ie, internet-delivered cognitive-behavioural therapy, iCBT) are a cost-effective alternative that makes it possible to reach more people with PGD. The main aim of this study is to assess the feasibility of a new iCBT-called GROw-for PGD. As a secondary objective, the potential effectiveness of GROw will be explored.

Methods and analysis: This study is a two-arm feasibility randomised trial. A total of 48 adults with PGD who meet the eligibility criteria will be randomised to the experimental group (iCBT: GROw) or the active control group (face-to-face CBT treatment). The treatment is organised sequentially in eight modules in the iCBT format and 8-10 sessions in the face-to-face format, and both formats have the same therapeutic components. There will be five assessment points with qualitative and quantitative evaluations: screening, baseline, after the intervention, 3-month follow-up and 12-month follow-up. Consistent with the objectives, the measures are related to the feasibility outcomes for the main aim of the study (participant adherence, expectations and satisfaction with the treatment, preferences, alliance and utility) and psychological and mental health outcomes for secondary analyses (symptoms of grief, symptoms of depression, symptoms of anxiety, affectivity, quality of life, work and social adaptation, post-traumatic growth, purpose in life, mindfulness and compassion).

Ethics and dissemination: The Ethics Committee of the Universitat Jaume I (Castellón, Spain) granted approval for the study (CD/002/2019). Dissemination will include publications and presentations at national and international conferences.

Trial registration number: NCT04462146.

Keywords: mental health; protocols & guidelines; therapeutics.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

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Figure 1
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References

    1. Jordan AH, Litz BT. Prolonged grief disorder: diagnostic, assessment, and treatment considerations. Prof Psychol 2014;45:180–7 10.1037/a0036836
    1. Lundorff M, Holmgren H, Zachariae R, et al. . Prevalence of prolonged grief disorder in adult bereavement: a systematic review and meta-analysis. J Affect Disord 2017;212:138–49. 10.1016/j.jad.2017.01.030
    1. World Health Organization . International statistical classification of diseases and related health problems. 11th edn, 2019.
    1. American Psychiatric Association . Diagnostic and statistical manual of mental disorders. 5th edn. Arlington, VA: American Psychiatric Publishing, 2013.
    1. Keyes KM, Pratt C, Galea S, et al. . The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. Am J Psychiatry 2014;171:864–71. 10.1176/appi.ajp.2014.13081132
    1. Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. Lancet 2007;370:1960–73. 10.1016/S0140-6736(07)61816-9
    1. Simon NM, Shear KM, Thompson EH, et al. . The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Compr Psychiatry 2007;48:395–9. 10.1016/j.comppsych.2007.05.002
    1. Lancel M, Stroebe M, Eisma MC. Sleep disturbances in bereavement: a systematic review. In: Sleep medicine reviews. 53. W.B. Saunders Ltd, 2020: 101331.
    1. Barbosa V, Sá M, Carlos Rocha J. Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood. Aging Ment Health 2014;18:354–62. 10.1080/13607863.2013.833164
    1. Boelen PA, de Keijser J, van den Hout MA, et al. . Treatment of complicated grief: a comparison between cognitive-behavioral therapy and supportive counseling. J Consult Clin Psychol 2007;75:277–84. 10.1037/0022-006X.75.2.277
    1. Bryant RA, Kenny L, Joscelyne A, et al. . Treating prolonged grief disorder: a randomized clinical trial. JAMA Psychiatry 2014;71:1332–9. 10.1001/jamapsychiatry.2014.1600
    1. Papa A, Sewell MT, Garrison-Diehn C, et al. . A randomized open trial assessing the feasibility of behavioral activation for pathological grief responding. Behav Ther 2013;44:639–50. 10.1016/j.beth.2013.04.009
    1. Rosner R, Pfoh G, Kotoucová M, et al. . Efficacy of an outpatient treatment for prolonged grief disorder: a randomized controlled clinical trial. J Affect Disord 2014;167:56–63. 10.1016/j.jad.2014.05.035
    1. Shear K, Frank E, Houck PR, et al. . Treatment of complicated grief: a randomized controlled trial. JAMA 2005;293:2601–8. 10.1001/jama.293.21.2601
    1. Shear MK, Wang Y, Skritskaya N, et al. . Treatment of complicated grief in elderly persons: a randomized clinical trial. JAMA Psychiatry 2014;71:1287–95. 10.1001/jamapsychiatry.2014.1242
    1. Shear MK, Reynolds CF, Simon NM, et al. . Optimizing treatment of complicated grief: a randomized clinical trial. JAMA Psychiatry 2016;73:685–94. 10.1001/jamapsychiatry.2016.0892
    1. O'Connor M, Nikoletti S, Kristjanson LJ, et al. . Writing therapy for the bereaved: evaluation of an intervention. J Palliat Med 2003;6:195–204. 10.1089/109662103764978443
    1. Range LM, Kovac SH, Marion MS. Does writing about the bereavement lessen grief following sudden, unintentional death? Death Stud 2000;24:115–34. 10.1080/074811800200603
    1. Kovac SH, Range LM. Writing projects: lessening undergraduates' unique suicidal bereavement. Suicide Life Threat Behav 2000;30:50–60.
    1. Constantino RE, Sekula LK, Rubinstein EN. Group intervention for widowed survivors of suicide. Suicide Life Threat Behav 2001;31:428–41. 10.1521/suli.31.4.428.22044
    1. Lieberman MA, Yalom I. Brief group psychotherapy for the spousally bereaved: a controlled study. Int J Group Psychother 1992;42:117–32. 10.1080/00207284.1992.11732583
    1. Sikkema KJ, Hansen NB, Kochman A, et al. . Outcomes from a randomized controlled trial of a group intervention for HIV positive men and women coping with AIDS-related loss and bereavement. Death Stud 2004;28:187–209. 10.1080/07481180490276544
    1. Huang F-Y, Hsu A-L, Hsu L-M, et al. . Mindfulness improves emotion regulation and executive control on bereaved individuals: an fMRI study. Front Hum Neurosci 2018;12:541. 10.3389/fnhum.2018.00541
    1. Alonso-Llácer L, Martín PB, Ramos-Campos M. Mindfulness and grief: the maded program mindfulness for the acceptance of pain and emotions in grief. Psicooncologia 2020;17:105–16.
    1. Johannsen M, Damholdt MF, Zachariae R, et al. . Psychological interventions for grief in adults: a systematic review and meta-analysis of randomized controlled trials. J Affect Disord 2019;253:69–86. 10.1016/j.jad.2019.04.065
    1. Kazdin AE. Evidence-based psychosocial treatment: advances, surprises, and needed shifts in foci. Cogn Behav Pract 2016;23:426–30. 10.1016/j.cbpra.2015.11.003
    1. Kazdin AE. Evidence-Based psychotherapies II: changes in models of treatment and treatment delivery. S Afr J Psychol 2015;45:3–21. 10.1177/0081246314538733
    1. Chisholm D, Sweeny K, Sheehan P, et al. . Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry 2016;3:415–24. 10.1016/S2215-0366(16)30024-4
    1. Aboujaoude E, Salame W, Naim L. Telemental health: a status update. World Psychiatry 2015;14:223–30. 10.1002/wps.20218
    1. Andersson G, Titov N, Dear BF, et al. . Internet‐delivered psychological treatments: from innovation to implementation. World Psychiatry 2019;18:20–8. 10.1002/wps.20610
    1. Musiat P, Tarrier N. Collateral outcomes in e-mental health: a systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health. Psychol Med 2014;44:3137–50. 10.1017/S0033291714000245
    1. Andersson G, Cuijpers P, Carlbring P, et al. . Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World Psychiatry 2014;13:288–95. 10.1002/wps.20151
    1. Andrews G, Basu A, Cuijpers P, et al. . Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: an updated meta-analysis. J Anxiety Disord 2018;55:70–8. 10.1016/j.janxdis.2018.01.001
    1. Carlbring P, Andersson G, Cuijpers P, et al. . Internet-Based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cogn Behav Ther 2018;47:1–18. 10.1080/16506073.2017.1401115
    1. Lewis C, Roberts NP, Simon N, et al. . Internet-Delivered cognitive behavioural therapy for post-traumatic stress disorder: systematic review and meta-analysis. Acta Psychiatr Scand 2019;140:508–21. 10.1111/acps.13079
    1. Sijbrandij M, Kunovski I, Cuijpers P. Effectiveness of internet-delivered cognitive behavioral therapy for posttraumatic stress disorder: a systematic review and meta-analysis. Depress Anxiety 2016;33:783–91. 10.1002/da.22533
    1. Lange A, van de Ven J-P, Schrieken B. Interapy: treatment of post-traumatic stress via the Internet. Cogn Behav Ther 2003;32:110–24. 10.1080/16506070302317
    1. Andersson G. Using the Internet to provide cognitive behaviour therapy. Behav Res Ther 2009;47:175–80. 10.1016/j.brat.2009.01.010
    1. Andersson G, Carlbring P, Hadjistavropoulos HD. Internet-Based Cognitive Behavior Therapy. In: The Science of Cognitive Behavioral Therapy [Internet]. Elsevier, 2017: 531–49.
    1. Karyotaki E, Kemmeren L, Riper H, et al. . Is self-guided Internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis. Psychol Med 2018;48:2456–66. 10.1017/S0033291718000648
    1. Eisma MC, Boelen PA, Lenferink LIM. Prolonged grief disorder following the coronavirus (COVID-19) pandemic. Psychiatry Res 2020;288:113031. 10.1016/j.psychres.2020.113031
    1. Nyatanga B. Impact of COVID-19 on loss and grief: a personal lens. Br J Community Nurs 2020;25:306–7. 10.12968/bjcn.2020.25.6.306
    1. Wallace CL, Wladkowski SP, Gibson A, et al. . Grief during the COVID-19 pandemic: considerations for palliative care providers. J Pain Symptom Manage 2020;60:e70–6. 10.1016/j.jpainsymman.2020.04.012
    1. Kang L, Ma S, Chen M, et al. . Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: a cross-sectional study. Brain Behav Immun 2020;87:11–17. 10.1016/j.bbi.2020.03.028
    1. Eisma MC, Boelen PA, van den Bout J, et al. . Internet-Based exposure and behavioral activation for complicated grief and Rumination: a randomized controlled trial. Behav Ther 2015;46:729–48. 10.1016/j.beth.2015.05.007
    1. Litz BT, Schorr Y, Delaney E, et al. . A randomized controlled trial of an Internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder. Behav Res Ther 2014;61:23–34. 10.1016/j.brat.2014.07.005
    1. Wagner B, Knaevelsrud C, Maercker A. Internet-Based cognitive-behavioral therapy for complicated grief: a randomized controlled trial. Death Stud 2006;30:429–53. 10.1080/07481180600614385
    1. Tur C, Campos D, Quero S. Internet-Based psychologycal treatments for grief: review of literature. Rev Argentina Clínica Psicológica 2019;XXVIII:884–900.
    1. van der Houwen K, Schut H, van den Bout J, et al. . The efficacy of a brief Internet-based self-help intervention for the bereaved. Behav Res Ther 2010;48:359–67. 10.1016/j.brat.2009.12.009
    1. Dominick SA, Irvine AB, Beauchamp N, et al. . An Internet tool to normalize grief. Omega 2010;60:71–87. 10.2190/OM.60.1.d
    1. Kersting A, Dölemeyer R, Steinig J, et al. . Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial. Psychother Psychosom 2013;82:372–81. 10.1159/000348713
    1. Brodbeck J, Berger T, Znoj HJ. An Internet-based self-help intervention for older adults after marital bereavement, separation or divorce: study protocol for a randomized controlled trial. Trials 2017;18. 10.1186/s13063-016-1759-5
    1. Greenwald N, Barrera M, Neville A, et al. . Feasibility of group intervention for bereaved siblings after pediatric cancer death. J Psychosoc Oncol 2017;35:220–38. 10.1080/07347332.2016.1252823
    1. Holtslander L, Duggleby W, Teucher U, et al. . Developing and pilot-testing a finding balance intervention for older adult bereaved family caregivers: a randomized feasibility trial. Eur J Oncol Nurs 2016;21:66–74. 10.1016/j.ejon.2016.01.003
    1. Patel SR, Cole A, Little V, et al. . Acceptability, feasibility and outcome of a screening programme for complicated grief in integrated primary and behavioural health care clinics. Fam Pract 2019;36:125–31. 10.1093/fampra/cmy050
    1. Scocco P, Zerbinati L, Preti A, et al. . Mindfulness-based weekend retreats for people bereaved by suicide (PANTA Rhei): a pilot feasibility study. Psychol Psychother 2019;92:39–56. 10.1111/papt.12175
    1. Schladitz K, Förster F, Löbner M, et al. . [Grief and loss in elderly people: A qualitative study regarding the user acceptance of an internet-based self-help program from user and expert perspective]. Z Evid Fortbild Qual Gesundhwes 2020;150-152:112–2. 10.1016/j.zefq.2020.01.007
    1. World Health Organization . International classification of diseases, 11th revision (ICD-11), 2019.
    1. Prigerson HG, Maciejewski PK, Reynolds CF, et al. . Inventory of complicated grief: a scale to measure maladaptive symptoms of loss. Psychiatry Res 1995;59:65–79. 10.1016/0165-1781(95)02757-2
    1. Limonero Garcia J, Lacasta Reverte M, Garcia Garcia J. Adaptación al castellano del inventario de duelo complicado. Med paliativa 2009;16:291–7.
    1. Eldridge SM, Chan CL, Campbell MJ, et al. . Consort 2010 statement: extension to randomised pilot and feasibility trials. BMJ 2016;355:i5239. 10.1136/bmj.i5239
    1. Eysenbach G, CONSORT-EHEALTH Group . CONSORT-EHEALTH: improving and standardizing evaluation reports of web-based and mobile health interventions. J Med Internet Res 2011;13:e126. 10.2196/jmir.1923
    1. Chan A-W, Tetzlaff JM, Gøtzsche PC, et al. . Spirit 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ 2013;346:e7586. 10.1136/bmj.e7586
    1. Chan A-W, Tetzlaff JM, Altman DG, et al. . Spirit 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med 2013;158:200–7. 10.7326/0003-4819-158-3-201302050-00583
    1. Andrews G, Cuijpers P, Craske MG, et al. . Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One 2010;5:e13196. 10.1371/journal.pone.0013196
    1. van Ballegooijen W, Cuijpers P, van Straten A, et al. . Adherence to Internet-based and face-to-face cognitive behavioural therapy for depression: a meta-analysis. PLoS One 2014;9:e100674. 10.1371/journal.pone.0100674
    1. Rachyla I, Mor S, Cuijpers P, et al. . A guided internet-delivered intervention for adjustment disorders: a randomized controlled trial. Clin Psychol Psychother 2021;28:1–12. 10.1002/cpp.2518
    1. Cohen J. Statistical power analysis for the behavioral sciences. 2nd edn. Hillsdale, NJ: Erlbaum, 1988.
    1. Rubio-Aparicio M, Marín-Martínez F, Sánchez-Meca J, et al. . A methodological review of meta-analyses of the effectiveness of clinical psychology treatments. Behav Res Methods 2018;50:2057–73. 10.3758/s13428-017-0973-8
    1. Faul F, Erdfelder E, Lang A-G, et al. . G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175–91. 10.3758/BF03193146
    1. Botella C, Osma J, Palacios AG, et al. . Treatment of complicated grief using virtual reality: a case report. Death Stud 2008;32:674–92. 10.1080/07481180802231319
    1. Neimeyer RA. Meaning reconstruction & the experience of loss. Washington, DC: American Psychological Association, 2000: 2000.
    1. Neimeyer RA. Meaning reconstruction & the experience of loss. Washington, DC: American Psychological Association, 2001: 359.
    1. Foa E, Rothbaum B. Treating the trauma of rape: cognitive-behavioral therapy for PTSD. Guilford Press, 1998.
    1. Linehan M. Diagnosis and treatment of mental disorders. Cognitive-behavioral treatment of borderline personality disorder. Guilford Press, 1993.
    1. Shear MK. Complicated grief treatment. Bereavement Care 2015.
    1. Stroebe M, Schut H. The dual process model of coping with bereavement: rationale and description. Death Stud 1999;23:197–224.
    1. Hoffmann R, Große J, Nagl M, et al. . Internet-based grief therapy for bereaved individuals after loss due to haematological cancer: study protocol of a randomized controlled trial. BMC Psychiatry 2018;18. 10.1186/s12888-018-1633-y
    1. Campos D, Navarro-Gil M, Herrera-Mercadal P. Feasibility of Internet Attachment-Based compassion therapy (iABCT) in the general population: study protocol (Preprint). JMIR Res Protoc 2019.
    1. Lopez-Montoyo A, Quero S, Montero-Marin J, et al. . Effectiveness of a brief psychological mindfulness-based intervention for the treatment of depression in primary care: study protocol for a randomized controlled clinical trial. BMC Psychiatry 2019;19:301. 10.1186/s12888-019-2298-x
    1. Navarro-Gil M, Lopez-del-Hoyo Y, Modrego-Alarcón M, et al. . Effects of Attachment-Based compassion therapy (ABCT) on Self-compassion and attachment style in healthy people. Mindfulness 2020;11:51–62. 10.1007/s12671-018-0896-1
    1. García-Campayo J, Navarro-Gil M, Demarzo M. Attachment-based compassion therapy. Mindfulness Compassion 2016;1:68–74. 10.1016/j.mincom.2016.10.004
    1. Javier G-C. La práctica de la compasión: Amabilidad Con Los demás Y Con uno mismo. In: ILUS books Siglantana, 2019.
    1. García Campayo J. Mindfulness : nuevo manual práctico : el camino de la atención plena, 2018.
    1. Bui E, Mauro C, Robinaugh DJ, et al. . The structured clinical interview for complicated grief: reliability, validity, and exploratory factor analysis. Depress Anxiety 2015;32:485–92. 10.1002/da.22385
    1. First MB, Spitzer RL, Gibbon M, et al. . Entrevista Clínica Estructurada para los Trastornos del Eje I del DSM-IV (SCID-I) [Internet]. Masson, ed. Barcelona, 1999.
    1. Di Nardo PA, Barlow DH, Brown TA. Anxiety disorders interview schedule for DSM-IV: lifetime version (ADIS-IV-L). Albany, New York: Graywind Publications, 1994.
    1. Borkovec TD, Nau SD. Credibility of analogue therapy rationales. J Behav Ther Exp Psychiatry 1972;3:257–60. 10.1016/0005-7916(72)90045-6
    1. Campos D, Mira A, Bretón-López J, et al. . The acceptability of an Internet-based exposure treatment for flying phobia with and without therapist guidance: patients' expectations, satisfaction, treatment preferences, and usability. Neuropsychiatr Dis Treat 2018;14:879–92. 10.2147/NDT.S153041
    1. Castilla D, Garcia-Palacios A, Miralles I, et al. . Effect of web navigation style in elderly users. Comput Human Behav 2016;55:909–20. 10.1016/j.chb.2015.10.034
    1. Horvath AO, Greenberg LS. Development and validation of the working alliance inventory. J Couns Psychol 1989;36:223–33. 10.1037/0022-0167.36.2.223
    1. Limonero J, Lacasta M, García JAG. Adaptación al castellano del inventario de duelo complicado. Med Paliativa 2009;16.
    1. Sanz J, Navarro ME, Vazquez C. Adaptación española del Inventario para La Depresión de Beck-II (BDI-II): 1. Propiedades psicométricas en estudiantes universitarios. Análisis y Modif Conduct [Internet]. 29, 2003: 239–88.
    1. Beck AT, Steer RA, Brown GK. Beck Depression Inventory-Second Edition (BDI-II) [Internet]. San Antonio, TX: Psychological Corporation, 1996.
    1. Skritskaya NA, Mauro C, Olonoff M, et al. . Measuring maladaptive Cognitions in complicated grief: introducing the typical beliefs questionnaire. Am J Geriatr Psychiatry 2017;25:541–50. 10.1016/j.jagp.2016.09.003
    1. Campbell-Sills L, Norman SB, Craske MG, et al. . Validation of a brief measure of anxiety-related severity and impairment: the overall anxiety severity and impairment scale (OASIS). J Affect Disord 2009;112:92–101. 10.1016/j.jad.2008.03.014
    1. González-Robles A, Mira A, Miguel C, et al. . A brief online transdiagnostic measure: psychometric properties of the overall anxiety severity and impairment scale (OASIS) among Spanish patients with emotional disorders. PLoS One 2018;13:e0206516. 10.1371/journal.pone.0206516
    1. Bentley KH, Gallagher MW, Carl JR, et al. . Development and validation of the overall depression severity and impairment scale. Psychol Assess 2014;26:815–30. 10.1037/a0036216
    1. Mira A, González-Robles A, Molinari G, et al. . Capturing the severity and impairment associated with depression: the overall depression severity and impairment scale (ODSIS) validation in a Spanish clinical sample. Front Psychiatry 2019;10. 10.3389/fpsyt.2019.00180
    1. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 1988;54:1063–70. 10.1037/0022-3514.54.6.1063
    1. Díaz-García A, González-Robles A, Mor S. Positive and negative affect schedule (PANAS): psychometric properties of the online version in a clinical sample with emotional disorders. BMC Psychiatry 2019:1–13.
    1. Mezzich JE, Ruipérez MA, Pérez C, et al. . The Spanish version of the quality of life index: presentation and validation. J Nerv Ment Dis 2000;188:301–5. 10.1097/00005053-200005000-00008
    1. Echezarraga A, Calvete E, Las Hayas C. Validation of the Spanish version of the work and social adjustment scale in a sample of individuals with bipolar disorder. J Psychosoc Nurs Ment Health Serv 2019;57:44–51. 10.3928/02793695-20181128-02
    1. Mundt JC, Marks IM, Shear MK, et al. . The work and social adjustment scale: a simple measure of impairment in functioning. Br J Psychiatry 2002;180:461–4. 10.1192/bjp.180.5.461
    1. Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 1996;9:455–71. 10.1002/jts.2490090305
    1. Weiss T, Berger R. Reliability and validity of a Spanish version of the posttraumatic growth inventory. Res Soc Work Pract 2006;16:191–9. 10.1177/1049731505281374
    1. García-Alandete Joaquín, Rosa Martínez E, Sellés Nohales P, et al. . Estructura factorial Y consistencia interna de Una versión española del Purpose-In-Life test. Univ Psychol 2013;12:517–30.
    1. Á A-M, Masluk B, Montero-Marin J. Validation of five facets mindfulness questionnaire – short form, in Spanish, general health care services patients sample: prediction of depression through mindfulness scale. PLoS One 2019;14:1–17.
    1. Raes F, Pommier E, Neff KD, et al. . Construction and factorial validation of a short form of the Self-Compassion scale. Clin Psychol Psychother 2011;18:250–5. 10.1002/cpp.702
    1. Garcia-Campayo J, Navarro-Gil M, Andrés E, et al. . Validation of the Spanish versions of the long (26 items) and short (12 items) forms of the Self-Compassion scale (scs). Health Qual Life Outcomes 2014;12:4–9. 10.1186/1477-7525-12-4
    1. Castle J, Phillips WL. Grief rituals: aspects that facilitate adjustment to bereavement. Journal of Loss and Trauma 2003;8:41–71. 10.1080/15325020305876
    1. Lobb EA, Kristjanson LJ, Aoun SM, et al. . Predictors of complicated grief: a systematic review of empirical studies. Death Stud 2010;34:673–98. 10.1080/07481187.2010.496686
    1. Andersson G, Titov N, Dear BF, et al. . Internet-Delivered psychological treatments: from innovation to implementation. World Psychiatry 2019;18:20–8. 10.1002/wps.20610
    1. Donker T, Blankers M, Hedman E, et al. . Economic evaluations of internet interventions for mental health: a systematic review. Psychol Med 2015;45:3357–76. 10.1017/S0033291715001427
    1. Baumeister H, Reichler L, Munzinger M, et al. . The impact of guidance on Internet-based mental health interventions — a systematic review. Internet Interv 2014;1:205–15. 10.1016/j.invent.2014.08.003
    1. Cuijpers P, Noma H, Karyotaki E, et al. . Effectiveness and acceptability of cognitive behavior therapy delivery formats in adults with depression: a network meta-analysis. JAMA Psychiatry 2019;76:700–7. 10.1001/jamapsychiatry.2019.0268

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